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.

Palmetto Health Council Inc (NPI 1740372473)

Field	Value
Entity Type	Organization
Organization	Palmetto Health Council Inc
Address	643 Main St
City	Palmetto
State	GA
ZIP	30268
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	September 29, 2006

Payer Source	Total Paid
Medicaid	$2.6M
Medicare	$0

Medicaid: Complete Services Breakdown

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
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…	17,580	$90	$1.6M
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,…	4,610	$100	$451.8K
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…	2,520	$90	$226.4K
D0999	N/A	1,070	$130	$137.5K
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…	470	$110	$49.8K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	370	$120	$43.4K
D1120	Prophylaxis–child	140	$80	$11.5K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	190	$50	$10K
D0140	Limited oral evaluation – problem focused	110	$60	$6.2K
D0150	Comprehensive oral evaluation – new or established patient	150	$30	$4K

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

Palmetto Health Council Inc — 0 of 17 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
D0999	N/A	5	10	2,280	$80	$470.3K
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…	61	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…	189	820	390	$70	$245K
0241U	N/A	17	20	140	$80	$176.7K
D1120	Prophylaxis–child	109	140	620	$30	$173.7K
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,…	50	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…	295	310	90	$90	$136.3K
D0120	Periodic oral evaluation - established patient	118	150	640	$20	$117.8K
D0274	N/A	87	110	340	$30	$96.8K
D0150	Comprehensive oral evaluation – new or established patient	71	130	210	$30	$75.4K

Showing 1–10 of 23

Nearby Providers

Other providers in the same ZIP code as Palmetto Health Council Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lawanda Miles	GA	Professional Counselor	$0	$276K

Palmetto Health Council Inc — Billing Profile & Reimbursement Data

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Palmetto Health Council Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References