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.

Simon-williamson Clinic, P.C. (NPI 1497702344)

Simon-williamson Clinic, P.C. is a internal medicine physician provider located in Birmingham, Alabama. This profile covers 0 Medicare and 103 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	Simon-williamson Clinic, P.C.
Address	832 Princeton Ave Sw
City	Birmingham
State	AL
ZIP	35211
Taxonomy	Internal Medicine Physician
NPI Enumerated	May 27, 2006

Payer Source	Total Paid
Medicaid	$3.6M
Medicare	$0

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

103 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	18,610	$60	$1.1M
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…	10,600	$80	$826.6K
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…	4,160	$70	$270.5K
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…	3,710	$70	$248.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3,520	$70	$228.5K
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…	4,450	$20	$80.1K
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.	1,010	$60	$59.7K
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…	2,770	$20	$55.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	890	$60	$54.9K
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…	1,160	$40	$50K

Showing 1–10 of 103

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

Simon-williamson Clinic, P.C. — 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

103 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	53	80	150	$1,540	$787.7K
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	53	90	500	$40	$303.6K
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…	146	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…	124	1,990	560	$40	$185.6K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	25	60	320	$130	$176.1K
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…	63	270	1,360	$60	$159.7K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	75	80	300	$10	$159.1K
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…	60	300	1,160	$50	$147.8K
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…	74	250	420	$50	$133K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	54	130	260	$10	$124.7K

Showing 1–10 of 103

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michael Garcia	AL	Medical Oncology Physician	$924.5K	$0
Maura Kennedy	AL	Rheumatology Physician	$686.3K	$0
Joelle Hamilton	AL	Medical Oncology Physician	$272K	$0
Matthew Purcell	AL	Urology Physician	$106K	$0
Gregory Cagle	SD	Physical Therapist	$103.8K	$0
Bruce Tucker	AL	Infectious Disease Physician	$95.6K	$0
Randall Real	AL	Otolaryngology Physician	$72.3K	$0
Harold Thomas	AL	Neurology Physician	$53.1K	$0
Charles Fagan	AL	Neurology Physician	$50.7K	$0
Stefanie Fieno	AL	Women's Health Nurse Practitioner	$9.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lifeguard Ambulance Service LLC	AL	Land Ambulance	$1.3M	$1.8M
Bbh Pbmc, LLC	AL	General Acute Care Hospital	$0	$3.1M
Farrell Mendelsohn	AL	Cardiovascular Disease Physician	$1.3M	$0
Simon Williamson Clinic Pediatrics PC	AL	Pediatrics Physician	$0	$1M
David Sibley	AL	Cardiovascular Disease Physician	$627.4K	$0
Hutton Brantley	AL	Cardiovascular Disease Physician	$552.2K	$0
Vasudeva Goli	AL	Cardiovascular Disease Physician	$454K	$0
Jason Tsai	AL	Nephrology Physician	$448K	$0
Thomas Cawthon	AL	Cardiovascular Disease Physician	$410.6K	$0
Ariana Diamond	AL	Ophthalmology Physician	$284.1K	$0

Simon-williamson Clinic, P.C. — Billing Profile & Reimbursement Data

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Simon-williamson Clinic, P.C. — 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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