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.

Central North Alabama Health Services, Inc. (NPI 1407891336)

Field	Value
Entity Type	Organization
Organization	Central North Alabama Health Services, Inc.
Address	751 Pleasant Row Nw
City	Huntsville
State	AL
ZIP	35816
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	June 17, 2006

Payer Source	Total Paid
Medicaid	$14.8M
Medicare	$0

Key Findings

CENTRAL NORTH ALABAMA HEALTH SERVICES, INC. is effectively a Medicaid-centric operator: Total Medicaid revenue on file is $14.8M while Medicare shows none (no Medicare billing on file), indicating a single-payer footprint in the available claims universe rather than a split Medicare/Medicaid mix. This payer concentration should shape benchmarking and payment risk assessments for the entity.

Revenue is extremely concentrated in a single encounter code: the precomputed top 3 Medicaid codes by revenue account for 99.2% of this provider's total Medicaid revenue, led by T1015 which alone contributes $14.5M revenue (98.0% of this provider's total Medicaid revenue). The next two codes in the top three are D9430 ($140.6K revenue, 1.0%) and 90651 ($29.1K revenue, 0.2%), so changes to reimbursement or utilization of T1015 would materially affect overall revenue.

The code mix and volumes point to a Federally Qualified Health Center operating as a high-throughput primary care and preventive clinic: T1015 (T1015 – Clinic visit/encounter, all-inclusive) shows 109K claims at $133 avg paid/claim, which aligns with bundled clinic encounter billing typical of FQHCs. The significant counts for vaccine codes (for example, 90686 with 3.5K claims and 90651 with 2.2K claims) indicate routine immunization services as a steady ancillary service line supporting the clinic workload.

CENTRAL NORTH ALABAMA ranks as a major in-state provider for its principal clinic encounter code: T1015 ranks #12 of 243 providers in-state (95th percentile; notably above typical state volume for this code), signaling market leadership in bundled clinic visit volume among Alabama peers. That standing suggests the organization is a prominent Medicaid service site for basic ambulatory care in its region.

Other codes show more modest or typical participation despite high percentiles for immunization services. D9430 ranks #8 of 25 providers in-state (71th percentile; typical, unremarkable volume for this code), while 90651 ranks #16 of 209 providers in-state (93th percentile; typical, unremarkable volume for this code) and 90686 ranks #27 of 363 providers in-state (93th percentile; typical, unremarkable volume for this code), indicating the provider participates meaningfully in vaccine delivery but without those codes driving material revenue compared with T1015.

The extreme dependence on a single revenue driver creates concentrated reimbursement exposure: with T1015 representing $14.5M of the $14.8M Medicaid total, payer policy changes, audit focus on bundled clinic encounter billing, or shifts in Medicaid enrollment could disproportionately affect the provider’s financials. Analysts should weight scenario testing and reserve planning toward variations in T1015 utilization and payment.

Operational tenure and scale considerations support an established local presence: the provider’s NPI was enumerated 2006-06-17 (~20 years ago), and the 109K T1015 claims volume indicates sustained patient throughput over time rather than a recent spike. This longevity combined with high encounter volumes is consistent with an established community health center role in Huntsville, AL.

The clinical footprint is heavily primary care and preventive-service oriented rather than procedure-driven: beyond T1015, the next-highest revenue items are dental/ancillary (D9430) and routine vaccines (multiple CPTs including 90651, 90686, 90670, 90734), which together represent the operational mix of bundled clinic visits plus preventive immunizations and some dental/ancillary services. For competitive or network planning, this profile signals capacity in ambulatory access and immunization programs rather than specialty procedural depth.

Medicaid: Complete Services Breakdown

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

98 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	108,960	$130	$14.5M
D9430	N/A	1,290	$110	$140.6K
90651	This code represents a nonavalent human papillomavirus (HPV) vaccine product administered into the muscle to protect against HPV infection. The vaccine protects against nine HPV types (6, 11, 16, 18,…	2,240	$10	$29.1K
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…	3,530	$10	$28.2K
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…	1,980	$10	$19.8K
90734	The provider administers a meningococcal conjugate vaccine in a diphtheria toxoid carrier (MenACWY–D) or CRM197 carrier (MenACWY–CRM) to protect the patient from four strains of meningococcal viruses…	1,300	$10	$15.6K
90633	This code represents a vaccine product administered into a muscle to protect against hepatitis A, a liver infection. This code is specific to a pediatric/adolescent dosage with a two–dose schedule.	1,710	$10	$13.7K
90723	The provider administers a combination inactivated vaccine intramuscularly to prevent multiple diseases, including diphtheria, tetanus, acellular pertussis, hepatitis B, and polio.	930	$10	$7.5K
90648	This code represents a Haemophilus influenzae type b (Hib) vaccine product administered into the muscle to protect against Hib disease. This formulation uses a PRP–T conjugate and follows a four–dose…	760	$10	$6.1K
90681	This code represents a live, weakened rotavirus vaccine given by mouth in a two–dose schedule to protect against rotavirus infection.	540	$10	$4.8K

Showing 1–10 of 98

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

Central North Alabama Health Services, Inc. — 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

98 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	12	240	6,820	$120	$2.9M
D9430	N/A	8	30	230	$130	$533.9K
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…	29	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…	45	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…	34	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…	118	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…	95	300	1,160	$50	$147.8K
D1120	Prophylaxis–child	350	520	810	$30	$104.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	54	320	640	$50	$98.1K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	147	300	210	$40	$77.9K

Showing 1–10 of 98

Nearby Providers

Other providers in the same ZIP code as Central North Alabama Health Services, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
J Taylor Dmd PC	AL	General Practice Dentistry	$0	$4.2M
Huntsville West Dental, PC	AL	Dental Clinic/Center	$0	$2.1M
Bhg Lxix, LLC	AL	Substance Use Disorder Rehabilitation Clinic/Center	$279.6K	$0
Michael Johnson	AL	Family Medicine Physician	$115K	$0
Billy Rippy	AL	Chiropractor	$10.8K	$0

Central North Alabama Health Services, Inc. — Billing Profile & Reimbursement Data

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Central North Alabama Health Services, Inc. — 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

Nearby Providers

Frequently Asked Questions

References