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.

Gadsden Regional Medical Center LLC (NPI 1225081516)

Gadsden Regional Medical Center LLC is a general acute care hospital provider located in Gadsden, Alabama. This profile covers 0 Medicare and 58 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	Gadsden Regional Medical Center LLC
Address	1007 Goodyear Ave
City	Gadsden
State	AL
ZIP	35903
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 18, 2006

Payer Source	Total Paid
Medicaid	$4.1M
Medicare	$0

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

58 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.	16,180	$60	$1M
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.	22,130	$40	$863K
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.	3,190	$220	$704.5K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	8,180	$30	$212.6K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	1,480	$140	$207.3K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	8,190	$20	$196.5K
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.	14,630	$10	$160.9K
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.	3,730	$40	$156.4K
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…	19,230	$10	$153.8K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	2,230	$40	$93.8K

Showing 1–10 of 58

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

Gadsden Regional Medical Center LLC — 1 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

58 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	18	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.	55	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.	70	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.	35	230	5,160	$40	$474.1K
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…	35	40	430	$10	$391.5K
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…	54	70	550	$50	$210.5K
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…	1,590	1,990	560	$40	$185.6K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	10	60	320	$130	$176.1K
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.	52	100	610	$40	$152.5K
42830	The provider performs an initial adenoidectomy in a patient who is less than 12 years old.	8	10	60	$280	$144K

Showing 1–10 of 58

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Farah Al Khitan	AL	Interventional Cardiology Physician	$839.9K	$0
Bankimchandra Patel	AL	Interventional Cardiology Physician	$441.8K	$0
Virenjan Narayan	AL	Cardiovascular Disease Physician	$424.3K	$0
Bryan Mcgwier	AL	Cardiovascular Disease Physician	$230K	$0
Ghanshyam Patel	AL	Cardiovascular Disease Physician	$209.2K	$0
Marian Manankil	AL	Cardiovascular Disease Physician	$151.9K	$0
Peter Scalise	AL	Interventional Cardiology Physician	$150.1K	$0
Darryl Prime	AL	Interventional Cardiology Physician	$62.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Quality Of Life Health Services Inc	AL	Community Health Clinic/Center	$0	$6.6M
Children And Teen Dental Group Of Alabama	AL	Pediatric Dentistry	$0	$5.2M
Elquis Castillo	AL	Medical Oncology Physician	$2.5M	$0
Oral Surgery Associates, PC	AL	Oral and Maxillofacial Surgery (Dentist)	$0	$1.2M
Womens Health Partners LLC	AL	Obstetrics & Gynecology Physician	$0	$1.1M
Omi Of Gadsden Petct LLC	AL	Diagnostic Radiology Physician	$910.5K	$0
Krishna Chaitanya Keri	AL	Nephrology Physician	$339.1K	$0
Rameshkumar Athippalayam Chellamuthu	AL	Nephrology Physician	$272.6K	$0
James Smith	AL	Orthopaedic Surgery Physician	$251.8K	$0
Merle Wade	AL	Urology Physician	$227.3K	$0

Gadsden Regional Medical Center LLC — Billing Profile & Reimbursement Data

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Gadsden Regional Medical Center LLC — 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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