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.

West Augusta Pediatrics (NPI 1992824205)

West Augusta Pediatrics is a pediatrics physician provider located in Augusta, Georgia. This profile covers 0 Medicare and 35 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	West Augusta Pediatrics
Address	1215 W Wheeler Pkwy
City	Augusta
State	GA
ZIP	30909
Taxonomy	Pediatrics Physician
NPI Enumerated	March 28, 2007

Payer Source	Total Paid
Medicaid	$534.7K
Medicare	$0

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

35 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…	3,830	$60	$233.4K
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.	2,170	$30	$73.8K
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…	610	$70	$42.8K
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…	400	$100	$41K
T1015	Clinic visit/encounter, all-inclusive	410	$80	$33.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	440	$70	$29.5K
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…	410	$70	$29.3K
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,…	930	$20	$22.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	160	$80	$13K
85018	The lab analyst measures the hemoglobin in a whole blood sample. Hemoglobin is the red pigmented iron compound contained in the red blood cell that combines with oxygen needed by the body tissue.	2,310	$1	$4.6K

Showing 1–10 of 35

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

West Augusta Pediatrics — 0 of 20 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

35 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…	193	920	370	$60	$360.6K
T1015	Clinic visit/encounter, all-inclusive	15	50	100	$100	$293.2K
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…	407	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…	94	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…	101	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.	95	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.	91	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,…	119	360	370	$50	$153.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	83	160	190	$110	$129.7K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	166	260	350	$10	$30.5K

Showing 1–10 of 35

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Private Diagnostic Clinic, PLLC	NC	General Practice Physician	$0	$46.5M
Duke Health Integrated Practice, Inc.	NC	General Practice Physician	$0	$36.3M
Balboa Nephrology Medical Group, Inc.	CA	Nephrology Physician	$0	$25.9M
Majda Hadziahmetovic	NC	Ophthalmology Physician	$2.3M	$0
Michael Allingham	NC	Retina Specialist (Ophthalmology) Physician	$1.7M	$0
Jonathan Cook	NC	Dermatology Physician	$1.6M	$0
Tywana Donaldson	NC	Nurse Practitioner	$1.4M	$0
Eleonora Lad	NC	Retina Specialist (Ophthalmology) Physician	$1.4M	$0
Dilraj Grewal	IL	Ophthalmology Physician	$1.1M	$0
Mayur Patel	NC	Rheumatology Physician	$1M	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Faircloth Bakeman Partnership	GA	Oral and Maxillofacial Surgery (Dentist)	$0	$4M
Augusta Obstetrics And Gynecology Specialists, LLC	GA	Obstetrics & Gynecology Physician	$0	$3.7M
Eye Surgery Center Of Augusta, LLC	GA	Ambulatory Surgical Clinic/Center	$3.2M	$0
Oksana Demediuk	GA	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Pediatricare Pm	GA	Pediatrics Physician	$0	$2.8M
Doctors Hospital Of Augusta LLC	GA	General Acute Care Hospital	$0	$2.2M
Joseph M Still Burn Centers, Inc	GA	Specialist	$0	$2M
Eugene Long	GA	Hematology & Oncology Physician	$1.9M	$0
Ranjit Dhaliwal	GA	Retina Specialist (Ophthalmology) Physician	$1.9M	$0
Dennis Marcus	GA	Ophthalmology Physician	$1.8M	$0

West Augusta Pediatrics — Billing Profile & Reimbursement Data

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West Augusta Pediatrics — 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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