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 Alabama for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Alabama 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. Alabama (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.

Northeast Orthopedic Clinic PC (NPI 1699785790)

Northeast Orthopedic Clinic PC is a orthopaedic surgery physician provider located in Gadsden, Alabama. This profile covers 0 Medicare and 24 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	Northeast Orthopedic Clinic PC
Address	507 S 4th St
City	Gadsden
State	AL
ZIP	35901
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	August 9, 2006

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

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

24 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	19,970	$30	$499.3K
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…	17,510	$30	$490.3K
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…	3,770	$50	$177K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	2,540	$10	$17.8K
L4361	Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf	120	$140	$16.3K
L3984	Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment	110	$120	$13.3K
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…	240	$50	$12.9K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	640	$20	$12.8K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	770	$20	$12.4K
97016	In this procedure, the provider applies the vasopneumatic device to an extremity for the purpose of reducing edema, or swelling.	1,790	$10	$10.7K

Showing 1–10 of 24

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alabama Distribution

Northeast Orthopedic Clinic PC — 3 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

24 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	1,297	1,990	680	$60	$201.7K
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…	131	1,990	560	$40	$185.6K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	179	320	1,170	$40	$182.3K
L4361	Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf	10	10	330	$140	$111.5K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	10	320	670	$20	$69.3K
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…	309	630	60	$80	$45.8K
L3984	Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment	3	10	110	$170	$32.5K
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…	13	660	80	$50	$26.8K
L1902	Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf	10	10	160	$40	$15.8K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	8	20	80	$60	$13.7K

Showing 1–10 of 24

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Christopher Kelley	AL	Adult Reconstructive Orthopaedic Surgery Physician	$114.9K	$0
Daniel Ryan	AL	Sports Medicine (Orthopaedic Surgery) Physician	$107.8K	$0
Marcus Thomson	AL	Physical Therapist	$69.1K	$0
Kaitlyn Revette	AL	Physical Therapist	$60.3K	$0
Courtney Washington	AL	Physical Therapist	$52.9K	$0
Erin Sparks	AL	Physical Therapist	$37.8K	$0
Michael Morris	AL	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$28K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Quality Of Life Health Services, Inc	AL	Community Health Clinic/Center	$0	$16.8M
Gadsden Pediatric Clinic, P.A.	AL	Pediatrics Physician	$0	$11.5M
Pediatric Dentistry East P.C.	AL	Pediatric Dentistry	$0	$5.4M
Northeast Alabama Pediatrics, P.C.	AL	Pediatrics Physician	$0	$5.3M
Prime Healthcare Services - Gadsden LLC	AL	General Acute Care Hospital	$0	$3.9M
Etowah County Health Dept Fp Clinic	AL	Public Health or Welfare Agency	$0	$2.9M
Pediatric Dental Associates	AL	Pediatric Dentistry	$0	$2.4M
Carr Mental Wellness, LLC	AL	Psychiatry Physician	$0	$2.2M
Alabama Emergency Physician Partners, LLC	AL	Emergency Medicine Physician	$0	$1.9M
George C. Stacey, Jr. D.m.d. Family Denistry P.C.	AL	Dentist	$0	$1.6M

Northeast Orthopedic Clinic PC — Billing Profile & Reimbursement Data

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Northeast Orthopedic Clinic PC — 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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