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.

Qhg Of Enterprise Inc (NPI 1720039712)

Qhg Of Enterprise Inc is a general acute care hospital provider located in Enterprise, Alabama. This profile covers 0 Medicare and 72 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	Qhg Of Enterprise Inc
Address	400 N Edwards St
City	Enterprise
State	AL
ZIP	36330
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 13, 2006

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.

72 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	32,730	$40	$1.2M
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.	14,710	$60	$867.8K
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.	14,990	$20	$224.8K
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.	950	$190	$182.4K
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.	13,530	$10	$162.3K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	4,980	$30	$129.5K
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…	15,720	$10	$125.7K
99281	The provider sees a patient for the lowest level emergency department visit.	3,120	$40	$118.7K
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.	3,090	$40	$117.4K
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.	13,030	$10	$117.3K

Showing 1–10 of 72

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

Qhg Of Enterprise Inc — 3 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

72 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	55	70	380	$60	$893.8K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	33	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.	59	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.	110	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.	17	230	5,160	$40	$474.1K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	151	180	1,490	$50	$404.5K
87389	The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an…	27	40	430	$10	$391.5K
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	57	90	500	$40	$303.6K
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…	1,609	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…	1,926	1,990	560	$40	$185.6K

Showing 1–10 of 72

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
William Gammill	AL	Internal Medicine Physician	$262.8K	$0
Venkat Nimmagadda	AL	Nephrology Physician	$212.6K	$0
Gabruce Young	AL	Internal Medicine Physician	$207.2K	$0
Joseph Kaplan	GA	Emergency Medicine Physician	$43.4K	$0
Becky Parker	AL	Certified Registered Nurse Anesthetist	$20.9K	$0
Chang Yu	AL	Certified Registered Nurse Anesthetist	$8.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Centrum Aba, LLC	AL	Community/Behavioral Health Agency	$0	$6.2M
Advantage Dental Oral Health And Vision Center Of Alabama, P.C.	AL	General Practice Dentistry	$0	$3.9M
Enterprise Rescue Inc.	AL	Land Ambulance	$1.2M	$1.9M
Enterprise Women's Center, LLC.	AL	Obstetrics & Gynecology Physician	$0	$2.3M
Southern Alabama Physicians,llp	AL	Emergency Medicine Physician	$0	$2M
Coffee County Health Dept-enterprise Fp Clinic	AL	Public Health or Welfare Agency	$0	$1.6M
Renal Treatment Centers-southeast, LP.	AL	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$857.2K
Phi Health, LLC	AL	Air Ambulance	$402.2K	$351.2K
Trinity Development, LLC	AL	Ambulatory Surgical Clinic/Center	$243K	$408.1K
Beverly Jordan	AL	Family Medicine Physician	$282.6K	$0

Qhg Of Enterprise Inc — Billing Profile & Reimbursement Data

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Qhg Of Enterprise Inc — 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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