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.

Tombigbee Healthcare Authority (NPI 1487291761)

Tombigbee Healthcare Authority is a rural health clinic/center provider located in Demopolis, Alabama. This profile covers 0 Medicare and 53 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Tombigbee Healthcare Authority
Address	203 Us Highway 80 W
City	Demopolis
State	AL
ZIP	36732
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	December 5, 2019

Payer Source	Total Paid
Medicaid	$1.7M
Medicare	$0

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

53 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	28,460	$60	$1.6M
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…	13,070	$10	$65.4K
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…	14,420	$1	$43.3K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	7,560	$1	$7.6K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	3,470	$1	$3.5K
83036	Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…	1,950	$1	$1.9K
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…	20	$90	$1.8K
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…	30	$50	$1.5K
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,…	200	$10	$1.4K
92552	The provider assesses a patient’s hearing with a series of tones at varying intensities to identify the lowest threshold at which the patient can hear.	300	$1	$1.2K

Showing 1–10 of 53

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

Tombigbee Healthcare Authority — 1 of 17 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

53 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	54	240	6,820	$120	$2.9M
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…	117	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…	260	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…	155	1,990	560	$40	$185.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	201	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…	40	300	210	$40	$77.9K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	133	370	1,540	$10	$65K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	81	230	410	$40	$59.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	202	300	330	$50	$56.3K
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…	496	630	60	$80	$45.8K

Showing 1–10 of 53

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tombigbee Healthcare Authority	AL	General Acute Care Hospital	$0	$1.5M
Tombigbee Healthcare Authority	AL	Specialist	$0	$1.3M
Douglas Tucker	MS	Anesthesiology Physician	$352K	$0
James Proctor	AL	Interventional Cardiology Physician	$340.8K	$0
Macy Smith	AL	Clinical Cardiac Electrophysiology Physician	$282.7K	$0
Mohamed Hassan	AL	Internal Medicine Physician	$264.3K	$0
John Eagan	AL	Cardiovascular Disease Physician	$254.9K	$0
Ashvini Sengar	AL	Hematology & Oncology Physician	$253.9K	$0
Alejandro Garcia	AL	Hematology & Oncology Physician	$230.4K	$0
Sanjeev Hasabnis	AL	Clinical Cardiac Electrophysiology Physician	$210.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Icare LLC	AL	Optometrist	$0	$8.5M
Comfort Care Hospice, LLC	AL	Community Based Hospice Care Agency	$0	$1.6M
Dva Healthcare Renal Care Inc	AL	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.3M
Bb&h Wellness Services	AL	Community/Behavioral Health Agency	$0	$1.2M
Michael Cappelli	AL	Radiation Oncology Physician	$291.6K	$0
Air Evac Ems Inc	AL	Air Ambulance	$213.1K	$19.4K
Ronnie Chu	AL	Family Medicine Physician	$174.8K	$0
Gregory Green	AL	Optometrist	$110.8K	$0
Archie Hooper	AL	Family Medicine Physician	$106.7K	$0
Keith Dismukes	AL	Family Medicine Physician	$85.5K	$0

Tombigbee Healthcare Authority — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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