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.

Troy Hospital Health Care Authority (NPI 1770814626)

Troy Hospital Health Care Authority is a rural acute care hospital provider located in Troy, Alabama. This profile covers 0 Medicare and 64 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	Troy Hospital Health Care Authority
Address	1330 Highway 231 S
City	Troy
State	AL
ZIP	36081
Taxonomy	Rural Acute Care Hospital
NPI Enumerated	January 15, 2010

Payer Source	Total Paid
Medicaid	$2.2M
Medicare	$0

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

64 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.	19,450	$40	$719.6K
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.	7,160	$60	$400.8K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	1,800	$110	$191.2K
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.	4,070	$40	$146.3K
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.	580	$210	$119.2K
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…	11,450	$10	$91.6K
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	2,730	$30	$81.9K
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.	720	$110	$76.7K
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.	7,390	$10	$66.5K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	3,190	$10	$28.7K

Showing 1–10 of 64

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

Troy Hospital Health Care Authority — 0 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

64 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…	51	70	380	$60	$893.8K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	36	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.	99	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.	125	190	1,480	$100	$730.7K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	31	40	450	$20	$591.3K
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.	41	230	5,160	$40	$474.1K
87661	The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique.	36	40	1,540	$10	$397.4K
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	49	90	500	$40	$303.6K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	56	60	320	$130	$176.1K
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.	92	100	480	$20	$165.1K

Showing 1–10 of 64

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Andrew Osborne	AL	Anesthesiology Physician	$57.8K	$0
Chavona Moore	AL	Family Nurse Practitioner	$15.4K	$0
James York	AL	Pain Medicine (Anesthesiology) Physician	$10K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Charles Henderson Memorial Association	AL	Clinic/Center	$0	$6.5M
Emedical Group Inc	AL	Health Service Clinic/Center	$0	$5.8M
Haynes Ambulance Of Troy LLC	AL	Land Ambulance	$1.2M	$3.7M
Pike County Health Dept Fp Clinic	AL	Public Health or Welfare Agency	$0	$1.6M
Pike County Health Dept Epsdt Cm	AL	Case Management Agency	$0	$894.5K
Sanjeev Singh	AL	Foot Surgery Podiatrist	$116.8K	$3.8K
Robert Liljeberg	AL	Orthopaedic Surgery Physician	$113.1K	$0
David Hamlin	AL	Optometrist	$37.2K	$0
Thomas Dunn	AL	Optometrist	$33.9K	$0
Richard Schloemer	AL	Surgery Physician	$31.7K	$0

Troy Hospital Health Care Authority — Billing Profile & Reimbursement Data

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Troy Hospital Health Care 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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