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.

Sbjs PC (NPI 1134106065)

Sbjs PC is a orthopaedic surgery physician provider located in Dothan, Alabama. This profile covers 0 Medicare and 20 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	Sbjs PC
Address	1500 Ross Clark Cir
City	Dothan
State	AL
ZIP	36301
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	December 30, 2005

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.

20 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…	20,170	$30	$584.9K
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…	4,380	$60	$262.8K
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…	3,180	$50	$171.7K
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…	1,780	$90	$152.9K
73630	In this diagnostic procedure, the provider takes a minimum of three views of the foot to assess injury, fracture, arthritis, tumor, or congenital abnormality.	2,550	$20	$40.8K
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,…	1,680	$20	$25.2K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	950	$20	$18K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	510	$30	$13.9K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	190	$60	$11K
J0702	Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	710	$10	$5.7K

Showing 1–10 of 20

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

Sbjs PC — 2 of 19 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

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	351	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…	113	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…	19	630	60	$80	$45.8K
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,…	46	500	120	$60	$42.2K
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…	19	660	80	$50	$26.8K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	7	20	80	$60	$13.7K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	362	660	260	$10	$12K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	6	40	100	$20	$9.3K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	15	140	50	$40	$7.5K
73630	In this diagnostic procedure, the provider takes a minimum of three views of the foot to assess injury, fracture, arthritis, tumor, or congenital abnormality.	5	60	120	$10	$7.4K

Showing 1–10 of 20

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Houston County Healthcare Authority	AL	Internal Medicine Physician	$0	$9.6M
State Of Alabama Department Of Public Health	AL	Home Health Agency	$0	$6.9M
Wiregrass Hospice, LLC	AL	Community Based Hospice Care Agency	$0	$5.8M
Dothan Ambulance Service	AL	Land Ambulance	$1.7M	$3.9M
Southeast Alabama Maternity Care Program	AL	Exclusive Provider Organization	$0	$5.1M
Houston County Healthcare Authority	AL	General Acute Care Hospital	$0	$4.9M
Houston County Health Dept Fp Clinic	AL	Public Health or Welfare Agency	$0	$4.4M
Southern Alabama Surgery Center LLC	AL	Ambulatory Surgical Clinic/Center	$3.8M	$94.3K
Edmund Lacour	AL	Rheumatology Physician	$3.7M	$0
Houston County Healthcare Authority	AL	Clinical Medical Laboratory	$591.7K	$2.1M

Sbjs PC — Billing Profile & Reimbursement Data

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Sbjs PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
James Fernandez	MN	Diagnostic Radiology Physician	$248.1K	$0
Christopher Robinson	AL	Orthopaedic Surgery Physician	$228.3K	$0
Timothy Haley	AL	Orthopaedic Surgery Physician	$227.2K	$0
Benjamin Werner	AL	Podiatrist	$176.5K	$0
Chase Smith	AL	Orthopaedic Surgery Physician	$174.2K	$0
Patrick Guin	AL	Orthopaedic Surgery Physician	$164.7K	$0
Jeremiah Maddox	AL	Orthopaedic Surgery Physician	$160.9K	$0
Samuel Armstrong	AL	Diagnostic Radiology Physician	$135K	$0
Judson Moore	AL	Orthopaedic Surgery Physician	$134.9K	$0
Orvis Chitwood	AL	Orthopaedic Surgery Physician	$134.8K	$0