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.

Premier Health Management, Inc. (NPI 1538154760)

Field	Value
Entity Type	Organization
Organization	Premier Health Management, Inc.
Address	2880 Dauphin St
City	Mobile
State	AL
ZIP	36606
Taxonomy	Ophthalmology Physician
NPI Enumerated	September 14, 2005

Payer Source	Total Paid
Medicaid	$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.

34 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…	16,340	$40	$670K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	4,830	$80	$376.4K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	1,920	$180	$353.8K
99203	The provider sees a new 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 provider…	4,390	$60	$281K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	2,750	$80	$217.3K
V2020	Frames, purchases	1,230	$100	$116.7K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	2,130	$50	$114.8K
92567	In this procedure, the provider measures the functioning of the middle ear by varying the pressure of air presented to the ear to identify the reason for hearing loss.	6,240	$20	$106.1K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	2,210	$40	$84K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	170	$430	$71.1K

Showing 1–10 of 34

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

Premier Health Management, Inc. — 5 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

34 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…	810	1,990	680	$60	$201.7K
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…	88	120	170	$160	$200.7K
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…	142	1,990	560	$40	$185.6K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	8	60	320	$130	$176.1K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	9	40	40	$380	$123.8K
86003	The lab analyst performs the technical lab test to analyze a specimen such as serum for allergen–specific immunoglobulin E (IgE), using a crude allergen extract. The test result is quantitative or…	5	10	170	$40	$102K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	16	30	350	$100	$91.2K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	86	330	720	$50	$85.5K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	2	90	160	$100	$75.1K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	26	320	400	$70	$70.3K

Showing 1–10 of 34

Related Providers

Other providers that share a Tax Identification Number (TIN) with Premier Health Management, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mark Douglas	AL	Ophthalmology Physician	$2.1M	$0
Henry Semple	AL	Ophthalmology Physician	$2M	$0
Stuart Ball	AL	Ophthalmology Physician	$1.3M	$0
Mark Gacek	AL	Otolaryngology Physician	$244.7K	$0
Curtis Graf	AL	Ophthalmology Physician	$242.9K	$0
Ryan Burton	AL	Ophthalmology Physician	$240.4K	$0
Joseph Turner	AL	Ophthalmology Physician	$239.7K	$0
Jay Brown	AL	Ophthalmology Physician	$211.9K	$0
Charles Salisbury	AL	Ophthalmology Physician	$199.6K	$0
Charles Mosteller	AL	Ophthalmology Physician	$197.9K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mobile Bay Dental, LLC	AL	General Practice Dentistry	$0	$3.6M
Scott Freeman	AL	MOHS-Micrographic Surgery Physician	$2.9M	$0
Lifeguard Ambulance Service LLC	AL	Land Ambulance	$414.6K	$2.2M
Rehab Medical, LLC	AL	Durable Medical Equipment & Medical Supplies	$0	$1.9M
Mobile Bay Vision, LLC	AL	Optometrist	$0	$1.8M
Surgicare Of Mobile Ltd	AL	Ambulatory Surgical Clinic/Center	$1.5M	$101.9K
Sleep Management, L.L.C.	AL	Oxygen Equipment & Supplies (DME)	$0	$1.5M
Odyssey Healthcare Operating B, LP	AL	Community Based Hospice Care Agency	$0	$1.4M
Lincare Inc.	AL	Oxygen Equipment & Supplies (DME)	$0	$1.4M
Vital Smiles Alabama PC	AL	Health Maintenance Organization	$0	$1.3M

Premier Health Management, Inc. — Billing Profile & Reimbursement Data

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Premier Health Management, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References