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.

The East Alabama Health Care Authority (NPI 1154386431)

The East Alabama Health Care Authority is a general acute care hospital provider located in Opelika, Alabama. This profile covers 0 Medicare and 166 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	The East Alabama Health Care Authority
Address	2000 Pepperell Pkwy
City	Opelika
State	AL
ZIP	36801
Taxonomy	General Acute Care Hospital
NPI Enumerated	April 19, 2006

Payer Source	Total Paid
Medicaid	$6.2M
Medicare	$0

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

166 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.	26,140	$70	$1.8M
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.	27,620	$40	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	15,730	$40	$676.5K
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.	28,050	$10	$280.5K
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…	27,340	$10	$246.1K
81220	The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR…	1,020	$180	$180K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	480	$270	$127.2K
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.	1,690	$60	$94.4K
88175	The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer…	3,730	$20	$89.6K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	330	$270	$89.5K

Showing 1–10 of 166

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

The East Alabama Health Care Authority — 2 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

166 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
81220	The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR…	3	10	5,570	$480	$4.1M
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	48	100	470	$130	$1.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	7	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.	27	240	4,820	$60	$807.6K
87536	A lab tests a patient’s specimen to measure the amount of HIV–1 present. This may be referred to as viral load.	4	10	1,760	$40	$569.6K
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.	26	230	5,160	$40	$474.1K
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…	113	180	1,490	$50	$404.5K
87389	The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an…	9	40	430	$10	$391.5K
88175	The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer…	6	20	1,500	$20	$389.4K
83021	The lab analyst measures and calculates the hemoglobin fractions in a whole blood sample demonstrated by this hemoglobin fractionation test by chromatography.	5	10	190	$20	$350.6K

Showing 1–10 of 166

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eamc Er Physicians	AL	Emergency Medical Services (Emergency Medicine) Physician	$0	$2.6M
Edward Parma	AL	Retina Specialist (Ophthalmology) Physician	$1.2M	$0
Rachel Kruspe	AL	Hematology & Oncology Physician	$1M	$0
Song-chu Ko	GA	Radiation Oncology Physician	$778.8K	$0
Clifford Tillman	LA	Gastroenterology Physician	$439.4K	$268.7K
Christopher Adams	FL	Rheumatology Physician	$555.3K	$0
David Holmes	AL	Cardiovascular Disease Physician	$338.1K	$0
Patrick Reilly	FL	Gastroenterology Physician	$241.3K	$0
Adam Vogt	AL	Anatomic Pathology Physician	$206K	$0
Kevin Ryan	AL	Cardiovascular Disease Physician	$172.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pediatric Clinic LLC	AL	Pediatrics Physician	$0	$24.9M
Pediatric Associates Of Auburn	AL	Pediatric Adolescent Medicine Physician	$0	$4.2M
East Alabama Ems, LLC	AL	Ambulance	$1.1M	$2.6M
Gw Stone Capital LLC	AL	Optometrist	$0	$2.2M
Lee County Health Dept Fp Clinic	AL	Public Health or Welfare Agency	$0	$2M
Premier Ob/gyn, LLC	AL	Obstetrics & Gynecology Physician	$0	$1.9M
Eamc Physicians Group	AL	General Practice Physician	$0	$1.1M
East Alabama Ear, Nose, & Throat, PC	AL	Otolaryngology Physician	$0	$869.3K
Sunil Sharma	AL	Family Medicine Physician	$370.6K	$0
Luke Massey	AL	Physician Assistant	$356.6K	$0

The East Alabama Health Care Authority — Billing Profile & Reimbursement Data

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The East Alabama Health Care Authority — 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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