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 1588690085)

Tombigbee Healthcare Authority is a general acute care hospital provider located in Demopolis, Alabama. This profile covers 0 Medicare and 102 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	105 Us Highway 80 E
City	Demopolis
State	AL
ZIP	36732
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 25, 2006

Payer Source	Total Paid
Medicaid	$1.5M
Medicare	$0

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

102 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	24,410	$30	$829.9K
87631	The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,…	2,080	$60	$120.6K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	8,470	$10	$67.7K
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…	8,920	$10	$62.4K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	570	$90	$51.7K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	2,840	$20	$51.1K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	1,860	$20	$42.7K
87430	The lab analyst performs an assay to evaluate the patient’s sample for antigens to Streptococcus, group A, using an immunoassay method, such as EIA.	2,000	$10	$28K
87070	The lab analyst performs the technical lab steps to culture a specimen from any source except urine, blood, or stool. This service involves aerobic culture, which refers to the presence of oxygen.…	2,820	$10	$25.4K
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…	580	$40	$21.3K

Showing 1–10 of 102

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 — 2 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

102 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	32	40	1,020	$40	$865.2K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	192	240	4,820	$60	$807.6K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	183	190	1,480	$100	$730.7K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	188	230	5,160	$40	$474.1K
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	74	90	500	$40	$303.6K
87631	The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,…	8	30	1,030	$40	$254.2K
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…	1,648	1,990	680	$60	$201.7K
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…	60	80	300	$10	$159.1K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	68	100	610	$40	$152.5K
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…	40	130	260	$10	$124.7K

Showing 1–10 of 102

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tombigbee Healthcare Authority	AL	Rural Health Clinic/Center	$0	$1.7M
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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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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