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.

Vaughan Regional Medical Center LLC (NPI 1871655993)

Vaughan Regional Medical Center LLC is a rural acute care hospital provider located in Selma, Alabama. This profile covers 0 Medicare and 131 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	Vaughan Regional Medical Center LLC
Address	1015 Medical Center Pkwy
City	Selma
State	AL
ZIP	36701
Taxonomy	Rural Acute Care Hospital
NPI Enumerated	December 14, 2006

Payer Source	Total Paid
Medicaid	$8.1M
Medicare	$0

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

131 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.	15,140	$200	$3M
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.	17,240	$60	$982.5K
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.	18,540	$40	$667.4K
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…	3,260	$200	$636.1K
76376	In this procedure, the provider performs 3D rendering for computed tomography magnetic resonance imaging, ultrasound, or another tomographic modality, typically for diagnostic purposes, with…	9,460	$50	$491.7K
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…	32,070	$10	$224.5K
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.	23,020	$10	$207.1K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	4,270	$40	$179.5K
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.	4,160	$40	$158.1K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	2,270	$70	$147.6K

Showing 1–10 of 131

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

Vaughan Regional Medical Center LLC — 4 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

131 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
81420	The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,…	2	10	21,250	$280	$5.9M
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	24	60	1,260	$60	$1.2M
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…	18	100	470	$130	$1.2M
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…	42	70	380	$60	$893.8K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	29	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.	49	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.	17	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.	44	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…	12	40	430	$10	$391.5K
87581	The lab analyst performs a test for Mycoplasma pneumonia, a bacteria, using amplified nucleic acid probe technique.	16	40	1,440	$20	$372.1K

Showing 1–10 of 131

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Dentistry Of Central Alabama, PC	AL	Pediatric Dentistry	$0	$27.3M
Selma Peditrics, P.C.	AL	Pediatrics Physician	$0	$21M
Dallas County Health Dept Fp Clinic	AL	Public Health or Welfare Agency	$0	$2.5M
University Of Alabama At Birmingham	AL	Family Medicine Physician	$0	$2.2M
Song Eye Center	AL	Ophthalmic Technician/Technologist	$0	$1.7M
Rural Health Medical Program, Inc.	AL	Federally Qualified Health Center (FQHC)	$0	$1.6M
Selma Family Practice Optometry, Inc.	AL	Optometrist	$0	$1.2M
Bio-medical Applications Of Alabama, Inc.	AL	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1M
Bio-medical Applications Of Alabama, Inc.	AL	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$931.6K
Behavioral Health Of Selma, LLC	AL	Psychologist	$0	$930.6K

Vaughan Regional Medical Center 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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