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.

Cahaba Medical Care Foundation (NPI 1316201809)

Field	Value
Entity Type	Organization
Organization	Cahaba Medical Care Foundation
Address	195 Hospital Dr
City	Centreville
State	AL
ZIP	35042
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	June 28, 2012

Payer Source	Total Paid
Medicaid	$68.6M
Medicare	$0

Key Findings

CAHABA MEDICAL CARE FOUNDATION is registered as a Federally Qualified Health Center (FQHC) in CENTREVILLE, AL with an NPI enumerated 2012-06-28 (~14 years ago). The provider reports $68.6M in lifetime Medicaid revenue and has no Medicare billing on file, making its financial footprint effectively single-payer (Medicaid)-centric in the available claims data.

Revenue is extremely concentrated: the precomputed top-3 Medicaid codes account for 99.9% of the provider’s total Medicaid revenue, and a single code, T1015, represents 97.0% of Medicaid receipts ($66.6M of $68.6M). This degree of concentration indicates that nearly all billed Medicaid dollars are captured through the clinic visit/encounter mechanism represented by T1015.

The code mix is consistent with an FQHC operating as a primary care-oriented outpatient clinic: T1015 (clinic visit/encounter, all-inclusive) is the dominant revenue driver and aligns with bundled encounter payments common in community health centers. High counts of vaccine and lab codes (e.g., 90686, 90688, 87811) appear as minor ancillary services, indicating routine preventive and point-of-care testing activity supplementing the core visit-based business.

T1015 is a statewide outlier by volume: it ranks #2 of 243 providers in-state (100th percentile; extreme outlier) with 346.8K claims at $192 avg paid/claim generating $66.6M. That ranking positions the provider as one of the largest users of the T1015 encounter code in Alabama, signalling a dominant role in state Medicaid encounter-based primary care.

Secondary revenue contributors are much smaller in scale but identifiable: D9430 (no description available) accounts for $2M (2.9% of Medicaid revenue) across 9.9K claims at $198 avg paid/claim and ranks #4 of 25 providers in-state (88th percentile). Q3014 (telehealth originating site facility fee) is present but immaterial to overall revenue at $23.7K (1.4K claims, $17 avg paid/claim) and ranks #17 of 55 providers in-state (70th percentile), indicating some telehealth activity but not a meaningful revenue stream.

Operationally, there is a notable billing pattern where common E/M CPTs show very high claim volumes but report $0 revenue: 99213 has 112.7K claims and 99214 has 109K claims with $0 avg paid/claim and $0 revenue. Those same E/M codes rank as extreme volume outliers in-state (#4 and #6 respectively, 100th percentile), which, together with the dominance of T1015, suggests that reimbursement is being captured primarily under the encounter code rather than the individual E/M fee-for-service codes in the Medicaid data.

Ancillary preventive services and vaccinations are consistently present but small contributors: multiple influenza and pneumococcal vaccine codes (90686, 90688, 90674, 90656, 90670, etc.) appear in the top code list with modest revenue (e.g., 90686 at $22.8K, 90688 at $11.8K) and generally occupy middle-to-upper percentiles in-state. This pattern supports a service model focused on routine primary care and preventive outreach typical of FQHCs rather than specialty or procedural lines of business.

From a risk and competitive perspective, the provider’s heavy dependence on Medicaid encounter payments (T1015 at 97.0% of Medicaid revenue) creates exposure to state Medicaid policy and encounter-rate changes but also establishes it as a significant Medicaid primary care provider in Alabama given the extreme outlier status on key visit metrics. The combination of long tenure (~14 years), FQHC taxonomy, and statewide leading volumes for encounter billing indicates a mature, high-volume community health center whose financial performance is tightly coupled to Medicaid encounter reimbursement structures.

Medicaid: Complete Services Breakdown

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

80 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	346,760	$190	$66.6M
D9430	N/A	9,950	$200	$2M
Q3014	Telehealth originating site facility fee	1,400	$20	$23.7K
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…	2,070	$10	$22.8K
90688	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It uses split virus technology and is given as a 0.5 mL dose.	980	$10	$11.8K
90674	This code represents a flu vaccine product that protects against four strains of influenza. It is derived from cell cultures, contains no preservatives or antibiotics, and is administered as a 0.5 mL…	190	$20	$4.1K
90656	This code represents a preservative–free trivalent influenza vaccine product containing split virus components. It is administered into the muscle in a 0.5 mL dosage.	340	$10	$2.4K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	1,950	$1	$2K
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.	950	$1	$1.9K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	130	$10	$1.8K

Showing 1–10 of 80

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

Cahaba Medical Care Foundation — 1 of 22 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

80 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	2	240	6,820	$120	$2.9M
D9430	N/A	4	30	230	$130	$533.9K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	254	380	440	$90	$362K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	22	120	500	$50	$317.7K
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…	6	1,990	680	$60	$201.7K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	21	330	140	$240	$197.4K
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…	4	1,990	560	$40	$185.6K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	54	110	240	$60	$175.6K
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…	177	270	1,360	$60	$159.7K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	15	50	380	$90	$157.3K

Showing 1–10 of 80

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
John Waits	AL	Surgery Physician	$178.6K	$0
Max Mam	GA	Diagnostic Radiology Physician	$61.6K	$0
Gwen Williams	AL	Rheumatology Physician	$40.5K	$0
Mason Helman	AL	Physician Assistant	$36.6K	$0
Reshu Saini	AL	Diagnostic Radiology Physician	$30.3K	$0

Nearby Providers

Other providers in the same ZIP code as Cahaba Medical Care Foundation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Bibb County Healthcare Authority	AL	Rural Health Clinic/Center	$0	$4.1M
Corey Mayer	AL	Family Medicine Physician	$15.5K	$0
Johnstone Hollis	AL	Family Medicine Physician	$10.6K	$0
George Hipp	AL	Emergency Medicine Physician	$9.4K	$0

Cahaba Medical Care Foundation — Billing Profile & Reimbursement Data

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Cahaba Medical Care Foundation — 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