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.

Focus, Inc (NPI 1407112329)

Field	Value
Entity Type	Organization
Organization	Focus, Inc
Address	3930-f Airport Blvd
City	Mobile
State	AL
ZIP	36608
Taxonomy	Adolescent Medicine (Internal Medicine) Physician
NPI Enumerated	April 4, 2012

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	14,580	$60	$860.3K
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…	6,070	$40	$230.7K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	21,390	$1	$85.6K
96132	The provider, a physician or other qualified healthcare professional, spends up to one hour administering neuropsychological tests, which includes time spent face–to–face with the patient in…	800	$80	$64.1K
Q3014	Telehealth originating site facility fee	1,860	$20	$35.4K
99204	The provider sees a new 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 provider…	240	$100	$25K
96138	A technician administers two or more psychological or neuropsychological tests and scores them. Report this code for the first 30 minutes of administration and scoring by any method.	770	$20	$17.7K
96120	N/A	260	$60	$14.7K
96119	N/A	260	$50	$13.5K
99205	The provider sees a new 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 provider…	20	$140	$2K

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

Focus, Inc — 1 of 10 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

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	101	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…	309	1,990	560	$40	$185.6K
99204	The provider sees a new 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 provider…	155	630	60	$80	$45.8K
96132	The provider, a physician or other qualified healthcare professional, spends up to one hour administering neuropsychological tests, which includes time spent face–to–face with the patient in…	7	20	210	$60	$41.1K
99205	The provider sees a new 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 provider…	134	160	70	$200	$39K
Q3014	Telehealth originating site facility fee	15	60	630	$10	$19.1K
96138	A technician administers two or more psychological or neuropsychological tests and scores them. Report this code for the first 30 minutes of administration and scoring by any method.	9	30	210	$20	$9.7K
96119	N/A	3	10	220	$30	$6.8K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	4	190	350	$1	$6.8K
96120	N/A	3	10	150	$20	$5.5K

Nearby Providers

Other providers in the same ZIP code as Focus, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Medical Group, P.A.	AL	Specialist	$0	$7.4M
Coast Diagnostics, LLC	AL	Clinical Medical Laboratory	$275.1K	$5.7M
Springhill Hospitals, Inc	AL	General Acute Care Hospital	$0	$5.3M
Pulmonary Associates Of Mobile PC	AL	Pulmonary Disease Physician	$0	$5.3M
Providence Hospital	AL	General Acute Care Hospital	$0	$4.8M
Alabama Providence Healthcare Services	AL	Internal Medicine Physician	$0	$4.7M
University Of South Alabama Health Care Authority	AL	Internal Medicine Physician	$0	$3.9M
Mobile Emergency Physicians, LLC	AL	Emergency Medicine Physician	$0	$3.3M
Imc-pediatric & Adolescent Medicine, LLC	AL	Pediatric Adolescent Medicine Physician	$0	$3.3M
Springhill Emergency Physicians, PC	AL	Emergency Medicine Physician	$0	$3.2M

Focus, Inc — Billing Profile & Reimbursement Data

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Focus, Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References