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.

Uahsf Neonatology (NPI 1619987302)

Key Findings

Field	Value
Entity Type	Organization
Organization	Uahsf Neonatology
Address	525 Nhb
City	Birmingham
State	AL
ZIP	35249
Taxonomy	Neonatal-Perinatal Medicine Physician
NPI Enumerated	August 8, 2006

Payer Source	Total Paid
Medicaid	$94M
Medicare	$0

UAHSF NEONATOLOGY reports no Medicare billing on file and $94M in lifetime Medicaid revenue, making its Medicare presence effectively nil and its operations overwhelmingly Medicaid-funded. This profile identifies the practice as functionally single-payer (Medicaid) in scale, concentrating reimbursement and payer exposure on state Medicaid policy and rates rather than diversified federal payers.

Revenue concentration is high: the precomputed top three Medicaid codes account for 73.2% of total Medicaid revenue, with a single code, 99472, representing 43.4% of the provider’s Medicaid revenue. That level of concentration indicates that a small set of neonatal critical-care services drives the majority of cash flow and creates potential revenue vulnerability to changes in reimbursement or utilization for those specific codes.

The code mix is strongly neonatal critical-care–focused. The top revenue drivers are 99472 (74.1K claims, $40.8M revenue), 99469 (31K claims, $17M revenue), and 99479 (65K claims, $11M revenue), which together reflect ongoing inpatient neonatal critical care, directed care of recovering low-birth-weight infants, and subsequent neonatal critical-care follow-up rather than ambulatory primary care or outpatient specialties. This pattern is consistent with a hospital-based NICU service line that handles high-acuity neonatal patients across initial and subsequent critical-care encounters.

Operational scale is substantial based on claim volumes and high-complexity E/M activity: 99472 has 74.1K claims and 99233 shows 77K claims ($10.9M revenue) with the latter describing high-complexity subsequent inpatient visits (≥50 minutes). Those volumes imply sustained throughput of critically ill infants and frequent intensive, time-consuming inpatient encounters, supporting a large, continuous NICU workload rather than episodic or low-acuity pediatric care.

On competitive standing within the state, UAHSF NEONATOLOGY is a dominant participant for multiple neonatal codes. It ranks #1 of 12 providers for 99472 (100th percentile; labeled an extreme outlier) and #1 of 245 providers for 99233 (100th percentile; extreme outlier), while also ranking #2 for 99469 and 99479 (both 92th percentile), indicating the practice operates well above typical state volume for key NICU services and is a major statewide provider in its specialty.

Several individual codes are flagged as statistical outliers or notably above typical state volume, reinforcing the provider’s atypical scale for neonatal services: 99472 is an extreme outlier (100th percentile), 99233 is an extreme outlier (100th percentile), 99238 and 99460 are each described as extreme outliers (100th and 99th percentiles respectively), and 99468 is noted as notably above typical state volume (100th percentile). These characterizations indicate recurring, unusually high utilization across multiple inpatient neonatal service codes rather than isolated spikes.

The billing mix includes both high-acuity critical-care codes and routine newborn services, which suggests an integrated service model that covers initial critical-care evaluation (99468), ongoing critical-care direction (99472, 99469), recovery management for low birth weight infants (99479, 99478), and routine newborn follow-ups (99460, 99462). This breadth—paired with high volumes—indicates the provider likely staffs or partners with a hospital NICU to deliver comprehensive neonatal inpatient care from immediate post-delivery stabilization through extended recovery.

UAHSF NEONATOLOGY has a long tenure in the NPI registry (enumerated 2006-08-08, ~20 years ago), which supports the interpretation that these high-volume Medicaid billing patterns reflect an established practice and enduring referral relationships rather than a recent operational expansion. The sustained presence coupled with repeated top-state rankings suggests institutional positioning as a core neonatal care provider in Birmingham/Alabama rather than a transient or small-scale clinic.

Medicaid: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	74,070	$550	$40.8M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	31,020	$550	$17M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	65,010	$170	$11M
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…	77,030	$140	$10.9M
99468	The provider evaluates and manages the initial care of a newborn or infant less than 28 days of age in a neonatal critical care setting.	4,670	$1,220	$5.7M
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	25,830	$100	$2.6M
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	18,260	$140	$2.5M
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	3,990	$260	$1M
99478	The provider directs the care of a recovering low birthweight infant, whose current weight is less than 1500 grams.	4,270	$190	$810.9K
54150	The provider performs a circumcision, a surgical procedure that removes the foreskin of the penis, using a clamp or other device and regional anesthesia consisting of a dorsal penile or ring block.	4,980	$150	$746.4K

Showing 1–10 of 19

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

Uahsf Neonatology — 12 of 19 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

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	1	10	140	$480	$4.8M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	2	10	1,820	$350	$3.2M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	2	10	3,160	$110	$1.7M
99468	The provider evaluates and manages the initial care of a newborn or infant less than 28 days of age in a neonatal critical care setting.	1	10	240	$850	$851.2K
99478	The provider directs the care of a recovering low birthweight infant, whose current weight is less than 1500 grams.	1	10	1,420	$140	$254.3K
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	250	420	$50	$133K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	2	80	220	$70	$103.1K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	306	400	470	$30	$97.1K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	2	200	170	$50	$60.5K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	6	240	130	$80	$46.1K

Showing 1–10 of 19

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of Alabama Health Services Foundation, PC	AL	Pediatrics Physician	$0	$79.6M
University Of Alabama Health Services Foundation, PC.	AL	Multi-Specialty Clinic/Center	$0	$77.1M
University Of Alabama Health Services Foundation PC	AL	Clinic/Center	$0	$18.6M
University Of Alabama Ophthalmology Services Foundation	AL	Ophthalmology Physician	$0	$6.9M
University Of Alabama At Birmingham	AL	Clinical Medical Laboratory	$2.9K	$3.2M
Chelsea Cockrell	MS	Family Nurse Practitioner	$3M	$0
University Of Alabama At Birmingham	AL	General Acute Care Hospital	$0	$2.7M
Primary Care Clinic	AL	Pediatrics Physician	$0	$1.9M
Mathew Sapp	AL	Retina Specialist (Ophthalmology) Physician	$1.6M	$0
Matthew Oltmanns	AL	Retina Specialist (Ophthalmology) Physician	$1.6M	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of Alabama At Birmingham	AL	General Acute Care Hospital	$0	$19.2M
Ryan Almeida	AL	Interventional Pain Medicine Physician	$757.3K	$0
Mustafa Ahmed	AL	Cardiovascular Disease Physician	$584.3K	$0
Racquel Innis-shelton	AL	Hematology & Oncology Physician	$422.5K	$0
Daniel Allendorf	AL	Student in an Organized Health Care Education/Training Program	$375.7K	$0
John Thomas	AL	Diagnostic Radiology Physician	$262.7K	$0
Ryan Telford	AL	Diagnostic Radiology Physician	$249.7K	$0
Biraj Bista	AL	Diagnostic Radiology Physician	$65.8K	$153.6K
Colin Stewart	AL	Diagnostic Radiology Physician	$206.7K	$0
Rachel Labovitz	AL	Internal Medicine Physician	$198.7K	$0

Uahsf Neonatology — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References