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.

Locust Grove Family Medicine (NPI 1629169164)

Locust Grove Family Medicine is a non-pharmacy dispensing site provider located in Locust Grove, Georgia. This profile covers 0 Medicare and 16 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Locust Grove Family Medicine
Address	3778 Highway 42
City	Locust Grove
State	GA
ZIP	30248
Taxonomy	Non-Pharmacy Dispensing Site
NPI Enumerated	September 28, 2006

Payer Source	Total Paid
Medicaid	$628.2K
Medicare	$0

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	4,410	$70	$308.6K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	4,470	$50	$232.5K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	980	$40	$36.3K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	310	$100	$29.7K
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	640	$20	$11.5K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	40	$60	$2.3K
99385	The provider performs a well–patient visit for a patient who is between the ages of 18 and 39.	10	$130	$1.7K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	160	$10	$1.6K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	20	$70	$1.6K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	10	$110	$1.4K

Showing 1–10 of 16

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

Locust Grove Family Medicine — 0 of 11 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

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	174	920	370	$60	$360.6K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	129	820	390	$70	$245K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	114	360	370	$50	$153.6K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	278	310	90	$90	$136.3K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	88	130	480	$20	$59.9K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	94	120	100	$80	$34.4K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	8	50	70	$90	$19.8K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	4	10	30	$90	$19.1K
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	9	30	220	$1	$16.4K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	70	160	270	$1	$10.6K

Showing 1–10 of 16

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Locust Grove Pediatrics	GA	Pediatrics Physician	$0	$2M
Takle Eye Surgery Center LLC	GA	Ambulatory Surgical Clinic/Center	$522.7K	$0
Nacolby's House, Incorporated	GA	Child Physical Disabilities Respite Care	$0	$318.8K
Jameson Estes	GA	Family Medicine Physician	$148.7K	$0
Regan Frake	GA	Family Medicine Physician	$142.6K	$0
Vivekanand Manocha	GA	Interventional Pain Medicine Physician	$113.4K	$0
Cody Hartley	GA	Physical Therapist	$41.1K	$0
James Rose	GA	Physician Assistant	$40.1K	$0

Locust Grove Family Medicine — Billing Profile & Reimbursement Data

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Locust Grove Family Medicine — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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Frequently Asked Questions

References