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 Alabama for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Alabama 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. Alabama (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.

Southview Medical Clinic LLC (NPI 1033554357)

Southview Medical Clinic LLC is a multi-specialty clinic/center provider located in Hanceville, Alabama. 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	Southview Medical Clinic LLC
Address	307 Main St Sw
City	Hanceville
State	AL
ZIP	35077
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	April 30, 2013

Payer Source	Total Paid
Medicaid	$3.1M
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
T1015	Clinic visit/encounter, all-inclusive	26,090	$110	$3M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	650	$130	$83.2K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	1,060	$20	$15.8K
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.	1,540	$10	$13.9K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	1,060	$10	$12.7K
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…	10,420	$1	$10.4K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	330	$20	$7.2K
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…	1,320	$1	$4K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	220	$10	$1.7K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	180	$1	$710

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Alabama providers billing the same CPT/HCPCS codes.

Claims Volume vs. Alabama Distribution

Southview Medical Clinic LLC — 0 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	58	240	6,820	$120	$2.9M
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…	128	1,990	680	$60	$201.7K
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…	207	1,990	560	$40	$185.6K
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…	193	630	60	$80	$45.8K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	64	300	140	$20	$34K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	265	790	390	$10	$33K
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.	208	680	400	$10	$29.2K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	177	410	240	$20	$27.6K
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…	61	660	80	$50	$26.8K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	52	210	150	$40	$23.8K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
James Parks	AL	Cardiovascular Disease Physician	$360.2K	$0
Frank Malensek	AL	Internal Medicine Physician	$257.2K	$0
Keith Russell	MS	Diagnostic Radiology Physician	$240.4K	$0
Jeremy Smith	AL	Internal Medicine Physician	$239.5K	$0
Craig Rich	AL	Internal Medicine Physician	$223.9K	$0
Edward Cullum	AL	Cardiovascular Disease Physician	$221.5K	$0
Stephen Stuart	AL	Internal Medicine Physician	$210.4K	$0
Michael Han	AL	Internal Medicine Physician	$191.9K	$0
Noah Fitzpatrick	AL	Internal Medicine Physician	$188.4K	$0
Gerald Norris	AL	Internal Medicine Physician	$169.8K	$0

Southview Medical Clinic LLC — Billing Profile & Reimbursement Data

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Southview Medical Clinic 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