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.

Children's Neurology Ctr Macon, LLC (NPI 1932485125)

Children's Neurology Ctr Macon, LLC is a neurology with special qualifications in child neurology physician provider located in Macon, Georgia. This profile covers 0 Medicare and 10 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	Children's Neurology Ctr Macon, LLC
Address	840 Pine St
City	Macon
State	GA
ZIP	31201
Taxonomy	Neurology with Special Qualifications in Child Neurology Physician
NPI Enumerated	November 1, 2011

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.

10 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…	12,430	$50	$596.7K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	2,710	$140	$387.5K
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…	1,700	$80	$129.4K
99245	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends…	480	$180	$84.1K
95816	Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. In this procedure the provider performs the EEG…	700	$50	$33K
95951	N/A	30	$620	$17.5K
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…	140	$110	$15.2K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	160	$90	$14.6K
95819	Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. In this procedure the provider performs the EEG…	180	$50	$9.1K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	10	$140	$1.7K

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

Children's Neurology Ctr Macon, LLC — 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

10 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…	88	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…	235	820	390	$70	$245K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	6	30	90	$160	$236.3K
95819	Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. In this procedure the provider performs the EEG…	8	10	190	$290	$165.6K
95951	N/A	4	10	240	$510	$108.1K
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…	102	230	100	$110	$97.1K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	14	30	160	$110	$77.4K
99245	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends…	2	10	70	$190	$38.4K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	54	60	40	$120	$30.6K
95816	Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. In this procedure the provider performs the EEG…	2	20	220	$80	$25.9K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Health Services Of Central Georgia, Inc	GA	Multi-Specialty Clinic/Center	$0	$18.5M
Central Georgia Emergency Group, LLC	GA	Emergency Medicine Physician	$0	$8.8M
Middle Georgia Pediatrics	GA	Pediatric Adolescent Medicine Physician	$0	$4.2M
Linda Hendricks	GA	Specialist	$3.1M	$0
Mgas Holdings, LLC	GA	Ambulance	$2.5M	$36.9K
Marcus Weldon	GA	Hematology & Oncology Physician	$2.5M	$0
Cogent Healthcare Of Macon, LLC	GA	Internal Medicine Physician	$0	$1.8M
Central Georgia Pediatrics, Inc.	GA	Pediatric Adolescent Medicine Physician	$0	$1.6M
Alan Justice	GA	Internal Medicine Physician	$1.4M	$0
Central Georgia Pet LLC	GA	Radiation Oncology Physician	$1.4M	$0

Children's Neurology Ctr Macon, LLC — Billing Profile & Reimbursement Data

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Children's Neurology Ctr Macon, LLC — 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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References