Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Georgia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Georgia only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Georgia (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Pacific Health Systems LLC (NPI 1568915809)

Field	Value
Entity Type	Organization
Organization	Pacific Health Systems LLC
Address	110 Eagle Spring Dr
City	Stockbridge
State	GA
ZIP	30281
Taxonomy	Home Health Agency
NPI Enumerated	August 3, 2016

Payer Source	Total Paid
Medicaid	$9.9M
Medicare	$0

Key Findings

PACIFIC HEALTH SYSTEMS LLC is effectively a Medicaid-focused home health agency: it has no Medicare billing on file and $9.9M in lifetime Medicaid revenue, indicating its operating scale and payor exposure are concentrated entirely in the Medicaid program rather than Medicare. This payer concentration means analyses and contracting discussions should treat Medicaid as the primary commercial channel for this provider.

Revenue concentration is extremely high within a narrow set of service codes: the precomputed top three Medicaid codes account for 99.9% of this provider’s total Medicaid revenue, signaling that a small number of service lines drive almost all reported dollars and operational emphasis. That concentration suggests the provider’s business model and staffing are likely organized around those core Medicaid service modalities.

T1019 (Personal care services, per 15 minutes) is the dominant revenue driver, accounting for $6.3M or 63.6% of this provider’s Medicaid revenue and representing 41.9K claims at an average paid amount of $150 per claim. In-state competitive data (rank #7 of 34; 82th percentile) show the provider delivers a high but not market-leading volume of this service relative to peers — it is a meaningful regional participant for personal care services but not the single largest provider.

T2025 (Waiver services; NOS) is the second-largest contributor with $2.6M in revenue (26.7% of Medicaid revenue) across 13K claims at $203 average paid per claim. The provider ranks #17 of 30 in-state (45th percentile) on this code, indicating typical, unremarkable utilization of waiver services compared with other state providers and suggesting room to grow relative to higher-volume waiver providers.

T1021 (Home health aide or certified nurse assistant, per visit) contributes $949.9K (9.6% of Medicaid revenue) from 2.3K claims at a reported $415 average paid per claim, and the provider ranks #10 of 18 in-state (47th percentile). This mix—large volumes of personal care (T1019) combined with nontrivial aide visit billing (T1021)—aligns with operations that deliver direct personal support and in-home assistance rather than medically intensive skilled nursing.

Operational implications: the dominance of personal care (T1019) and waiver-related codes (T2025) implies staffing, scheduling, and training priorities centered on personal care aides and waiver program compliance. Given the low contribution from specialized supply codes such as T2028 ($10.2K, 0.1% of revenue), ancillary supply-based revenues are negligible and unlikely to be a meaningful profit center.

Competitive standing across codes is mixed: the provider is a strong regional participant for T1019 (top third of in-state providers by volume) but is mid- to lower-tier for the other top codes (T2025 at 45th percentile and T1021 at 47th percentile). This pattern suggests the provider has carved out a solid niche in personal care services while remaining a modest competitor in broader waiver and aide-visit markets.

Tenure: the provider’s NPI was enumerated on 2016-08-03 (~10 years ago), indicating approximately a decade of active enrollment in federal provider directories. This length of enrollment supports established operational processes and a track record in the Medicaid market that analysts can correlate with the revenue patterns above.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	41,910	$150	$6.3M
T2025	Waiver services; not otherwise specified (nos)	12,980	$200	$2.6M
T1021	Home health aide or certified nurse assistant, per visit	2,290	$420	$949.9K
T2028	Specialized supply, not otherwise specified, waiver	40	$250	$10.2K

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Georgia providers billing the same CPT/HCPCS codes.

Claims Volume vs. Georgia Distribution

Pacific Health Systems LLC — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. Georgia median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2025	Waiver services; not otherwise specified (nos)	17	30	15,890	$130	$7.5M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	7	30	17,680	$90	$6.9M
T1021	Home health aide or certified nurse assistant, per visit	10	20	2,310	$80	$4.3M
T2028	Specialized supply, not otherwise specified, waiver	15	20	2,190	$210	$854K

Nearby Providers

Other providers in the same ZIP code as Pacific Health Systems LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Apex Family Healthcare Services, LLC	GA	Community/Behavioral Health Agency	$0	$19M
Southern Crescent Pediatrics PC	GA	Pediatrics Physician	$0	$9.6M
Healthsource Agency Inc	GA	Home Health Agency	$0	$5.8M
Piedmont Hospitalist Physicians LLC	GA	Family Medicine Physician	$0	$3.6M
National Premier Laboratories Inc	GA	Clinical Medical Laboratory	$0	$3.4M
Covenant Care Pediatrics PC	GA	Pediatrics Physician	$0	$3M
Stockbridge Pediatrics	GA	Pediatrics Physician	$0	$2.6M
Surgical Center For Urology LLC	GA	Ambulatory Surgical Clinic/Center	$805.2K	$0
Regenerative Orthopaedics Surgery Center, LLC	GA	Ambulatory Surgical Clinic/Center	$622K	$0
Tambrea Ellison	GA	Physical Medicine & Rehabilitation Physician	$509.4K	$0

Pacific Health Systems LLC — Billing Profile & Reimbursement Data

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Pacific Health Systems LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References