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.

American Family Care, LLC (NPI 1669429080)

Key Findings

Field	Value
Entity Type	Organization
Organization	American Family Care, LLC
Address	1680 Montgomery Hwy
City	Birmingham
State	AL
ZIP	35216
Taxonomy	Primary Care Clinic/Center
NPI Enumerated	May 30, 2006

Payer Source	Total Paid
Medicaid	$12.9M
Medicare	$0

AMERICAN FAMILY CARE, LLC shows no Medicare billing on file and is effectively a single-payer Medicaid operator, reporting $12.9M in lifetime Medicaid revenue and "none" for Medicare. This makes Medicaid the sole visible public-payer revenue stream for the practice rather than a balanced Medicare/Medicaid mix.

Revenue is highly concentrated in a small set of service lines: the precomputed top-3 Medicaid codes account for 78.6% of the provider's total Medicaid revenue. That concentration indicates the business is largely dependent on a few high-volume services rather than a broad mix of procedures.

S9083 (Global fee urgent care centers) is by far the dominant revenue driver at $7.4M and 60.4K claims, representing 57.8% of this provider's Medicaid revenue and ranking #1 of 18 providers in-state (100th percentile; extreme outlier). This profile and the code descriptor indicate the organization operates at scale as an urgent care center or urgent-care network, capturing the majority of its Medicaid dollars through a bundled urgent care encounter fee.

87635 (amplified NAAT SARS–CoV–2 test) accounts for $1.8M with 46.2K claims and an average paid/claim of $38, representing 13.7% of Medicaid revenue and ranking #2 of 296 providers in-state (100th percentile; extreme outlier). The very large claim volume for this diagnostic code, together with other COVID testing codes on the list, signals that high-throughput infectious disease testing (COVID) is a material part of the provider’s service mix and revenue strategy.

99214 (established patient office/outpatient visit, moderate complexity) generated $919.2K from 35.4K claims with an average paid/claim of $26, making up 7.2% of Medicaid revenue and ranking #27 of 1990 providers in-state (99th percentile; notably above typical state volume). High volumes of E/M codes like 99214, 99213, and 99204 alongside urgent care billing suggest a blended model of walk-in urgent care visits and standard outpatient evaluation-and-management services.

Multiple lab and specimen-collection codes appear at very high volumes and percentiles — for example, G2023 (specimen collection for SARS–CoV–2) has 21.3K claims and ranks #3 of 148 providers in-state (99th percentile; extreme outlier), and 87804 (influenza immunoassay) has 33.9K claims and ranks #7 of 793 providers in-state (99th percentile; notably above typical state volume). These patterns show significant reliance on point-of-care and lab testing revenue streams with modest average paid/claim amounts, consistent with a high-throughput testing operation.

Competitive standing is strong in state-level urgent care and testing categories: S9083 is an extreme outlier and top-ranked in-state, and 87635 also sits at an extreme outlier position in its peer group. At the same time, for routine E/M care the provider is well above typical state volume (99th percentile for 99214) but not the single dominant statewide provider in that category, indicating market leadership primarily through urgent care/test volume rather than traditional office-based primary care.

The provider has long tenure in the data set, with its NPI enumerated on 2006-05-30 (~20 years ago). That longevity combined with the concentrated revenue mix suggests an established urgent-care/testing operation that has scaled testing and walk-in visit volumes over time, but also that its financial performance could be sensitive to changes in reimbursement or demand for its top-coded services.

Medicaid: Complete Services Breakdown

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

54 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S9083	Global fee urgent care centers	60,370	$120	$7.4M
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…	46,240	$40	$1.8M
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…	35,350	$30	$919.2K
99204	The provider sees a new 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 provider…	10,830	$60	$660.8K
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…	30,720	$20	$583.7K
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…	18,130	$30	$562.2K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	21,260	$20	$382.7K
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.	33,860	$10	$237K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	25,250	$10	$126.2K
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…	4,330	$20	$64.9K

Showing 1–10 of 54

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

American Family Care, LLC — 12 of 24 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

54 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S9083	Global fee urgent care centers	1	20	370	$120	$467.9K
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…	27	1,990	680	$60	$201.7K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	208	330	140	$240	$197.4K
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…	66	1,990	560	$40	$185.6K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	47	100	480	$20	$165.1K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	52	110	610	$40	$143.9K
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.	148	200	2,000	$10	$105.9K
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…	2	300	210	$40	$77.9K
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…	104	370	1,540	$10	$65K
87081	The lab analyst cultures a patient specimen on a test medium designed to grow only a specific pathogenic organism.	12	60	1,060	$10	$49.9K

Showing 1–10 of 54

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratory Corporation Of America Holdings	NC	Clinical Medical Laboratory	$0	$264.7M
Bilal Islam	FL	Sports Medicine (Family Medicine) Physician	$364.2K	$0
Jennifer Holcombe	AL	Nurse Practitioner	$199.8K	$0
Ashley Mcintyre	AL	General Practice Physician	$136.3K	$0
George Astin	GA	Family Medicine Physician	$73.3K	$0
Bobbie Bode	MO	Family Nurse Practitioner	$56.4K	$0
Carmen Herring	AL	Family Nurse Practitioner	$53.5K	$0
Daphne Berry	AL	Family Nurse Practitioner	$52.6K	$0
Elisha Collins	AL	General Practice Physician	$52.2K	$0
James Henderson	AL	Family Medicine Physician	$49.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Children's Hospital Of Alabama	AL	Pediatrics Physician	$0	$2.7M
Surgical Clinic Solutions, LLC	AL	Ambulatory Surgical Clinic/Center	$2.2M	$0
Alacare Home Health Services, Inc.	AL	Community Based Hospice Care Agency	$0	$1.6M
Upperline Healthcare, PC	AL	Foot & Ankle Surgery Podiatrist	$0	$1.4M
Drs. Koslin & Kahn, P.C.	AL	Oral and Maxillofacial Surgery (Dentist)	$0	$1.3M
Child's Play Therapy LLC	AL	Rehabilitation Hospital Unit	$0	$1.2M
Nephrology Vascular Lab Of Central Alabama Asc LLC	AL	Ambulatory Surgical Clinic/Center	$706.8K	$0
Scott Rooney	AL	Interventional Pain Medicine Physician	$333.4K	$0
Donald Walters	AL	Dermatology Physician	$289.8K	$0
Daniel Bergman	AL	MOHS-Micrographic Surgery Physician	$274.6K	$0

American Family Care, LLC — Billing Profile & Reimbursement Data

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American Family Care, LLC — 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