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.

Marion Regional Medical Center, Inc. (NPI 1932160082)

Marion Regional Medical Center, Inc. is a general acute care hospital provider located in Hamilton, Alabama. This profile covers 0 Medicare and 32 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	Marion Regional Medical Center, Inc.
Address	1256 Military St S
City	Hamilton
State	AL
ZIP	35570
Taxonomy	General Acute Care Hospital
NPI Enumerated	March 29, 2006

Payer Source	Total Paid
Medicaid	$917.1K
Medicare	$0

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

32 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	4,140	$70	$273.1K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	3,570	$60	$210.5K
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.	2,490	$40	$94.6K
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.	300	$280	$83.4K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	4,130	$20	$74.4K
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.	2,690	$20	$40.3K
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…	2,940	$10	$26.5K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	1,010	$20	$24.1K
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.	1,550	$10	$18.6K
87430	The lab analyst performs an assay to evaluate the patient’s sample for antigens to Streptococcus, group A, using an immunoassay method, such as EIA.	960	$20	$14.5K

Showing 1–10 of 32

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

Marion Regional Medical Center, Inc. — 0 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

32 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	129	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.	142	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.	154	230	5,160	$40	$474.1K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	120	130	260	$10	$124.7K
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.	73	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.	116	200	2,000	$10	$105.9K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	83	160	400	$10	$88.3K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	292	300	210	$40	$77.9K
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…	142	370	1,540	$10	$65K
87086	Culture, bacterial; quantitative, colony count, urine.	88	100	400	$10	$57.9K

Showing 1–10 of 32

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Monroe Health Services, Inc.	MS	General Acute Care Hospital	$0	$16.4M
Marion Regional Medical Center, Inc.	AL	Rural Health Clinic/Center	$0	$5.5M
William Carroll	MS	Cardiovascular Disease Physician	$1.1M	$0
John Estess	MS	Cardiovascular Disease Physician	$953.3K	$0
William Calhoun	MS	Cardiovascular Disease Physician	$861.1K	$0
Douglas Hill	MS	Cardiovascular Disease Physician	$777.8K	$0
James Johnson	MS	Cardiovascular Disease Physician	$708.5K	$0
Barry Bertolet	MS	Cardiovascular Disease Physician	$667.9K	$0
Nelson Little	MS	Cardiovascular Disease Physician	$597.2K	$0
Benjamin Blossom	MS	Cardiovascular Disease Physician	$299.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aseracare Hospice - Hamiliton, LLC	AL	Community Based Hospice Care Agency	$0	$2.7M
Ouch Urgent Care Of Hamilton LLC	AL	Family Medicine Physician	$0	$1M
Marion County Health Dept-hamilton Fp Clinic	AL	Public Health or Welfare Agency	$0	$883.8K
Raymond Cobb	AL	Optometrist	$80.2K	$98K
Courtney Dubose	AL	Family Nurse Practitioner	$47.3K	$0
Wal-mart Stores East LP	AL	Community/Retail Pharmacy	$42.5K	$0

Marion Regional Medical Center, Inc. — Billing Profile & Reimbursement Data

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Marion Regional Medical Center, Inc. — 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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