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.

Sylacauga Health Care Authority Inc (NPI 1972527265)

Sylacauga Health Care Authority Inc is a rural acute care hospital provider located in Sylacauga, Alabama. This profile covers 0 Medicare and 78 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	Sylacauga Health Care Authority Inc
Address	315 W Hickory St
City	Sylacauga
State	AL
ZIP	35150
Taxonomy	Rural Acute Care Hospital
NPI Enumerated	July 27, 2006

Payer Source	Total Paid
Medicaid	$4.2M
Medicare	$0

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

78 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.	3,690	$270	$989.2K
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.	24,710	$40	$939K
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.	14,720	$60	$868.6K
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…	6,510	$50	$306.1K
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.	11,060	$10	$121.7K
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…	13,080	$10	$104.6K
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.	2,650	$40	$103.3K
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.	6,590	$20	$98.9K
87400	The lab analyst performs the technical lab test to detect antigens of influenza A or B using an immunoassay technique, such as EIA. This analysis will distinguish if a patient has influenza A or B.	16,630	$10	$83.2K
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.	800	$70	$54.1K

Showing 1–10 of 78

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

Sylacauga Health Care Authority Inc — 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

78 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.	58	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.	62	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.	27	230	5,160	$40	$474.1K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	1,926	1,990	560	$40	$185.6K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	33	60	320	$130	$176.1K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	17	30	570	$40	$110.1K
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.	38	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.	41	200	2,000	$10	$105.9K
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.	39	110	340	$30	$90.9K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	32	80	200	$40	$90.3K

Showing 1–10 of 78

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Khaleel Ashraf	AL	Hematology & Oncology Physician	$1.4M	$0
Allen Yeilding	AL	Hematology & Oncology Physician	$980.4K	$0
Michael Gibson	AL	Interventional Pain Medicine Physician	$359.2K	$0
Song Yu	AL	Family Medicine Physician	$314.9K	$590
David Mooney	AL	Hematology & Oncology Physician	$303.4K	$0
Nitin Chhabra	GA	Pain Medicine (Anesthesiology) Physician	$276.7K	$0
Jonathan Bridges	AL	Hematology & Oncology Physician	$204.6K	$0
Mohamed Aldaher	AL	Internal Medicine Physician	$198.2K	$0
Emily Rehberg	AL	Pulmonary Disease Physician	$172.7K	$0
Hubert Rodriguez	AL	Anesthesiology Physician	$78K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pathway Pediatrics, Inc.	AL	Pediatrics Physician	$0	$8.6M
Sylacauga Pediatric Clinic, LLC	AL	Rural Health Clinic/Center	$0	$7.4M
Sylacauga Pediatric Clinic, LLC	AL	Pediatrics Physician	$0	$4.4M
Nes Tennessee Inc	AL	Emergency Medicine Physician	$0	$2.3M
Marble City Pediatric Dentistry	AL	Preferred Provider Organization	$0	$2.2M
Sylacauga Ambulance Service, Inc.	AL	Land Ambulance	$433.6K	$958.7K
Talladega County Health Dept-sylacauga Epsdt Cm	AL	Case Management Agency	$0	$1.2M
Family Eye Care Of Sylacauga LLC	AL	Optometrist	$0	$1.2M
Talladega County Health Dept-sylacauga Fp Clinic	AL	Public Health or Welfare Agency	$0	$951.3K
Hamo Neurology Clinic	AL	Neurology Physician	$0	$943.7K

Sylacauga Health Care Authority 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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