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NPI 1356377576 · Birmingham, AL · Pediatrics Physician
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University Of Alabama Health Services Foundation, PC is a pediatrics physician provider located in Birmingham, Alabama. This profile covers 0 Medicare and 68 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | University Of Alabama Health Services Foundation, PC |
| Address | 1600 7th Ave S |
| City | Birmingham |
| State | AL |
| ZIP | 35233 |
| Taxonomy | Pediatrics Physician |
| NPI Enumerated | June 23, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $79.6M |
| Medicare | $0 |
This provider reports no Medicare billing on file and $79.6M in lifetime Medicaid revenue, indicating its fiscal activity in these datasets is effectively single-payer and concentrated in Medicaid rather than split across Medicare and Medicaid. Analysts should treat Medicare comparisons as not applicable for this NPI because Total Medicare revenue: none (no Medicare billing on file).
Revenue concentration is high: the precomputed top-3 Medicaid codes (99284, 99214, 99285) account for 57.5% of the provider's total Medicaid revenue, with 99284 generating $18.5M (23.7%), 99214 $14.9M (19.1%), and 99285 $11.4M (14.6%). This level of concentration means a small set of E/M codes drive the majority of the Medicaid dollars for this entity.
The code mix reflects a large, high-volume clinical operation with heavy emergency and outpatient E/M activity: top contributors include emergency department codes 99284 and 99285 and outpatient E/M codes 99214 and 99215. Coupled with substantial inpatient and consultation codes (for example 99232, 99233, 99222, 99223, 99254/99255) the profile is consistent with an organization that provides ED care, inpatient management, consult services, and time-intense outpatient visits rather than a narrow ambulatory clinic.
Competitive standing in-state is dominant for multiple high-value codes: 99284 ranks #3 of 238 providers in Alabama (99th percentile; extreme outlier), 99214 ranks #5 of 1990 providers (100th percentile; extreme outlier), and 99215 ranks #1 of 334 providers (100th percentile; extreme outlier). These rank and percentile positions indicate the provider is a major Medicaid volume leader in Alabama for both ED and complex outpatient E/M services.
Not all high-revenue codes are uniformly unusual for the state: 99285 (high-acuity ED E/M) is $11.4M and ranks #7 of 193 providers (97th percentile) and is described as typical, unremarkable volume for this code, showing that some high-acuity ED work is within expected state-level volumes even while total ED throughput is exceptional. Analysts should separate dominance in volume (rank/percentile) from whether a code’s volume is characterized as an outlier.
The presence and state-leading ranks of procedural and diagnostic codes beyond E/M suggest broad service lines: 43239 (EGD with biopsy) generates $1.2M and ranks #1 of 64 providers (100th percentile; extreme outlier), 95720 (prolonged EEG review) generates $1M and ranks #1 of 5 providers (100th percentile), and 88189 (flow cytometry interpretation) generates $191.4K and ranks #1 of 4 providers (100th percentile). These items indicate the organization bills high-volume procedural and specialty diagnostic services in addition to core E/M work.
Given the provider taxonomy of Pediatrics Physician and the inclusion of pediatric-specific codes such as 99472 (follow-up care of a critically ill infant) at $1.8M, the operational footprint likely includes pediatric inpatient critical care and specialty pediatric services; the code mix supports a pediatric-focused hospital or large multi-site pediatric practice handling both routine and complex cases.
The NPI has been enumerated since 2006-06-23 (~20 years ago), indicating long tenure in the market; combined with the high-volume, top-ranked code usage, this suggests an established, institution-scale provider rather than a recently created or small independent practice.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
68 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. | 107,030 | $170 | $18.5M |
| 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… | 118,600 | $130 | $14.9M |
| 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. | 44,780 | $260 | $11.4M |
| 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… | 27,920 | $170 | $4.6M |
| 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. | 50,370 | $90 | $4.6M |
| 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… | 39,920 | $90 | $3.7M |
| 99244 | The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider… | 16,870 | $210 | $3.6M |
| 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… | 19,970 | $130 | $2.5M |
| 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. | 3,500 | $500 | $1.8M |
| 99291 | Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is… | 4,720 | $350 | $1.7M |
Showing 1–10 of 68
How this provider's Medicaid billing volume and revenue compare to other Alabama providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Alabama median
68 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. | 5 | 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. | 12 | 10 | 1,820 | $350 | $3.2M |
| 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. | 3 | 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. | 7 | 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. | 9 | 230 | 5,160 | $40 | $474.1K |
| 95951 | N/A | 2 | 10 | 580 | $480 | $386.2K |
| 95720 | A physician or other QHCP reviews recorded events and analyzes spike and seizure detection of a continuous electroencephalography, a study of the electrical activity of the brain. A video is… | 1 | 10 | 360 | $190 | $347.6K |
| 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… | 113 | 120 | 500 | $50 | $317.7K |
| 95782 | A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters. | 1 | 10 | 820 | $350 | $257.1K |
| 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… | 5 | 1,990 | 680 | $60 | $201.7K |
Showing 1–10 of 68
Other providers in the same ZIP code as University Of Alabama Health Services Foundation, PC, ranked by combined Medicare and Medicaid revenue.
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