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.

Franklin Primary Health Center Inc. (NPI 1679532303)

Field	Value
Entity Type	Organization
Organization	Franklin Primary Health Center Inc.
Address	1303 Dr Martin L King Jr Ave
City	Mobile
State	AL
ZIP	36603
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	March 21, 2006

Payer Source	Total Paid
Medicaid	$26.6M
Medicare	$0

Key Findings

FRANKLIN PRIMARY HEALTH CENTER INC. reports $26.6M in lifetime Medicaid revenue and has no Medicare billing on file, making it effectively a single‑payer (Medicaid) operation based on the current claims records. This payer concentration means the provider’s financial profile and utilization patterns are driven almost entirely by Medicaid reimbursement and program policies.

Revenue is extremely concentrated in one encounter code: T1015 accounts for $26.3M of Medicaid revenue (98.9% of the provider’s total Medicaid revenue) with 283K claims at $93 avg paid/claim. The precomputed top‑3 codes together drive 99.4% of Medicaid revenue, indicating a heavy reliance on a single all‑inclusive clinic visit code for the bulk of billing.

As an FQHC filing predominantly T1015 (clinic visit/encounter, all‑inclusive), the code mix is consistent with a federally qualified health center model that bills comprehensive, bundled encounter payments for primary care and related services. The dominance of T1015 suggests the site operates high-volume, visit‑based primary care clinics that capture many services under the FQHC encounter rate rather than itemized fee‑for‑service billing.

Although vaccines generate only small shares of total Medicaid revenue individually, the provider shows consistently high immunization throughput relative to state peers: 90715 ranks #3 of 197 providers (99th percentile; notably above typical state volume), 90734 ranks #5 of 215 (98th percentile; extreme outlier), and 90651 ranks #12 of 209 (95th percentile; notably above typical). These high ranks across multiple vaccine codes indicate a substantial pediatric/adolescent preventive care program with sizable claim volumes (many vaccine codes show thousands of claims) despite low avg paid/claim amounts (commonly $7–$10).

Competitive standing for the primary revenue driver is dominant within the state: T1015 ranks #3 of 243 providers in Alabama (99th percentile; extreme outlier), positioning FRANKLIN PRIMARY HEALTH CENTER as one of the largest in‑state billers for the FQHC encounter code. By contrast, several ancillary codes (for example D9430 at rank #9 of 25, 67th percentile) reflect only modest or typical participation at the state level.

The high volume of T1015 encounters (283K claims) combined with the clinic’s FQHC taxonomy implies operational scale in routine primary care delivery and likely broad patient access points (e.g., multiple sites or high daily visit counts). This operational profile aligns with an FQHC mission of providing comprehensive care to Medicaid populations but also signals operations optimized for encounter‑based reimbursement rather than procedure‑driven revenue.

The clinic’s lifetime NPI enumeration date is 2006-03-21 (~20 years ago), indicating long tenure in the market. That longevity, coupled with very high T1015 volumes, suggests an established Medicaid patient base and institutionalized billing practices centered on the FQHC encounter rate.

Because top revenue is so concentrated (top 3 codes = 99.4% of Medicaid revenue) and there is no Medicare revenue on file, the provider’s financial exposure is sensitive to changes in Medicaid encounter rates, reimbursement policy for T1015, or payer participation. From a payer/contracting perspective, any negotiations or payment-model changes around the FQHC encounter code would disproportionately affect this entity’s revenue stream and should be prioritized in risk assessments.

Medicaid: Complete Services Breakdown

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

128 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	283,050	$90	$26.3M
D9430	N/A	1,280	$80	$104K
90651	This code represents a nonavalent human papillomavirus (HPV) vaccine product administered into the muscle to protect against HPV infection. The vaccine protects against nine HPV types (6, 11, 16, 18,…	2,620	$10	$21K
90715	The provider uses this combination vaccine as a booster to help protect patients who are 7 years old or older from lockjaw, diphtheria, and whooping cough.	2,090	$10	$20.9K
90734	The provider administers a meningococcal conjugate vaccine in a diphtheria toxoid carrier (MenACWY–D) or CRM197 carrier (MenACWY–CRM) to protect the patient from four strains of meningococcal viruses…	2,960	$10	$20.7K
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…	2,520	$10	$20.1K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	1,920	$10	$19.2K
90633	This code represents a vaccine product administered into a muscle to protect against hepatitis A, a liver infection. This code is specific to a pediatric/adolescent dosage with a two–dose schedule.	2,210	$10	$15.5K
90710	This code represents an MMRV vaccine product administered beneath the skin to protect against measles, mumps, rubella (German measles), and varicella (chickenpox).	1,860	$10	$13K
90680	This code represents a live pentavalent rotavirus vaccine given by mouth in a three–dose schedule to protect against rotavirus infection.	1,150	$10	$8.1K

Showing 1–10 of 128

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

Franklin Primary Health Center Inc. — 4 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

128 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	3	240	6,820	$120	$2.9M
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	29	40	450	$20	$591.3K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	30	40	460	$20	$584.1K
D9430	N/A	9	30	230	$130	$533.9K
87661	The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique.	30	40	1,540	$10	$397.4K
88175	The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer…	20	20	1,500	$20	$389.4K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	359	380	440	$90	$362K
80074	The lab analyst performs an acute hepatitis panel; the panel must include tests for hepatitis A IgM antibody, hepatitis B core IgM antibody, hepatitis B surface antigen, and hepatitis C antibody.	8	10	430	$20	$282.5K
87624	The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result.	22	20	360	$20	$221K
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…	15	1,990	680	$60	$201.7K

Showing 1–10 of 128

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Timothy Mott	AL	Family Medicine Physician	$43.5K	$0
Anna Leurck	AL	Family Nurse Practitioner	$37.7K	$0

Nearby Providers

Other providers in the same ZIP code as Franklin Primary Health Center Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mobile County Board Of Health	AL	Federally Qualified Health Center (FQHC)	$0	$30.6M
Mobile County Health Department Epsdt Cm	AL	Case Management Agency	$0	$1.9M
Laboratory Corporation Of America Holdings	AL	Clinical Medical Laboratory	$0	$1M
Edna Harris	AL	Family Nurse Practitioner	$131.9K	$0

Franklin Primary Health Center Inc. — Billing Profile & Reimbursement Data

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Franklin Primary Health Center Inc. — 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