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NPI 1093768723 · Birmingham, AL · Multi-Specialty Clinic/Center
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University Of Alabama Health Services Foundation, PC. is a multi-specialty clinic/center provider located in Birmingham, Alabama. This profile covers 0 Medicare and 280 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | University Of Alabama Health Services Foundation, PC. |
| Address | 619 19th Street South |
| City | Birmingham |
| State | AL |
| ZIP | 35233 |
| Taxonomy | Multi-Specialty Clinic/Center |
| NPI Enumerated | May 17, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $77.1M |
| Medicare | $0 |
This provider effectively operates on a single-payer footprint in the available data: there is no Medicare billing on file and total Medicaid revenue is $77.1M, indicating Medicaid is the dominant — effectively sole — recorded public payer in our dataset for this entity. The absence of Medicare billing on file makes comparisons to national Medicare peers unavailable and concentrates our analysis on Medicaid activity.
Revenue is highly concentrated in a small set of E/M codes: the precomputed top 3 Medicaid codes account for 45.1% of the provider's total Medicaid revenue, with 99214 generating $13.4M (20.8%), 99284 generating $8.5M (13.2%), and 99232 generating $7.1M (11.0%). This concentration shows that nearly half of Medicaid revenue is driven by a handful of evaluation-and-management services.
The code mix indicates a broad, high-throughput clinical operation spanning outpatient, emergency, and inpatient care: top revenue drivers include office/outpatient E/M (99214, 99213, 99215), emergency department E/M (99284, 99285), and subsequent/initial inpatient E/M (99232, 99233, 99222). Such a profile is consistent with a multi-specialty clinic/center that functions as both ambulatory care provider and acute-care service hub for Medicaid patients.
Beyond E/M services, the provider reports substantial ancillary volumes consistent with hospital-based specialties: pathology codes 88305 ($2.9M, 4.5%) and 88307 ($1.1M, 1.8%), cardiac imaging 93306 ($1.4M, 2.1%), head CT 70450 ($1M, 1.6%), and obstetric imaging and delivery codes 76811 ($1M, 1.6%), 76816 ($746.3K, 1.2%), 76819 ($599.7K, 0.9%), 01967 ($2M, 3.1%) and 59409 ($1.1M, 1.7%) all appear in the top-coded list. This mix points to integrated inpatient, peri‑partum, imaging, and laboratory/pathology services supporting the clinical E/M volumes.
State-level competitive standing is strong: several high-volume codes are labeled as extreme outlier or top-ranked in Alabama — for example, 99214 ranks #3 of 1990 providers in-state (100th percentile; extreme outlier), 99213 ranks #7 of 1988 (100th percentile; extreme outlier), 93306 ranks #1 of 111 providers (100th percentile; extreme outlier), and 76811 ranks #1 of 19 providers (100th percentile; extreme outlier). These ranks and percentiles indicate the provider is a dominant Medicaid participant statewide for multiple service lines.
There is heterogeneity across code-level statistical standing: some high-revenue emergency and critical care codes have more typical in-state positions — 99285 ranks #12 of 193 providers (94th percentile; typical, unremarkable volume) and 01967 ranks #5 of 31 providers (87th percentile; typical, unremarkable volume) — while critical care 99291 is labeled notably above typical state volume. This variability suggests dominance in certain ambulatory and diagnostic services alongside more ordinary volumes in select high-acuity procedures.
From an operational and revenue-risk perspective, the reliance on a narrow set of E/M-heavy codes (the top 3 codes representing 45.1% of Medicaid revenue) means the provider’s Medicaid financial performance is sensitive to changes in outpatient, ED, and inpatient evaluation-and-management throughput and reimbursement. Strategic or operational changes that affect ED/inpatient census or ambulatory visit mix would disproportionately impact overall Medicaid revenue.
The provider has a long tenure in the dataset, with NPI enumerated 2006-05-17 (~20 years), and the combination of longstanding enumeration plus broad, high-volume code coverage across E/M, imaging, pathology, and obstetrics supports the interpretation of an established, large-scale multi-specialty clinical operation serving Medicaid patients at scale.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
280 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… | 125,400 | $110 | $13.4M |
| 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. | 63,580 | $130 | $8.5M |
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 90,630 | $80 | $7.1M |
| 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… | 90,700 | $80 | $6.9M |
| 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. | 22,110 | $160 | $3.6M |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 30,750 | $90 | $2.9M |
| 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… | 16,110 | $140 | $2.3M |
| 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… | 10,750 | $210 | $2.3M |
| 01967 | The provider performs neuraxial anesthesia services for a patient undergoing a planned vaginal delivery. | 2,210 | $890 | $2M |
| 93306 | The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent… | 25,520 | $50 | $1.4M |
Showing 1–10 of 280
How this provider's Medicaid billing volume and revenue compare to other Alabama providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Alabama median
280 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 93303 | The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization… | 5 | 10 | 470 | $170 | $973.4K |
| 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. | 7 | 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. | 12 | 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. | 130 | 230 | 5,160 | $40 | $474.1K |
| 95951 | N/A | 1 | 10 | 580 | $480 | $386.2K |
| 90791 | In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. | 62 | 180 | 100 | $120 | $381.8K |
| 90837 | In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or… | 154 | 380 | 440 | $90 | $362K |
| 95720 | A physician or other QHCP reviews recorded events and analyzes spike and seizure detection of a continuous electroencephalography, a study of the electrical activity of the brain. A video is… | 2 | 10 | 360 | $190 | $347.6K |
| 77387 | The provider uses imaging guidance to locate the target site for delivery of radiation treatment over the tumor. This helps to protect the surrounding healthy tissues. | 1 | 10 | 3,540 | $100 | $338.1K |
| D7240 | N/A | 17 | 60 | 610 | $180 | $336.5K |
Showing 1–10 of 280
Other providers in the same ZIP code as University Of Alabama Health Services Foundation, PC., ranked by combined Medicare and Medicaid revenue.
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