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.

Alabama Children's Clinic (NPI 1578962932)

Alabama Children's Clinic is a pediatrics physician provider located in Huntsville, Alabama. This profile covers 0 Medicare and 59 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	Alabama Children's Clinic
Address	333 Whitesport Dr Sw
City	Huntsville
State	AL
ZIP	35801
Taxonomy	Pediatrics Physician
NPI Enumerated	August 21, 2014

Payer Source	Total Paid
Medicaid	$4M
Medicare	$0

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

59 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…	28,100	$60	$1.7M
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…	8,800	$80	$739.4K
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…	4,700	$60	$286.8K
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…	4,430	$60	$265.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3,980	$50	$211K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,670	$50	$125.6K
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	2,210	$30	$75.2K
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…	3,630	$20	$65.3K
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…	3,200	$20	$57.5K
90723	The provider administers a combination inactivated vaccine intramuscularly to prevent multiple diseases, including diphtheria, tetanus, acellular pertussis, hepatitis B, and polio.	2,270	$20	$40.9K

Showing 1–10 of 59

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

Alabama Children's Clinic — 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

59 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…	177	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…	75	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…	51	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…	53	300	1,160	$50	$147.8K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	76	80	220	$70	$103.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	42	320	640	$50	$98.1K
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…	271	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.	104	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.	36	300	330	$50	$56.3K
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…	46	260	910	$20	$47.2K

Showing 1–10 of 59

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tennessee Valley Neonatology, Inc	AL	Neonatal-Perinatal Medicine Physician	$0	$22.2M
The Health Care Authority Of The City Of Huntsville	AL	General Acute Care Hospital	$0	$17.8M
Happi Health	AL	Federally Qualified Health Center (FQHC)	$0	$17.6M
Emergency Physicians Group	AL	Emergency Medicine Physician	$0	$13.5M
Healthgroup Of Alabama	AL	Contractor	$0	$13.4M
The Valley Foundation	AL	Multi-Specialty Clinic/Center	$0	$11.3M
David White	AL	Neurology Physician	$7M	$0
The Children's Hospital Of Alabama	AL	Pediatric Pulmonology Physician	$0	$5.6M
Huntsville Pediatric Associates, LLC	AL	Pediatrics Physician	$0	$4.8M
Dental Associates Of Huntsville, LLC	AL	General Practice Dentistry	$0	$4.7M

Alabama Children's Clinic — Billing Profile & Reimbursement Data

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Alabama Children's Clinic — 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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References