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.

Hospital Physician Services - Southeast Professional Corporation (NPI 1760410385)

Key Findings

Field	Value
Entity Type	Organization
Organization	Hospital Physician Services - Southeast Professional Corporation
Address	2151 W Spring St
City	Monroe
State	GA
ZIP	30655
Taxonomy	Hospitalist Physician
NPI Enumerated	June 30, 2006

Payer Source	Total Paid
Medicaid	$8.4M
Medicare	$0

This entity appears to operate as a hospitalist-focused inpatient service based on its code mix: the top revenue-driving Medicaid codes are 99233, 99232 and 99223, all hospital inpatient/observation E/M codes covering subsequent and initial inpatient encounters, plus significant billing for discharge management (99239) and critical care (99291). The dominance of these E/M codes indicates the organization’s primary activity is inpatient evaluation-and-management rather than outpatient procedural or office-based work.

Medicaid revenue is concentrated: the top three Medicaid codes (99233, 99232, 99223) account for 89.3% of the provider’s total Medicaid revenue; individually those codes generate $3.4M (40.1%), $2.1M (25.1%), and $2M (24.1%) of Medicaid revenue respectively. These figures show the provider’s Medicaid earnings are highly dependent on a narrow set of inpatient E/M services.

This provider has no Medicare billing on file while reporting $8.4M in Medicaid revenue, making its observable payer mix effectively single-payer Medicaid in the available data. The absence of Medicare billing changes how one should assess market exposure and regulatory/reimbursement risk, since all reported federal fee-for-service activity is concentrated in Medicaid.

Competitive standing in-state is dominant for the lead codes: 99233 ranks #1 of 160 providers in-state (100th percentile; extreme outlier), 99232 ranks #2 of 191 (99th percentile; extreme outlier), and 99223 ranks #1 of 110 (100th percentile; extreme outlier). Additional codes—99239 and 99291—also rank #1 in-state (100th percentile; extreme outlier) and contribute measurable revenue ($428.7K and $392.9K respectively), reinforcing the provider’s outlier position in high-volume inpatient services.

Volumes per code are unusually large for an in-state provider: for example 96.1K claims for 99233 and 75.3K claims for 99232 are far above typical state volumes for these codes, which aligns with the provided labels of “extreme outlier.” These claim counts, together with average paid/claim levels of $35 for 99233 and $28 for 99232, suggest the operation is high-throughput with mid-to-low unit reimbursement, relying on large encounter counts to generate revenue.

The mix of high-volume subsequent inpatient visits (99233 and 99232) plus substantial billing for initial high-complexity admissions (99223) and critical care (99291) implies coverage across the inpatient continuum—admissions, ongoing hospital management, ICU-level care, and discharge management. That pattern is consistent with an embedded hospitalist group providing continuous inpatient coverage rather than episodic consultative services.

The provider has a long-tenured NPI (enumerated 2006-06-30 (~20 years ago)), indicating an established presence in the market; combined with the outlier statewide rankings, this tenure supports a hypothesis of sustained high-volume inpatient operations rather than a recent throughput spike. Analysts should treat the organization as an established, Medicaid-focused inpatient service line when evaluating network capacity and competitive positioning.

Medicaid: Complete Services Breakdown

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	96,120	$40	$3.4M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	75,310	$30	$2.1M
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	28,530	$70	$2M
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	12,610	$30	$428.7K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	5,860	$70	$392.9K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	1,630	$30	$43.9K
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	670	$20	$14.7K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	270	$20	$6.4K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	80	$60	$4.9K
99220	N/A	30	$100	$2.6K

Showing 1–10 of 17

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

Hospital Physician Services - Southeast Professional Corporation — 5 of 13 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

17 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	1	50	180	$220	$177.6K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	1	160	230	$30	$141.4K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	2	190	310	$30	$92K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	1	110	80	$70	$81.1K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	8	90	90	$60	$41.4K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	1	60	130	$40	$37.5K
99220	N/A	9	10	110	$60	$33.9K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	40	100	250	$10	$31.7K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	27	70	50	$50	$17.3K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	6	20	90	$20	$8.4K

Showing 1–10 of 17

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jason Della Vecchia	TN	Addiction Medicine (Internal Medicine) Physician	$108.8K	$623.2K
Amarabalan Rajendran	GA	Physical Medicine & Rehabilitation Physician	$690.5K	$0
Kenneth Santiago	SC	Internal Medicine Physician	$467.1K	$0
Jorge Chabrier-rosello	SC	Nephrology Physician	$367.2K	$0
David Budhoo	SC	Internal Medicine Physician	$362.7K	$0
Noman Hussain	TX	Internal Medicine Physician	$240.3K	$0
Sandhya Talakokkla	SC	Internal Medicine Physician	$224.6K	$0
Veronica Ortiz	SC	Internal Medicine Physician	$206.1K	$0
Sharif Elkabbani	GA	Hospitalist Physician	$148.9K	$0
Christopher Walker	SC	Internal Medicine Physician	$121.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Premier Kids Care, Inc.	GA	Community/Retail Pharmacy	$0	$19.6M
Excellent Pediatrics	GA	Primary Care Clinic/Center	$0	$6.3M
Amar Mohan	GA	Internal Medicine Physician	$1.1M	$0
Board Of Commissioners Of Walton County	GA	Land Ambulance	$932.2K	$0
Vest Monroe, LLC	GA	Psychiatric Hospital	$0	$550.4K
Lenox Morris	GA	Family Medicine Physician	$286.5K	$0
Michelle Plaster	GA	Family Medicine Physician	$252.9K	$0
Tiaya Welsh	GA	Family Nurse Practitioner	$163.3K	$0
Bryan Kirkland	GA	Internal Medicine Physician	$132K	$0
Amy Sargent	GA	Family Nurse Practitioner	$110.6K	$0

Hospital Physician Services - Southeast Professional Corporation — Billing Profile & Reimbursement Data

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Hospital Physician Services - Southeast Professional Corporation — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References