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.

St. Vincent's Birmingham (NPI 1841298999)

St. Vincent's Birmingham is a general acute care hospital provider located in Birmingham, Alabama. This profile covers 0 Medicare and 34 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	St. Vincent's Birmingham
Address	810 Saint Vincents Dr
City	Birmingham
State	AL
ZIP	35205
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 12, 2005

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

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

34 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.	2,900	$230	$672.8K
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.	5,260	$60	$320.6K
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.	3,970	$40	$138.8K
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…	8,580	$10	$60.1K
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.	6,650	$10	$59.9K
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…	720	$10	$7.9K
84484	The lab analyst performs the technical lab test typically using serum, plasma, or whole blood to quantitate troponin. Troponin is a protein labs commonly measure to verify a myocardial infarction and…	360	$10	$2.9K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	570	$10	$2.9K
81001	Urinalysis is used to detect substances or cellular material in the urine associated with different metabolic and kidney disorders. It is used to detect urinary tract infections (UTI) and other…	950	$1	$2.8K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	60	$50	$2.6K

Showing 1–10 of 34

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

St. Vincent's Birmingham — 0 of 20 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

34 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1016	Case management, each 15 minutes	4	10	200	$10	$6M
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.	114	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.	74	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.	128	230	5,160	$40	$474.1K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	41	50	380	$90	$157.3K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	93	110	610	$40	$143.9K
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.	130	130	420	$40	$106K
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.	58	200	2,000	$10	$105.9K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	254	320	670	$20	$69.3K
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…	80	370	1,540	$10	$65K

Showing 1–10 of 34

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Van Wadlington	AL	Diagnostic Radiology Physician	$97.5K	$0
Edward Sullivan	AL	Diagnostic Radiology Physician	$90.7K	$0
Jill Rutherford	AL	Diagnostic Radiology Physician	$86.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Paragon Contracting Services LLC	AL	Emergency Medicine Physician	$0	$54.5M
Oral & Facial Surgery Of Al, PC	AL	Specialist	$0	$6.4M
Pediatric Dental Associates Of Birmingham, LLC	AL	Pediatric Dentistry	$0	$6.1M
University Of Alabama At Birmingham	AL	Developmental Disabilities Clinic/Center	$0	$4.8M
Magnolia Pediatrics South Inc	AL	Pediatric Adolescent Medicine Physician	$0	$2.9M
Birmingham Pediatric Assoc	AL	Pediatrics Physician	$0	$2.5M
Alabama Ophthalmology Associates, P.C.	AL	Ophthalmology Physician	$0	$2.1M
St. Vincent's P.e.t. Center, LLC	AL	Diagnostic Radiology Physician	$1.6M	$0
Cara Bondly	AL	Hematology & Oncology Physician	$986.3K	$0
Redmont Pediatric Associates, P.C.	AL	Specialist	$0	$946.2K

St. Vincent's Birmingham — Billing Profile & Reimbursement Data

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St. Vincent's Birmingham — 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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