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.

Jackson Hospital & Clinic, Inc. (NPI 1043262488)

Jackson Hospital & Clinic, Inc. is a general acute care hospital provider located in Montgomery, Alabama. This profile covers 0 Medicare and 112 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	Jackson Hospital & Clinic, Inc.
Address	1725 Pine St
City	Montgomery
State	AL
ZIP	36106
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 16, 2006

Payer Source	Total Paid
Medicaid	$8.9M
Medicare	$0

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

112 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	37,910	$70	$2.5M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	48,270	$40	$1.9M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	31,970	$30	$895K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	13,350	$40	$574.2K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	7,950	$50	$397.4K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	27,960	$10	$307.6K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	6,590	$40	$250.3K
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…	5,670	$40	$243.9K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	24,070	$10	$168.5K
81001	Urinalysis is used to detect substances or cellular material in the urine associated with different metabolic and kidney disorders. It is used to detect urinary tract infections (UTI) and other…	33,670	$1	$134.7K

Showing 1–10 of 112

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

Jackson Hospital & Clinic, Inc. — 10 of 25 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

112 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	5	40	1,020	$40	$865.2K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	18	240	4,820	$60	$807.6K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	130	190	1,480	$100	$730.7K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	11	230	5,160	$40	$474.1K
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	61	90	500	$40	$303.6K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	25	50	380	$90	$157.3K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	11	100	610	$40	$152.5K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	10	110	610	$40	$143.9K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	15	20	320	$110	$130.8K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	37	130	260	$10	$124.7K

Showing 1–10 of 112

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jackson Hospital And Clinic, Inc.	AL	Emergency Medicine Physician	$0	$1.1M
Jackson Surgery Center, LLC	AL	Ambulatory Surgical Clinic/Center	$734.9K	$41K
Praful Patel	AL	Internal Medicine Physician	$334.2K	$0
Xiongying Chen	AL	Internal Medicine Physician	$286.8K	$0
Brian Sellers	AL	Vascular Surgery Physician	$237.1K	$0
Mukeshkumar Patel	AL	General Practice Physician	$225.6K	$290
Taimoor Hashim	AL	Interventional Cardiology Physician	$210.3K	$0
John Jernigan	AL	Internal Medicine Physician	$202.8K	$0
Himanshu Aggarwal	AL	Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician	$183K	$0
Raghu Mukkamala	AL	Internal Medicine Physician	$180.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Associated Psychologists LLC	AL	Clinical Psychologist	$0	$2.7M
Govil Health LLC	AL	Pediatrics Physician	$0	$2.6M
All About Kids Inc	AL	Pediatrics Physician	$0	$2.4M
Nes Tennessee Inc	AL	Emergency Medicine Physician	$0	$1.8M
Gift Of Life Foundation	AL	Contractor	$0	$1.3M
Bush Pediatric Dentistry	AL	Pediatric Dentistry	$0	$1.2M
State Of Alabama Department Of Public Health	AL	Home Health Agency	$0	$1.2M
Integrated Care-alabama LLC	AL	Emergency Medicine Physician	$0	$1.1M
Montgomery Eye Surgery Center LLC	AL	Ambulatory Surgical Clinic/Center	$1M	$400
The Health Care Authority For Baptist Health, An Affiliate Of Uabhs	AL	Hematology & Oncology Physician	$0	$1M

Jackson Hospital & Clinic, Inc. — 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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