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 1245898683)

Field	Value
Entity Type	Organization
Organization	Usa Health Physician Billing Services LLC
Address	1700 Center St
City	Mobile
State	AL
ZIP	36604
Taxonomy	Neonatal-Perinatal Medicine Physician
NPI Enumerated	May 31, 2019

Payer Source	Total Paid
Medicaid	$28.2M
Medicare	$0

Key Findings

This entity is effectively a Medicaid-focused neonatal/perinatal practice: lifetime Medicare revenue is listed as none (no Medicare billing on file) while lifetime Medicaid revenue is $28.2M, indicating single-payer dependence on Medicaid for billed services. The NPI was enumerated on 2019-05-31 (~7 years ago), giving it several years of operational history under this payer mix. Changes in Medicaid policy or reimbursement could therefore have a material impact on overall revenue.

Top-line clinical activity is consistent with a NICU-focused neonatal-perinatal operation: the largest revenue-driving codes are 99469, 99472, and 99479, which describe neonatal critical care follow-up, inpatient follow-up of critically ill infants, and direction of care for recovering low birth weight infants respectively. The average paid per claim for these top codes ($442 for 99469, $432 for 99472, $138 for 99479) and their large claim counts (21.9K, 21.9K, and 27.7K claims) indicate high-volume, procedure-specific billing tied to inpatient newborn and NICU workflows. This code mix points to routine management of critically ill and low-birthweight infants rather than general pediatric ambulatory care.

Revenue is highly concentrated in a small set of Medicaid codes: the precomputed top-three share shows that the top 3 Medicaid codes by revenue account for 81.6% of this provider's total Medicaid revenue, with 99469 producing $9.7M (34.4%), 99472 producing $9.5M (33.6%), and 99479 producing $3.8M (13.6%). That concentration suggests most of the $28.2M Medicaid revenue flows from a narrow set of neonatal critical care and low-birthweight management services, creating revenue exposure to utilization changes in those specific service lines.

Competitive standing within the state is strong for core neonatal codes: the provider ranks #2 of 12 for 99472 (91th percentile), #3 of 13 for 99469 (83th percentile), and #3 of 14 for 99479 (85th percentile), which places it among the leading in-state billers for those neonatal critical care services. While these placements reflect prominence in neonatal care, they are not uniquerly dominant across all codes, indicating a major but not exclusive role in Alabama’s neonatal service market.

Several follow-up and discharge management codes show unusually high volumes relative to peers and are notable contributors to Medicaid revenue: 99462 is labeled an extreme outlier, far above typical state volume, with 8.2K claims and $468.7K revenue (1.7%), and 99238 is described as notably above typical state volume with 8.8K claims and $868.7K revenue (3.1%). These patterns imply substantial patient throughput and recurrent inpatient follow-up encounters, reinforcing the profile of a high-volume neonatal inpatient service.

The provider bills for both high-acuity and routine newborn services, demonstrating a mix of intensity in its case portfolio: high-acuity initial critical care is present (99468 with 758 claims, $1086 avg paid/claim, $823.2K revenue, 2.9% and ranked #3 of 10, 78th percentile), alongside routine newborn evaluations (99460 with 7.1K claims, $134 avg paid/claim, $945.6K revenue, 3.4% and ranked #4 of 82, 96th percentile). This spread of codes suggests clinical capacity to manage both intensive NICU cases and more standard newborn care episodes within the same operational footprint.

Operationally, reliance on a small number of high-revenue neonatal codes means payer contracting and utilization for those services will disproportionately influence financial performance: the combination of $28.2M in Medicaid revenue, the 81.6% revenue concentration among the top three codes, and the absence of Medicare billing underscores a single-payer revenue exposure. Payer analysts should prioritize monitoring state Medicaid reimbursement changes, NICU admission trends, and discharge/follow-up volumes when assessing near-term revenue risk.

There is mixed participation across broader inpatient E/M services, consistent with a specialized rather than general inpatient footprint: mid-to-lower state rankings on some subsequent and initial inpatient E/M codes (for example 99232 at rank #168 of 396, 58th percentile, and 99233 at rank #85 of 245, 66th percentile) indicate moderate engagement in non-neonatal general inpatient care. This pattern supports the interpretation that the practice concentrates on neonatal-perinatal services rather than broad adult or general pediatric inpatient case management.

Medicaid: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	21,890	$440	$9.7M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	21,930	$430	$9.5M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	27,700	$140	$3.8M
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	13,040	$130	$1.7M
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	7,060	$130	$945.6K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	8,780	$100	$868.7K
99468	The provider evaluates and manages the initial care of a newborn or infant less than 28 days of age in a neonatal critical care setting.	760	$1,090	$823.2K
99462	The provider performs the evaluation and management of a normal newborn on a day subsequent to the initial hospital evaluation.	8,220	$60	$468.7K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	790	$150	$122K
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…	850	$90	$78.2K

Showing 1–10 of 15

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 15 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

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	2	10	140	$480	$4.8M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	3	10	1,820	$350	$3.2M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	3	10	3,160	$110	$1.7M
99468	The provider evaluates and manages the initial care of a newborn or infant less than 28 days of age in a neonatal critical care setting.	3	10	240	$850	$851.2K
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	2	10	3,260	$80	$701.3K
99478	The provider directs the care of a recovering low birthweight infant, whose current weight is less than 1500 grams.	3	10	1,420	$140	$254.3K
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…	85	250	420	$50	$133K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	4	80	220	$70	$103.1K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	168	400	470	$30	$97.1K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	6	200	170	$50	$60.5K

Showing 1–10 of 15

Related Providers

Other providers that share a Tax Identification Number (TIN) with Usa Health Physician Billing Services LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
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	Pediatrics Physician	$0	$11M
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

Nearby Providers

Other providers in the same ZIP code as Usa Health Physician Billing Services LLC, ranked by combined Medicare and Medicaid revenue.

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

Sign up for Usa Health Physician Billing Services LLC — Billing Profile & Reimbursement Data policy alerts

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

Sign up for Usa Health Physician Billing Services LLC — Billing Profile & Reimbursement Data policy alerts

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