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.

Southern Crescent Ent, P.C. (NPI 1841281391)

Southern Crescent Ent, P.C. is a otolaryngology physician provider located in Stockbridge, Georgia. This profile covers 0 Medicare and 13 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	Southern Crescent Ent, P.C.
Address	1101 Hospital Dr
City	Stockbridge
State	GA
ZIP	30281
Taxonomy	Otolaryngology Physician
NPI Enumerated	November 3, 2005

Payer Source	Total Paid
Medicaid	$392.4K
Medicare	$0

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

13 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…	2,780	$60	$178.2K
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…	860	$120	$106.3K
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.	2,620	$20	$47.1K
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…	460	$70	$34.3K
92587	Code 92587 is in the Medicine/Special Otorhinolaryngologic Services Section. It involves special procedures of the ears/nose/throat. This code is for screening purposes with interpretation and…	400	$40	$17.4K
92557	The provider assesses a patient’s hearing with a series of tones at varying intensities to identify the softest level at which the patient can hear. He also measures the patient’s ability to…	100	$40	$3.6K
92555	The provider measures a patient’s speech reception/awareness threshold (the lowest volume at which the patient can recognize speech).	170	$10	$2.2K
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…	30	$60	$1.6K
92582	The provider measures the type and severity of hearing loss in a young child, generally two to four years of age without any developmental or physical impairment. He analyzes the patient’s response…	40	$30	$1K
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…	20	$60	$830

Showing 1–10 of 13

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

Southern Crescent Ent, P.C. — 0 of 10 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

13 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…	780	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…	177	820	390	$70	$245K
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…	80	310	90	$90	$136.3K
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…	35	230	100	$110	$97.1K
92582	The provider measures the type and severity of hearing loss in a young child, generally two to four years of age without any developmental or physical impairment. He analyzes the patient’s response…	3	10	170	$80	$72.6K
92587	Code 92587 is in the Medicine/Special Otorhinolaryngologic Services Section. It involves special procedures of the ears/nose/throat. This code is for screening purposes with interpretation and…	17	30	510	$50	$71.5K
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.	9	40	230	$30	$47K
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…	100	120	100	$80	$34.4K
92555	The provider measures a patient’s speech reception/awareness threshold (the lowest volume at which the patient can recognize speech).	6	10	360	$30	$27.3K
92557	The provider assesses a patient’s hearing with a series of tones at varying intensities to identify the softest level at which the patient can hear. He also measures the patient’s ability to…	10	10	400	$40	$22.1K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Apex Family Healthcare Services, LLC	GA	Community/Behavioral Health Agency	$0	$19M
Pacific Health Systems LLC	GA	Home Health Agency	$0	$9.9M
Southern Crescent Pediatrics PC	GA	Pediatrics Physician	$0	$9.6M
Healthsource Agency Inc	GA	Home Health Agency	$0	$5.8M
Piedmont Hospitalist Physicians LLC	GA	Family Medicine Physician	$0	$3.6M
National Premier Laboratories Inc	GA	Clinical Medical Laboratory	$0	$3.4M
Covenant Care Pediatrics PC	GA	Pediatrics Physician	$0	$3M
Stockbridge Pediatrics	GA	Pediatrics Physician	$0	$2.6M
Surgical Center For Urology LLC	GA	Ambulatory Surgical Clinic/Center	$805.2K	$0
Regenerative Orthopaedics Surgery Center, LLC	GA	Ambulatory Surgical Clinic/Center	$622K	$0

Southern Crescent Ent, P.C. — Billing Profile & Reimbursement Data

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Southern Crescent Ent, P.C. — 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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