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.

Alignmed Partners, PC (NPI 1881109452)

Key Findings

Field	Value
Entity Type	Organization
Organization	Alignmed Partners, PC
Address	420 Dean Dr
City	Gardendale
State	AL
ZIP	35071
Taxonomy	Geriatric Medicine (Internal Medicine) Physician
NPI Enumerated	December 5, 2017

Payer Source	Total Paid
Medicaid	$16.8M
Medicare	$0

ALIGNMED PARTNERS, PC shows an effectively single-payer footprint: there is no Medicare billing on file and the practice reports $16.8M in lifetime Medicaid revenue. This billing profile indicates Medicaid is the primary revenue source and the organization operates predominantly within the Medicaid-covered population rather than Medicare beneficiaries.

Revenue is highly concentrated in nursing-facility evaluation and management services: the top three Medicaid codes (99309, 99308, 99310) together account for 92.9% of the provider’s total Medicaid revenue. Individually, 99309 represents $12.9M (77.0%), 99308 $1.6M (9.7%), and 99310 $1M (6.2%), signaling dependence on a very narrow set of high-volume visit codes.

The code mix points to a dedicated nursing facility care operation: dominant utilization of 99309/99308/99310 (subsequent nursing facility E/M at varying time and decision-making levels), plus presence of initial nursing facility codes 99306 and 99305, indicates the provider primarily conducts on-site nursing facility visits and ongoing longitudinal management of residents. The inclusion of codes such as 99497 (advance care planning) and 99316 (discharge management) further supports a service-line focused on long-term/post-acute care coordination and end-of-life planning.

ALIGNMED is a statewide volume leader for key nursing-facility E/M services: 99309 ranks #1 of 184 providers in-state (100th percentile; extreme outlier), 99308 ranks #1 of 227 providers (100th percentile; extreme outlier), and 99310 ranks #1 of 53 providers (100th percentile; extreme outlier). These ranks and percentile placements characterize the entity as a dominant provider of nursing facility visits in Alabama relative to peers.

Several secondary codes reinforce the nursing-facility specialization and show similar competitive dominance: 99306 ($534.8K, 3.2%) and 99305 ($257.6K, 1.5%) each rank #1 in-state (100th percentile; extreme outlier), and 99497 (advance care planning) ranks #1 with $121.1K (0.7%) in revenue (100th percentile; extreme outlier). This pattern indicates the provider not only delivers high volumes of routine nursing-facility follow-ups but also performs initial assessments and structured advance-care conversations at above-typical state volumes.

Operational scale is reflected in very high claim counts paired with low average payments per claim, consistent with a high-throughput nursing-facility visit model: for example, 99309 shows 446.1K claims at $29 avg paid/claim, 99308 has 81.3K claims at $20 avg paid/claim, and 99310 has 24.7K claims at $42 avg paid/claim. This suggests revenue is driven by frequent short- to moderate-length encounters rather than high unit prices, implying staffing and visit-volume capacity are key business drivers.

There are anomalous payment patterns on several preventive/annual codes that warrant attention for payer/contracting analysis: G0438 shows 143 claims with $0 revenue (rank #1 of 10, 100th percentile; notably above typical state volume) and G0439 shows 580 claims with $-1.2K revenue (rank #1 of 49, 100th percentile; extreme outlier), while 99423 shows 89 claims with $0 revenue. These zero or negative aggregate payments could reflect state-specific adjudication, bundling, offsets, or reporting adjustments and should be reviewed when reconciling capitated or fee-for-service arrangements.

The provider’s NPI was enumerated on 2017-12-05 (listed as ~9 years ago), indicating several years of enrollment during which it established a highly concentrated Medicaid nursing-facility business. Combined with the extreme outlier ranks and large claim volumes, this tenure supports the view of a sustained, high-volume operational presence in the state's nursing-facility care market.

Medicaid: Complete Services Breakdown

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	446,150	$30	$12.9M
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	81,330	$20	$1.6M
99310	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…	24,680	$40	$1M
99306	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves high medical decision making, and/or the provider spends at least…	12,150	$40	$534.8K
99305	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	9,200	$30	$257.6K
99316	The provider sees a patient for nursing facility discharge management requiring more than 30 minutes.	6,230	$30	$180.6K
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	7,570	$20	$121.1K
99356	N/A	2,680	$20	$48.2K
99358	Report this service if the provider spends time in either preparation or evaluation of the outcome of treatment before or after a direct encounter with a patient.	2,310	$10	$25.5K
99307	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the…	3,250	$10	$19.5K

Showing 1–10 of 18

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

Alignmed Partners, PC — 10 of 15 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

18 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	1	180	480	$20	$86.2K
99316	The provider sees a patient for nursing facility discharge management requiring more than 30 minutes.	1	10	30	$30	$61K
99310	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…	1	50	130	$30	$24.1K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	1	230	920	$10	$22.8K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	48	50	210	$50	$21.6K
99306	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves high medical decision making, and/or the provider spends at least…	1	40	50	$40	$17.1K
99356	N/A	1	10	50	$20	$8.3K
99305	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	1	50	30	$20	$6.4K
99358	Report this service if the provider spends time in either preparation or evaluation of the outcome of treatment before or after a direct encounter with a patient.	1	10	200	$10	$6.2K
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	1	30	40	$10	$3.9K

Showing 1–10 of 18

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mohammad Suhail	RI	Internal Medicine Physician	$126.3K	$16M
Imran Haque	NC	Internal Medicine Physician	$2.7M	$0
Stephen Greco	MD	Radiation Oncology Physician	$1.3M	$0
Caitlin Trainor	PA	Family Nurse Practitioner	$1.3M	$0
Mir Ahmad	NJ	Specialist	$1.3M	$0
Akindele Majekodunmi	MA	Internal Medicine Physician	$404.3K	$730.9K
Jerry Hahn	WV	Procedural Dermatology Physician	$1.1M	$0
Shawna Murphy	PA	Emergency Medicine Physician	$989.5K	$0
Sanjay Bharti	WV	Internal Medicine Physician	$934.5K	$5.9K
Geps Physician Group Of West Virginia PC	WV	Geriatric Medicine (Internal Medicine) Physician	$0	$923.7K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children And Teen Dental Group Of Alabama	AL	Pediatric Dentistry	$0	$2.1M
North Jefferson Pediatrics	AL	Specialist	$0	$1.8M
North Jefferson Pediatric Dentistry, LLC	AL	Pediatric Dentistry	$0	$1.5M
Andrew Ellard	AL	Physical Therapist	$185.4K	$0
Ryan Carlton	AL	Family Nurse Practitioner	$172.7K	$0
Ricky Tubbs	AL	Internal Medicine Physician	$132.8K	$0
Ashley Pauldin	AL	Family Nurse Practitioner	$109.9K	$0
Edward Tucker	AL	Psychiatric/Mental Health Nurse Practitioner	$102.2K	$0
Hali Mcdonald	AL	Nurse Practitioner	$80K	$0
Howard Day	AL	Optometrist	$34.2K	$0

Alignmed Partners, PC — Billing Profile & Reimbursement Data

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Alignmed Partners, PC — 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