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 Children's Hospital Of Alabama (NPI 1205935012)

Field	Value
Entity Type	Organization
Organization	The Children's Hospital Of Alabama
Address	1600 7th Ave S
City	Birmingham
State	AL
ZIP	35233
Taxonomy	Children's Hospital
NPI Enumerated	September 21, 2006

Payer Source	Total Paid
Medicaid	$59M
Medicare	$0

Key Findings

THE CHILDREN'S HOSPITAL OF ALABAMA is effectively a single-payer Medicaid provider: there is no Medicare revenue on file and lifetime Medicaid revenue is $59M, indicating the hospital’s public-pay mix is heavily concentrated in Medicaid rather than Medicare. Its NPI was enumerated on 2006-09-21 (~20 years ago), establishing a long tenure in the market that aligns with a mature, pediatric-focused facility.

Revenue concentration is high: the precomputed top three Medicaid codes (G0463, 99283, 99284) account for 60.7% of this provider's total Medicaid revenue, showing that a few service lines drive the majority of billing. G0463 alone generates $21.9M (40.9% of Medicaid revenue), making outpatient clinic visits the dominant revenue source for this hospital.

The code mix points to a large hospital-based pediatric ambulatory and emergency operation. Very high volume for G0463 (446.3K claims, $49 avg paid/claim) paired with heavy ED E/M activity across 99283 (141.2K claims, $44 avg paid/claim), 99284 (56.8K claims, $77 avg paid/claim), and 99282 (18.1K claims, $40 avg paid/claim) indicates extensive outpatient clinic throughput plus a high-volume pediatric emergency department handling low- to moderate-acuity visits.

The hospital is a dominant statewide provider for multiple high-revenue codes. G0463 ranks #1 of 43 providers in-state (100th percentile; extreme outlier), 99283 ranks #2 of 230 (100th percentile; extreme outlier), and several procedural and dental codes such as 69436 and D9420 also appear at or near the top of state rankings, which collectively signal market leadership in pediatric outpatient, ED, ENT, and dental services.

Surgical and procedure-heavy pediatric service lines are prominent: 69436 (tympanostomy with tube) accounts for $3.2M (6.1% of Medicaid revenue) with 23.9K claims and ranks #2 of 64 providers in-state (98th percentile; extreme outlier), and tonsil/adenoid procedures 42820 and 42830 also appear in the top codes. This pattern supports a high-volume pediatric ENT and ambulatory surgery practice alongside the hospital’s outpatient and ED volumes.

Use of high-cost therapeutics and monitored-anesthesia dental services are notable but more concentrated: J1745 (infliximab) produces $3.6M (6.7% of Medicaid revenue) with 2K claims and ranks #1 of 2 providers in-state (100th percentile; typical, unremarkable volume), while G0330 (dental rehabilitation with monitored anesthesia) yields $1.4M (2.5% of Medicaid revenue) and ranks #1 of 7 providers (100th percentile; notably above typical state volume). These entries suggest targeted specialty infusion and pediatric dental anesthesia programs that contribute materially to revenue despite smaller claim counts.

Laboratory, imaging, and sleep services contribute across many smaller but meaningful codes: 80053, 85025, 95782, 70553, 87635 and 87633 appear in the top-25 list, each representing typical to above-typical state volumes and supporting a broad in-house diagnostic capability. The presence of high-cost lab codes like 81229 ($387.3K) and imaging codes like 70553 ($364.8K) indicate on-site genetic and advanced imaging services that complement clinical care.

Overall competitive standing is that of a statewide pediatric leader with concentrated Medicaid revenue and extreme outlier volumes for core outpatient and ED codes. The combination of market-leading ranks (multiple #1 placements and 100th-percentile designations) and the fact that top codes account for 60.7% of Medicaid revenue implies the hospital operates as a major, high-throughput pediatric center in Alabama rather than a marginal participant.

Medicaid: Complete Services Breakdown

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

301 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	446,260	$50	$21.9M
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.	141,160	$40	$6.2M
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.	56,810	$80	$4.4M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	1,980	$1,830	$3.6M
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	23,890	$140	$3.2M
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.	7,680	$320	$2.5M
D9420	N/A	5,990	$260	$1.6M
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	3,900	$400	$1.6M
G0330	Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an…	1,410	$970	$1.4M
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.	18,110	$40	$724.6K

Showing 1–10 of 301

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 Children's Hospital Of Alabama — 15 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

301 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
81479	Use 81479 to report a molecular pathology procedure that does not have a specific code.	4	10	1,190	$1,590	$67M
82139	The lab analyst performs testing for 6 or more amino acids, usually on a specimen such as blood, plasma, urine, or other body fluids, by quantitative analysis to determine if any are outside the…	2	10	161,680	$20	$3.5M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	1	10	1,040	$1,770	$1.8M
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	40	60	1,260	$60	$1.2M
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…	32	100	470	$130	$1.2M
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	7	20	160	$20	$1.1M
83520	The lab analyst measures the analyte, which is not an infectious agent antibody or infectious agent antigen, by immunoassay. Use 83520 for procedures that have no specific code assigned for the…	3	10	140	$20	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	1	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.	9	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.	32	190	1,480	$100	$730.7K

Showing 1–10 of 301

Related Providers

Other providers that share a Tax Identification Number (TIN) with The Children's Hospital Of Alabama, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Children's Hospital Of Alabama	AL	Pediatrics Physician	$0	$22.2M
The Children's Hospital Of Alabama	AL	Pediatrics Physician	$0	$18.4M
The Children's Hospital Of Alabama	AL	Pediatrics Physician	$0	$17.7M
The Children's Hospital Of Alabama	AL	Pediatric Otolaryngology Physician	$0	$15.8M
The Children's Hospital Of Alabama	AL	Psychologist	$0	$12M
The Children's Hospital Of Alabama	AL	Pediatrics Physician	$0	$7.5M
The Children's Hospital Of Alabama	AL	Pediatrics Physician	$0	$5.7M
The Children's Hospital Of Alabama	AL	Pediatric Pulmonology Physician	$0	$5.6M
The Children's Hospital Of Alabama	AL	Pediatrics Physician	$0	$5.3M
The Children's Hospital Of Alabama	AL	Pediatrics Physician	$0	$4.6M

Nearby Providers

Other providers in the same ZIP code as The Children's Hospital Of Alabama, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratory Corporation Of America Holdings	AL	Clinical Medical Laboratory	$60.5M	$289.1M
University Of Alabama Health Services Foundation, PC	AL	Pediatrics Physician	$0	$79.6M
University Of Alabama Health Services Foundation, PC.	AL	Multi-Specialty Clinic/Center	$0	$77.1M
M&o Enterprises LLC	AL	Home Infusion Therapy Pharmacy	$0	$31.2M
Medical Resources, Inc	AL	Oxygen Equipment & Supplies (DME)	$0	$23.6M
Southern Lab Partners, LLC	AL	Clinical Medical Laboratory	$5.4M	$14.4M
University Of Alabama Health Services Foundation PC	AL	Clinic/Center	$0	$18.6M
Jefferson County Board Of Health	AL	Public Health or Welfare Agency	$0	$12.2M
Pediatric Anesthesia Associates PC	AL	Anesthesiology Physician	$0	$7.2M
University Of Alabama Ophthalmology Services Foundation	AL	Ophthalmology Physician	$0	$6.9M

The Children's Hospital Of Alabama — 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