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.

Medical West Hospital Authority, An Affiliate Of Uab Health System (NPI 1790896710)

Key Findings

Field	Value
Entity Type	Organization
Organization	Medical West Hospital Authority, An Affiliate Of Uab Health System
Address	5000 Medical West Way
City	Bessemer
State	AL
ZIP	35022
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 31, 2006

Payer Source	Total Paid
Medicaid	$11.4M
Medicare	$0

This provider effectively operates as a Medicaid-focused hospital: it has no Medicare billing on file and reports Total Medicaid revenue of $11.4M, so the available payer data describe an organization that is functionally single-payer (Medicaid) in this data set. Analysts should treat any Medicare comparisons as not applicable because there is no Medicare activity recorded for this NPI.

Revenue is heavily concentrated in a small set of emergency department codes: the precomputed top-3 Medicaid codes account for 67.8% of the provider's Medicaid revenue. Those three codes are 99285 ($4.8M revenue, 43.0% of Medicaid revenue), 99282 ($1.9M revenue, 16.6%), and 99284 ($919.6K revenue, 8.2%), indicating that a large share of dollars flows from ED evaluation-and-management services.

The code mix signals a high-volume emergency department with a broad acuity mix: 99285 (high medical decision making) has 19.5K claims and $247 avg paid/claim, while 99282 (straightforward E/M) has 46.3K claims and $40 avg paid/claim and 99284 (moderate E/M) has 13.5K claims. The large claim counts across high-, moderate-, and low-acuity ED codes point to sustained ED throughput and both complex and high-volume low-acuity caseloads driving revenue.

On competitive standing within Alabama, the provider is a statewide leader for several ED- and ED-adjacent codes: 99282 ranks #1 of 134 providers in-state (100th percentile; labeled an extreme outlier), and 99281 ranks #1 of 47 providers (100th percentile; extreme outlier), indicating the provider reports far above typical state volume for low-acuity ED visits. By contrast, 99285 ranks #14 of 193 (93th percentile), which is above typical but not at the same dominance level as the low-acuity codes, so the facility appears especially concentrated in high-volume, lower-acuity ED visits relative to peers.

Diagnostic testing and rapid infectious-disease screening are significant ancillary revenue lines: 87804 (influenza immunoassay) shows 21.5K claims and $494.1K revenue (98th percentile), and 87426 (SARS–CoV–2 antigen) shows 15.3K claims and $320.7K revenue (99th percentile; extreme outlier). High percentile ranks for these codes indicate the hospital processes large numbers of point-of-care or lab rapid tests, consistent with an ED-driven patient flow and strong on-site diagnostic throughput.

Other hospital outpatient and lab services provide modest but meaningful revenue and capacity signals: G0463 (hospital outpatient clinic visit) contributed $345.7K (3.1% of Medicaid revenue) and 80053 (comprehensive metabolic panel) produced $350.2K (3.1%), both ranking at high percentiles in-state. Imaging and routine inpatient/ED labs (for example 70450 CT head $74.8K, 71045 single-view chest $116K, and 85025 CBC $299.8K) further demonstrate that standard hospital diagnostic services support the ED-dominant case mix.

There are several code-level statistical outliers that reinforce an ED/throughput operational profile: J7030 (normal saline 1000 cc) is ranked #1 of 43 providers in-state (100th percentile; extreme outlier), and 87426 is an extreme outlier at the 99th percentile. These high ranks for IV fluids and point-of-care infectious testing comport with frequent unscheduled visits that require immediate diagnostics and IV therapy.

The provider has an established presence: its NPI was enumerated on 2006-08-31 (~20 years ago), indicating longevity in the market. Combined with the current Medicaid concentration and the concentrated revenue in ED E/M codes, the historical tenure suggests a stable, long-standing hospital operation whose near-term revenue profile is driven primarily by high ED volume and related diagnostics.

Medicaid: Complete Services Breakdown

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

90 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	19,460	$250	$4.8M
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.	46,270	$40	$1.9M
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.	13,520	$70	$919.6K
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.	21,480	$20	$494.1K
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.	12,080	$40	$471.2K
99281	The provider sees a patient for the lowest level emergency department visit.	11,860	$40	$450.8K
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.	31,830	$10	$350.2K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	9,340	$40	$345.7K
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,…	15,270	$20	$320.7K
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…	33,310	$10	$299.8K

Showing 1–10 of 90

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

Medical West Hospital Authority, An Affiliate Of Uab Health System — 9 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

90 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	84	100	470	$130	$1.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	10	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.	65	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.	14	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.	68	230	5,160	$40	$474.1K
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…	15	40	430	$10	$391.5K
83021	The lab analyst measures and calculates the hemoglobin fractions in a whole blood sample demonstrated by this hemoglobin fractionation test by chromatography.	11	10	190	$20	$350.6K
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	35	90	500	$40	$303.6K
87522	A lab tests a patient’s specimen to measure the amount of hepatitis C virus present. This may be referred to as viral load.	4	10	200	$20	$180.7K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	42	80	300	$10	$159.1K

Showing 1–10 of 90

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	General Acute Care Hospital	$0	$2.7M
Primary Care Clinic	AL	Pediatrics Physician	$0	$1.9M
Michael Rosemore	AL	Physical Medicine & Rehabilitation Physician	$649.5K	$0
Sadri Avsar	AL	Physical Medicine & Rehabilitation Physician	$299.9K	$0
Priscilla Fowler	AL	Ophthalmology Physician	$123.1K	$0
Michael Mauney	MO	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$119.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pediatric Smiles	AL	Pediatric Dentistry	$0	$5.2M
Bessemer Emergency Physicians, LLC.	AL	Emergency Medicine Physician	$0	$4.7M
Babi Pediatrics,pc Dba Peds459	AL	Primary Care Clinic/Center	$0	$2.5M
Northstar Ems, Inc.	AL	Land Ambulance	$155.6K	$1M
Joanne Rossman	AL	Hematology & Oncology Physician	$874.6K	$0
Michael Burch	AL	Hospitalist Physician	$311K	$0
Mohannad Azzam	AL	Internal Medicine Physician	$282.3K	$0
Ttc, LLC	AL	Substance Use Disorder Rehabilitation Clinic/Center	$215.8K	$0
Leigh Ann Clanton	AL	Family Nurse Practitioner	$91.3K	$0
Lancing Patterson	AL	Urology Physician	$74.5K	$0

Medical West Hospital Authority, An Affiliate Of Uab Health System — 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