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.

Dr. Miniyars Pediatrics, P.C. (NPI 1760651806)

Key Findings

Field	Value
Entity Type	Organization
Organization	Dr. Miniyars Pediatrics, P.C.
Address	330 Turner Mccall Blvd Sw
City	Rome
State	GA
ZIP	30165
Taxonomy	Pediatrics Physician
NPI Enumerated	February 22, 2008

Payer Source	Total Paid
Medicaid	$18.8M
Medicare	$0

This practice is effectively single‑payer in the claims data: Total Medicare revenue: none (no Medicare billing on file), while Total Medicaid revenue is $18.8M. The NPI was enumerated on 2008-02-22 (~18 years ago), indicating a long-established presence in the market that is reporting predominantly to Medicaid rather than Medicare.

Revenue concentration is high: the precomputed top‑3 Medicaid codes account for 63.5% of the provider's Medicaid revenue. Specifically, the three largest contributors are 99214 ($5.6M, 30.0%), 99213 ($4.6M, 24.4%), and 90460 ($1.7M, 9.2%), together forming the bulk of the $18.8M Medicaid footprint.

The code mix signals a pediatric primary‑care operation focused on high volumes of established evaluation-and-management visits and routine immunizations. High‑revenue E/M codes 99214 and 99213 plus vaccine administration 90460 are the top drivers, and additional preventive codes (99393, 99392, 99394, 99391) further support a well‑child/preventive services orientation.

On competitive standing for core visit codes, the provider is a statewide outlier: 99214 ranks #10 of 824 providers in-state (99th percentile; extreme outlier) and 99213 ranks #13 of 917 (99th percentile; notably above typical state volume). These ranks indicate the practice is a dominant in-state provider of high‑complexity established pediatric visits compared with peers.

The provider also ranks strongly on preventive and immunization services. 90460 ranks #4 of 246 providers in-state (99th percentile; extreme outlier) and 99393 ranks #2 of 173 (99th percentile; extreme outlier), reflecting above‑typical in‑state volume for routine vaccine delivery and school‑age well visits.

Several ancillary services are notable for unusual volume compared with peers: 99173 (vision screen) is #1 of 143 providers in-state (100th percentile; extreme outlier), 87635 (SARS‑CoV‑2 NAAT) is #2 of 97 (99th percentile; notably above typical), and allergy dosing/administration codes 95165 and 95117 rank highly in-state. These patterns suggest the practice performs broad, high‑throughput preventive and point‑of‑care testing and immunotherapy services.

Operationally, claim counts are very large for core codes—71.2K claims for 99213, 57.1K claims for 99214, and 30.6K claims for 90460—indicating very high visit and vaccine volumes. Such claim volumes imply substantial patient throughput or multiple clinicians/sites contributing to the reported Medicaid activity, consistent with the practice’s long tenure.

The provider’s heavy reliance on a small set of Medicaid services creates revenue concentration risk: with $18.8M concentrated and the top three codes comprising 63.5% of Medicaid revenue, changes in Medicaid reimbursement or coding for office visits and vaccine administration would materially affect overall revenue. Analysts should monitor state policy and fee schedules for E/M and immunization codes when assessing financial exposure.

Medicaid: Complete Services Breakdown

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

86 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…	57,060	$100	$5.6M
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…	71,160	$60	$4.6M
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	30,570	$60	$1.7M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	12,470	$100	$1.3M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	12,060	$100	$1.2M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	6,150	$110	$669.8K
99051	The provider sees a patient during regular office hours that occur outside of traditional office hours, i.e., in the evening, on a weekend, or on a holiday.	23,820	$30	$619.4K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	6,360	$90	$572K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	8,630	$50	$440.2K
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,…	9,680	$40	$377.4K

Showing 1–10 of 86

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

Dr. Miniyars Pediatrics, P.C. — 16 of 25 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

86 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…	13	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…	10	820	390	$70	$245K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	4	180	680	$90	$226.7K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	17	180	720	$90	$204.2K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	4	250	660	$40	$172.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2	170	500	$100	$170.6K
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,…	30	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…	188	310	90	$90	$136.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	6	160	190	$110	$129.7K
99051	The provider sees a patient during regular office hours that occur outside of traditional office hours, i.e., in the evening, on a weekend, or on a holiday.	5	50	100	$20	$119.1K

Showing 1–10 of 86

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dimple Modi	GA	Retina Specialist (Ophthalmology) Physician	$2.7M	$0
Floyd Physicians, LLC	GA	Neonatal-Perinatal Medicine Physician	$0	$2.6M
Gregory Harris	GA	Hematology & Oncology Physician	$2M	$0
Melissa Dillmon	GA	Hematology & Oncology Physician	$2M	$0
Ear,nose,& Throat Of Northwest Georgia	GA	Otolaryngology Physician	$0	$2M
Dilawar Khan	GA	Hematology & Oncology Physician	$1.9M	$0
Amtran Medical Transport Inc	GA	Land Ambulance	$1.8M	$1.7K
Floyd Healthcare Management Inc	GA	Family Medicine Physician	$0	$1.3M
Jeffrey Peller	GA	Rheumatology Physician	$1.1M	$0
Travis Whitehead	GA	Emergency Medicine Physician	$70.8K	$702.1K

Dr. Miniyars Pediatrics, P.C. — Billing Profile & Reimbursement Data

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Dr. Miniyars Pediatrics, P.C. — 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

Nearby Providers

Frequently Asked Questions

References