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.

Capstone Health (NPI 1821043837)

Field	Value
Entity Type	Organization
Organization	Capstone Health
Address	5947 Highway 269
City	Parrish
State	AL
ZIP	35580
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	May 24, 2006

Payer Source	Total Paid
Medicaid	$4.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

38 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	41,660	$110	$4.7M
D9430	N/A	300	$100	$31.1K
90688	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It uses split virus technology and is given as a 0.5 mL dose.	310	$10	$3.8K
90674	This code represents a flu vaccine product that protects against four strains of influenza. It is derived from cell cultures, contains no preservatives or antibiotics, and is administered as a 0.5 mL…	190	$20	$2.8K
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,…	140	$10	$1.7K
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…	60	$20	$1.3K
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.	60	$20	$930
90656	This code represents a preservative–free trivalent influenza vaccine product containing split virus components. It is administered into the muscle in a 0.5 mL dosage.	10	$20	$200
90658	This code represents a trivalent influenza vaccine product containing split virus components. It is administered into the muscle in a 0.5 mL dosage.	10	$10	$110
0001A	N/A	30	$0	$0

Showing 1–10 of 38

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

Capstone Health — 0 of 9 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

38 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	40	240	6,820	$120	$2.9M
D9430	N/A	12	30	230	$130	$533.9K
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…	145	1,990	680	$60	$201.7K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	72	330	140	$240	$197.4K
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…	145	1,990	560	$40	$185.6K
D1208	Topical application of fluoride - excluding varnish	503	540	970	$10	$60.1K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	212	230	410	$40	$59.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	292	300	330	$50	$56.3K
99204	The provider sees a new 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 provider…	404	630	60	$80	$45.8K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	108	500	120	$60	$42.2K

Showing 1–10 of 38

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jeffrey Long	AL	Family Medicine Physician	$122.7K	$0
Kerry Clark	AL	Family Nurse Practitioner	$53.6K	$0
Stephanie Williams	AL	Nurse Practitioner	$51.6K	$0
April Poe	AL	Family Nurse Practitioner	$12.3K	$0

Capstone Health — Billing Profile & Reimbursement Data

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Capstone Health — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Frequently Asked Questions

References