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.

Primary Care Clinic (NPI 1306967427)

Field	Value
Entity Type	Organization
Organization	Primary Care Clinic
Address	1616 6th Ave S
City	Birmingham
State	AL
ZIP	35233
Taxonomy	Pediatrics Physician
NPI Enumerated	April 3, 2007

Payer Source	Total Paid
Medicaid	$1.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

37 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	12,100	$100	$1.1M
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…	2,430	$130	$320.9K
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…	1,450	$60	$88.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,430	$60	$82.8K
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…	1,120	$60	$70.5K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	3,470	$10	$31.2K
99173	The provider checks the eyesight in both eyes of a pediatric patient by asking him to read letters of varying sizes on a standard chart, such as a Snellen’s chart, which he keeps 20 feet away from…	7,190	$1	$28.8K
92551	The provider delivers a limited series of tones or sounds to a patient to determine if the patient’s hearing is in an acceptable range to detect hearing problems.	6,380	$1	$25.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	400	$60	$23.9K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	580	$20	$12.2K

Showing 1–10 of 37

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

Primary Care Clinic — 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

37 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.	11	10	140	$480	$4.8M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	122	180	100	$120	$381.8K
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…	537	1,990	680	$60	$201.7K
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…	179	1,990	560	$40	$185.6K
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…	142	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…	136	300	1,160	$50	$147.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	120	320	640	$50	$98.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	143	300	330	$50	$56.3K
88189	The clinician, typically a pathologist, interprets flow cytometry results of 16 or more markers.	4	10	140	$60	$51.8K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	138	260	910	$20	$47.2K

Showing 1–10 of 37

Related Providers

Other providers that share a Tax Identification Number (TIN) with Primary Care Clinic, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Uahsf Neonatology	AL	Neonatal-Perinatal Medicine Physician	$0	$94M
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
University Of Alabama At Birmingham	AL	General Acute Care Hospital	$0	$19.2M
University Of Alabama Health Services Foundation PC	AL	Clinic/Center	$0	$18.6M
Medical West Hospital Authority, An Affiliate Of Uab Health System	AL	General Acute Care Hospital	$0	$11.4M
University Of Alabama Ophthalmology Services Foundation	AL	Ophthalmology Physician	$0	$6.9M
University Of Alabama At Birmingham	AL	Clinical Medical Laboratory	$2.9K	$3.2M
Chelsea Cockrell	MS	Family Nurse Practitioner	$3M	$0
Jay Glover	TN	Retina Specialist (Ophthalmology) Physician	$2.9M	$0

Nearby Providers

Other providers in the same ZIP code as Primary Care Clinic, 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
The Children's Hospital Of Alabama	AL	Children's Hospital	$0	$59M
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
Jefferson County Board Of Health	AL	Public Health or Welfare Agency	$0	$12.2M
The Children's Hospital Of Alabama	AL	Psychologist	$0	$12M
The Children's Hospital Of Alabama	AL	Pediatrics Physician	$0	$7.5M
Pediatric Anesthesia Associates PC	AL	Anesthesiology Physician	$0	$7.2M
Pediatric Radiology Associates PC	AL	Pediatric Radiology Physician	$0	$6.8M

Primary Care Clinic — Billing Profile & Reimbursement Data

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Primary Care Clinic — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References