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.

The Dch Healthcare Authority (NPI 1841394418)

Key Findings

Field	Value
Entity Type	Organization
Organization	The Dch Healthcare Authority
Address	809 University Blvd E
City	Tuscaloosa
State	AL
ZIP	35401
Taxonomy	General Acute Care Hospital
NPI Enumerated	September 12, 2006

Payer Source	Total Paid
Medicaid	$16M
Medicare	$0

THE DCH HEALTHCARE AUTHORITY is effectively a single-payer Medicaid provider in the claims data: it has no Medicare billing on file and reports $16M in total Medicaid revenue, making Medicaid the sole observed payer driving all recorded facility revenue. This concentration in one public payer should be treated as the operating baseline when evaluating reimbursement sensitivity and network positioning.

Revenue concentration is high: the precomputed top 3 Medicaid codes account for 57.7% of this provider's total Medicaid revenue, dominated by 99283 ($3.4M, 22.7%), 99284 ($3.1M, 21.2%) and 87636 ($2M, 13.8%). That split indicates the hospital’s Medicaid revenue is narrowly driven by a few high-volume emergency-department E/M codes and a single high-volume multiplex respiratory infectious-disease test.

Business and service-line implications from the code mix point to a strong emergency department and in-house diagnostic laboratory operation. The two leading E/M codes (99283 and 99284) are emergency-department visit codes at low and moderate medical-decision levels, and 87636 is a multiplex SARS–CoV–2/influenza test, so the facility’s revenue profile is consistent with high ED throughput plus substantial respiratory infectious-disease testing capacity.

Competitive standing is uneven by service: 87636 ranks #1 of 45 providers in-state at the 100th percentile and is described as an extreme outlier, indicating THE DCH HEALTHCARE AUTHORITY is the statewide leader for multiplex SARS–CoV–2/influenza testing volume. Likewise, 99283 ranks #4 of 230 providers in-state at the 99th percentile and is also an extreme outlier, underscoring the hospital’s unusually large Medicaid ED volume for lower-acuity E/M visits.

Within the ED acuity mix the facility bills across low, moderate and high decision‑making visits: 99283 ($3.4M, 22.7%), 99284 ($3.1M, 21.2%), and 99285 ($1.8M, 12.0%). 99284’s rank (#13 of 238, 95th percentile) and 99285’s rank (#34 of 193, 83th percentile) indicate the provider handles a broad spectrum of ED case complexity and is a meaningful statewide participant for moderate- and high-acuity ED services.

Ancillary and diagnostic services are also prominent: high volumes of lab and monitoring codes such as CMP 80053 (61.7K claims, $554.9K revenue; rank #3 of 201, 99th percentile), CBC 85025 (63.3K claims, $506.4K revenue; rank #5 of 371, 99th percentile), and EKG interpretation 93010 (56.1K claims, $168.3K revenue; rank #2 of 173, 99th percentile, labeled an extreme outlier) point to heavy use of routine inpatient/outpatient monitoring and lab infrastructure supporting the ED and hospital clinics. Imaging utilization (71046 chest x‑ray at 17.1K claims, $171K revenue; rank #11 of 247, 96th percentile) further supports an ED/acute-care service mix.

Concentration risk is material because a small set of codes drives a majority of Medicaid revenue: with the top three codes representing 57.7% of Medicaid revenue, shifts in ED visit patterns, Medicaid testing reimbursement, or infectious disease prevalence could disproportionately affect total revenue. Analysts should monitor trends in ED visit counts and multiplex respiratory testing (87636) as leading indicators of near‑term revenue volatility.

The provider has long tenure in the NPI system (NPI enumerated 2006-09-12 (~20 years ago)), which combined with its high statewide ranks on several core codes suggests a well-established hospital footprint in Tuscaloosa with entrenched ED and diagnostic services that distinguish it from many in-state peers.

Medicaid: Complete Services Breakdown

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

147 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.	90,620	$40	$3.4M
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.	49,610	$60	$3.1M
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…	19,830	$100	$2M
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.	7,550	$240	$1.8M
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.	61,660	$10	$554.9K
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…	63,300	$10	$506.4K
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.	13,230	$30	$357.3K
11043	The provider uses surgical instruments to remove the dead tissue in muscle and/or fascia, including any debridement of the epidermis, dermis, and subcutaneous tissue, for the first or only 20 cm2 or…	2,810	$110	$297.3K
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.	12,780	$20	$281.2K
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.	7,970	$40	$279.1K

Showing 1–10 of 147

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

The Dch Healthcare Authority — 12 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

147 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	14	20	160	$20	$1.1M
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…	24	70	380	$60	$893.8K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	8	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.	13	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.	34	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.	18	40	450	$20	$591.3K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	16	40	460	$20	$584.1K
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.	4	230	5,160	$40	$474.1K
87661	The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique.	24	40	1,540	$10	$397.4K
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…	16	40	430	$10	$391.5K

Showing 1–10 of 147

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
George Hemstreet	AL	Interventional Cardiology Physician	$935.1K	$0
Terrence Chambers	IN	Diagnostic Radiology Physician	$152.4K	$700.7K
Edward Carraway	AL	Interventional Cardiology Physician	$712.5K	$0
Sakina Kamal	AL	Cardiovascular Disease Physician	$531.4K	$0
James Barnett	AL	Physical Medicine & Rehabilitation Physician	$424.2K	$0
Ross Vaughn	AL	Internal Medicine Physician	$344.2K	$0
James Proctor	AL	Interventional Cardiology Physician	$340.8K	$0
Charles Abney	AL	Family Medicine Physician	$322.6K	$0
Scott Fulgham	AL	Internal Medicine Physician	$280.5K	$0
Amit Shah	AL	Clinical Cardiac Electrophysiology Physician	$261.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Capstone Health Services Foundation PC	AL	Family Medicine Physician	$0	$12.5M
Whatley Health Services Inc	AL	Federally Qualified Health Center (FQHC)	$0	$8.8M
Northstar Ems, Inc.	AL	Land Ambulance	$2.1M	$5.6M
Greater Alabama Health Network	AL	Case Management Agency	$0	$5.1M
Relias Emergency Medicine Specialists Of Regional, LLC	AL	Emergency Medicine Physician	$0	$4.4M
Tuscaloosa Neonatal PC	AL	Neonatal-Perinatal Medicine Physician	$0	$2.9M
Dva Healthcare Of Tuscaloosa LLC	AL	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.1M
Neonatal Medical Care P.C.	AL	Neonatal-Perinatal Medicine Physician	$0	$1.7M
Greater Alabama Health Network	AL	Exclusive Provider Organization	$0	$1.4M
Samuel Taylor	AL	Retina Specialist (Ophthalmology) Physician	$1.3M	$0

The Dch Healthcare Authority — 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