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.

South Alabama Medical Clinic, LLC (NPI 1811288038)

South Alabama Medical Clinic, LLC is a rural health clinic/center provider located in Grand Bay, Alabama. This profile covers 0 Medicare and 54 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	South Alabama Medical Clinic, LLC
Address	10075 Grand Bay Wilmer Rd S
City	Grand Bay
State	AL
ZIP	36541
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	April 21, 2011
NPI Deactivated	July 23, 2024

Payer Source	Total Paid
Medicaid	$8.7M
Medicare	$0

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
T1015	Clinic visit/encounter, all-inclusive	82,230	$90	$7.7M
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.	15,140	$10	$181.7K
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…	7,000	$30	$175.1K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	1,770	$100	$167.8K
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.	8,760	$20	$166.4K
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…	340	$160	$54.9K
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,…	1,280	$30	$32.1K
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…	2,440	$10	$22K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	760	$30	$19.8K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	4,660	$1	$14K

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

South Alabama Medical Clinic, LLC — 2 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

54 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	16	240	6,820	$120	$2.9M
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…	56	100	470	$130	$1.2M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	163	180	100	$120	$381.8K
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…	375	380	440	$90	$362K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	106	120	500	$50	$317.7K
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…	124	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…	33	1,990	560	$40	$185.6K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	49	270	1,360	$60	$159.7K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	68	300	1,160	$50	$147.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	72	320	640	$50	$98.1K

Showing 1–10 of 54

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ttc, LLC	AL	Substance Use Disorder Rehabilitation Clinic/Center	$122.6K	$0
William Patton	AL	Orthopaedic Surgery Physician	$34.4K	$0

South Alabama Medical Clinic, LLC — Billing Profile & Reimbursement Data

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South Alabama Medical Clinic, LLC — 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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