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.

Usa Health Physician Billing Services LLC (NPI 1134787567)

Key Findings

Field	Value
Entity Type	Organization
Organization	Usa Health Physician Billing Services LLC
Address	1601 Center St
City	Mobile
State	AL
ZIP	36604
Taxonomy	Pediatrics Physician
NPI Enumerated	May 31, 2019

Payer Source	Total Paid
Medicaid	$11M
Medicare	$0

This provider is effectively a single‑payer Medicaid operation: there is no Medicare billing on file and lifetime Medicaid revenue is $11M. The NPI was enumerated on 2019-05-31 (~7 years ago), indicating several years of established activity concentrated in the Medicaid program. Analysts should treat Medicaid as the material revenue source for any commercial or network negotiations.

Revenue concentration is high: the precomputed top three Medicaid codes account for 61.6% of this provider’s total Medicaid revenue, with 99214 (27.4%), 99213 (20.1%), and 92507 (14.1%) identified as the primary revenue drivers. Those three codes together dominate the revenue profile, which signals that changes to E/M reimbursement or audiology-related coverage in the state could materially affect the provider’s overall revenue.

The code mix indicates a core ambulatory pediatric primary-care footprint with integrated therapy/diagnostic services. High-volume established-patient office visits (99214: 26.3K claims, $3M revenue; 99213: 27K claims, $2.2M revenue) and preventive medicine services (99391, 99392, 99393) point to routine well-child and chronic care management as central activities, while frequent vaccine codes (90670, 90648, 90686, 90680) confirm substantial immunization throughput.

Beyond primary care, the provider has significant activity in hearing/communication and rehabilitative services: 92507 shows 14.3K claims and $1.5M revenue, and therapy codes such as 97530 (18.8K claims, $1.4M) and 97110 (9.2K claims, $512.9K) are material contributors. The presence of swallowing treatment (92526) and sensory integration (97533) suggests bundled pediatric therapy or early intervention programs co-located with primary care.

Competitive standing within the state is strong for core ambulatory pediatric codes. The provider ranks #43 of 1990 for 99214 (98th percentile) and #80 of 1988 for 99213 (96th percentile), described in the source as "notably above typical state volume," which indicates a prominent in‑state role for established‑patient pediatric visits rather than a modest or fringe participant.

Preventive services are also a distinguishing feature: 99391 ranks #9 of 270 providers in-state (97th percentile) and 99392 ranks #17 of 299 (95th percentile), both labeled "notably above typical state volume." This pattern underscores a sustained emphasis on well‑child care and preventive visits as part of the provider’s service mix.

Operationally, the profile shows high throughput with low unit payments on some lines: vaccines and point-of-care lab tests have low average paid/claim ($6–$27) but large claim volumes (e.g., 90670: 5.5K claims; 87804: 3K claims), implying vaccination clinics and rapid testing are high‑volume, low-margin services that support patient flow and population health activities.

For payer and network analysis, the provider’s Medicaid concentration and code mix warrant monitoring for policy or reimbursement shifts in pediatric E/M and therapy/audiology services. Given that 61.6% of Medicaid revenue is driven by three codes and there is no Medicare activity, state Medicaid policy changes, prior‑authorization trends, or audit focus on high‑volume E/M and therapy codes could have outsized impact on this provider’s financial stability and contracting posture.

Medicaid: Complete Services Breakdown

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

71 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…	26,330	$110	$3M
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…	27,010	$80	$2.2M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	14,280	$110	$1.5M
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	18,820	$80	$1.4M
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…	13,270	$60	$796.4K
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…	9,980	$60	$568.9K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	9,160	$60	$512.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,570	$60	$151.3K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	1,290	$110	$142.6K
97533	In this procedure, the provider uses sensory integrative techniques in patients with established dysfunction of sensory processing, for example, children with autism, and brain injuries. This service…	1,580	$40	$63.3K

Showing 1–10 of 71

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

Usa Health Physician Billing Services LLC — 3 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

71 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	35	180	1,490	$50	$404.5K
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…	43	1,990	680	$60	$201.7K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	190	330	140	$240	$197.4K
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…	80	1,990	560	$40	$185.6K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	22	320	1,170	$40	$182.3K
99245	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends…	23	30	120	$190	$175.5K
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…	9	270	1,360	$60	$159.7K
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…	17	300	1,160	$50	$147.8K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	208	250	420	$50	$133K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	74	320	640	$50	$98.1K

Showing 1–10 of 71

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of South Alabama	AL	Neonatal-Perinatal Medicine Physician	$0	$11.6M
University Of South Alabama	AL	Case Management Agency	$0	$8M
University Of South Alabama	AL	Obstetrics & Gynecology Physician	$0	$4M
University Of South Alabama	AL	Pediatrics Physician	$0	$3.4M
Vital Smiles Alabama, P.C.	AL	General Practice Dentistry	$0	$1.7M
University Of South Alabama	AL	Hospitalist Physician	$0	$1.7M
Usa Health Physician Billing Services LLC	AL	Pediatric Cardiology Physician	$0	$1.6M
University Of South Alabama	AL	Family Medicine Physician	$0	$1.3M
Alan Franklin	AL	Retina Specialist (Ophthalmology) Physician	$1.2M	$0
University Of South Alabama	AL	Neurology Physician	$0	$1.1M

Usa Health Physician Billing Services LLC — Billing Profile & Reimbursement Data

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Usa Health Physician Billing Services LLC — Billing Profile & Reimbursement Data

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Key Findings

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
Usa Health Physician Billing Services LLC	AL	Neonatal-Perinatal Medicine Physician	$0	$28.2M
University Of South Alabama	AL	Children's Hospital	$0	$24.8M
Usa Health Physician Billing Services LLC	AL	Emergency Medicine Physician	$0	$12.7M
Usa Health Physician Billing Services LLC	AL	Obstetrics & Gynecology Physician	$0	$6.3M
Usa Health Physician Billing Services LLC	AL	Diagnostic Radiology Physician	$0	$2.9M
Usa Health Physician Billing Services LLC	AL	Orthopaedic Surgery Physician	$0	$2.6M
Usa Health Physician Billing Services LLC	AL	Hospitalist Physician	$0	$2.3M
Usa Health Physician Billing Services LLC	AL	Neurology Physician	$0	$2.1M
Usa Health Physician Billing Services LLC	AL	Pediatric Gastroenterology Physician	$0	$2.1M
Usa Health Physician Billing Services LLC	AL	Internal Medicine Physician	$0	$2M