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.

Milton Hall Surgical Associates, LLC (NPI 1649238460)

Milton Hall Surgical Associates, LLC is a specialist provider located in Alpharetta, Georgia. This profile covers 0 Medicare and 23 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	Milton Hall Surgical Associates, LLC
Address	2365 Old Milton Pkwy
City	Alpharetta
State	GA
ZIP	30009
Taxonomy	Specialist
NPI Enumerated	May 2, 2006

Payer Source	Total Paid
Medicaid	$3.8M
Medicare	$0

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

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	5,340	$210	$1.1M
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…	16,510	$40	$610.8K
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…	6,930	$60	$415.6K
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…	7,620	$50	$411.5K
31231	In this procedure, the provider inserts an endoscope into the nasal cavity to examine the structures of the nasal cavity on one or both sides.	6,430	$60	$398.4K
99204	The provider sees a new 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 provider…	3,000	$90	$270.3K
95117	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives 2 or more injections at a single visit.	12,260	$20	$183.9K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	640	$160	$104.8K
92567	In this procedure, the provider measures the functioning of the middle ear by varying the pressure of air presented to the ear to identify the reason for hearing loss.	3,820	$10	$53.5K
69210	The provider uses an instrument such as a curette, vacuum evacuation, or forceps to remove entrapped wax from a patient's external auditory canal.	1,890	$30	$50.9K

Showing 1–10 of 23

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

Milton Hall Surgical Associates, LLC — 5 of 23 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

23 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	8	20	190	$1,120	$833.4K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	9	20	260	$560	$608.1K
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…	65	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…	86	820	390	$70	$245K
70486	The provider uses computed tomography, or CT, to examine the maxillofacial area, such as the upper jaw or face structures. The provider does not administer contrast for this exam.	9	10	400	$350	$174.7K
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,…	292	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…	9	310	90	$90	$136.3K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	1	20	110	$200	$105.6K
99204	The provider sees a new 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 provider…	10	230	100	$110	$97.1K
92579	The provider performs a battery of tests to evaluate hearing loss in infants and toddlers. He uses sound sources to evaluate the auditory response, with reinforcement by animated toys.	6	10	150	$70	$89.3K

Showing 1–10 of 23

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
James Burson	GA	Otolaryngology Physician	$179.1K	$0
James French	GA	Otolaryngology Physician	$111.1K	$0
Stephanie Martin	GA	Nurse Practitioner	$106.7K	$0
Ronald Alvarez	GA	Specialist	$90.5K	$0
Charles Bass	GA	Physician Assistant	$80K	$0
Daniel Carothers	GA	Otolaryngology Physician	$60.7K	$0
Matthew Karen	GA	Otolaryngology Physician	$58.1K	$0
George Livermore	GA	Otolaryngology Physician	$47K	$0
Amanda Calchary	GA	Audiologist	$18.3K	$0
Gulsum Topbas	GA	Speech-Language Pathologist	$12.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Public Partnerships LLC	GA	Supports Brokerage Agency	$0	$522.8M
Public Partnerships LLC	GA	Supports Brokerage Agency	$0	$7.2M
Robert S. Smith Md, Inc	GA	Anatomic Pathology & Clinical Pathology Physician	$0	$3.5M
Public Partnerships LLC	GA	In Home Supportive Care Agency	$0	$3.1M
Jeremy Alexander	GA	General Practice Dentistry	$0	$1.7M
Laura Michael	GA	Anatomic Pathology Physician	$1.3M	$71.5K
Chattahoochee Physicians Laboratory Services, LLC	GA	Clinical Medical Laboratory	$388.1K	$810.5K
A Smile 4 U	GA	General Practice Dentistry	$0	$1.1M
Kishore Rasamallu	GA	Internal Medicine Physician	$1M	$0
Tara Chang	GA	Anatomic Pathology & Clinical Pathology Physician	$325.1K	$28.9K

Milton Hall Surgical Associates, LLC — Billing Profile & Reimbursement Data

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Milton Hall Surgical Associates, LLC — 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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