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.

State Of Alabama Department Of Public Health (NPI 1982747192)

Key Findings

Field	Value
Entity Type	Organization
Organization	State Of Alabama Department Of Public Health
Address	204 Legends Ct
City	Prattville
State	AL
ZIP	36066
Taxonomy	Clinical Medical Laboratory
NPI Enumerated	February 15, 2007

Payer Source	Total Paid
Medicaid	$374.3M
Medicare	$0

This entity reports no Medicare billing on file and $374.3M in lifetime Medicaid revenue, making it effectively a Medicaid-focused clinical laboratory at scale. The absence of Medicare activity indicates its operational footprint and revenue exposure are concentrated in state public-health and Medicaid-funded programs rather than fee-for-service Medicare patients.

Revenue is highly concentrated in a very small number of Medicaid codes: the top three Medicaid codes together account for 77.6% of the provider's total Medicaid revenue, and a single code, 81479, accounts for $267.7M (71.5%) of the $374.3M total. The remaining two codes in the top-three group, 83498 and 81220, each contribute $11.3M (3.0% each), underscoring that a single molecular pathology line dominates the payer revenue mix.

The CPT/HCPCS mix and volumes point to a public‑health laboratory and newborn/genetic screening operation with a heavy molecular-testing orientation. High-revenue and high-volume codes include 81479 (molecular pathology), 83498 (17 hydroxyprogesterone), 81220 (CFTR mutation panel), and multiple metabolic/newborn screening assays (eg, 82775, 82261, 82017, 82379), which together indicate routine statewide screening and confirmatory testing workflows.

Operational throughput is evident in the claim and unit-price patterns: several routine newborn/metabolic tests show very large claim counts (for example many codes report 323.3K claims with low average paid/claim in the $8–$27 range), whereas 81479 shows 166.4K claims at a much higher average paid/claim ($1609). This combination of very high-volume, low-price screening assays alongside a smaller number of higher-priced molecular procedures is consistent with a centralized public-health lab that processes large specimen volumes and refers or performs specialized molecular work.

Competitive standing within Alabama is mixed by assay. The provider ranks #1 in-state for 81479 (1 of 4, 100th percentile) but that ranking is annotated as a "typical, unremarkable volume for this code," indicating it is a leading in-state supplier for molecular pathology without an unusual statewide market share for that specific code. In contrast, several codes show dominance or extreme statewide concentration — for example 87801 ranks #1 of 92 providers in-state and is labeled an "extreme outlier, far above typical state volume," and 84443 ranks #2 of 131 (99th percentile; also an "extreme outlier"), indicating areas where the lab operates well above typical state volumes.

Several assays have no state peer volume comparison available or are sole providers in the state, consistent with centralized public-health testing responsibilities: 82775, 82261, 82017, 82379, and 84437 are all reported as #1 of 1 or listed with "no state peer volume comparison available," which suggests exclusive or near-exclusive provision of those specific newborn/metabolic tests at the state level. These sole-provider signals are important when assessing market access and referral pathways for specialty assays.

The profile shows multiple statistical outliers and notably elevated volumes across test categories that align with public-health priorities: besides 87801 and 84443 being called "extreme outlier," codes such as 83021 and 86780 also register as extreme outliers (100th percentile) while 87661 and 83655 are "notably above typical" for the state. These outlier labels identify assays where this provider materially exceeds peer activity and may be the primary in-state resource for specific infectious disease and screening services.

The provider's NPI was enumerated on 2007-02-15 (~19 years ago), indicating long-term operation within the state. Combined with the concentrated Medicaid revenue ($374.3M) and the pattern of statewide sole-provider or high-percentile ranks on many public-health assays, this tenure supports a sustained role as Alabama's central public-health laboratory for newborn screening, metabolic testing, and selected molecular diagnostics.

Medicaid: Complete Services Breakdown

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

49 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
81479	Use 81479 to report a molecular pathology procedure that does not have a specific code.	166,370	$1,610	$267.7M
83498	The lab analyst measures the 17 hydroxyprogesterone in a sample such as blood, serum, urine, or even amniotic fluid. This hormone is a building block for the adrenal cortex hormone cortisol.	323,330	$40	$11.3M
81220	The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR…	10,130	$1,110	$11.3M
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	249,530	$40	$10M
82775	The lab analyst measures the amount of galactose–1–phosphate uridyl transferase in a blood sample, usually following a positive newborn screen that shows an abnormal result, or to monitor compliance…	323,330	$30	$8.7M
82017	This test is for the analysis of quantitative acylcarnitines, which clinicians use to diagnose various fatty acid metabolic disorders. The clinician may also use this testing to help determine the…	323,330	$20	$7.1M
82139	The lab analyst performs testing for 6 or more amino acids, usually on a specimen such as blood, plasma, urine, or other body fluids, by quantitative analysis to determine if any are outside the…	323,330	$20	$7.1M
82261	The lab analyst performs a measurement of the enzyme biotinidase, typically on a blood sample. This enzyme test is useful for the identification of a deficiency of biotinidase and also for the…	323,330	$20	$7.1M
82379	The lab analyst measures both the total and free carnitine on serum, plasma, urine, or tissue specimens. Total carnitine includes both the free carnitine and all the acylcarnitines. Carnitines are…	323,330	$20	$7.1M
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…	324,160	$20	$6.8M

Showing 1–10 of 49

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

State Of Alabama Department Of Public Health — 15 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

49 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
81479	Use 81479 to report a molecular pathology procedure that does not have a specific code.	1	10	1,190	$1,590	$67M
82775	The lab analyst measures the amount of galactose–1–phosphate uridyl transferase in a blood sample, usually following a positive newborn screen that shows an abnormal result, or to monitor compliance…	1	10	323,330	$30	$8.7M
82017	This test is for the analysis of quantitative acylcarnitines, which clinicians use to diagnose various fatty acid metabolic disorders. The clinician may also use this testing to help determine the…	1	10	323,330	$20	$7M
82261	The lab analyst performs a measurement of the enzyme biotinidase, typically on a blood sample. This enzyme test is useful for the identification of a deficiency of biotinidase and also for the…	1	10	323,330	$20	$7M
82379	The lab analyst measures both the total and free carnitine on serum, plasma, urine, or tissue specimens. Total carnitine includes both the free carnitine and all the acylcarnitines. Carnitines are…	1	10	323,330	$20	$7M
81220	The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR…	2	10	5,570	$480	$4.1M
83498	The lab analyst measures the 17 hydroxyprogesterone in a sample such as blood, serum, urine, or even amniotic fluid. This hormone is a building block for the adrenal cortex hormone cortisol.	1	10	21,240	$30	$3.8M
82139	The lab analyst performs testing for 6 or more amino acids, usually on a specimen such as blood, plasma, urine, or other body fluids, by quantitative analysis to determine if any are outside the…	1	10	161,680	$20	$3.5M
81329	The lab analyst performs the technical lab test to detect deletions in the survival of motor neuron 1 (SMN1), telomeric, gene and may also analyze the survival of motor neuron 2 (SMN2), centromeric,…	1	10	40,330	$70	$2.9M
84437	The lab analyst performs a test to measure thyroxine in specimens that require elution, which is washing whole blood from an absorbent material using a solvent, typically in whole blood neonatal…	1	10	323,330	$10	$2.7M

Showing 1–10 of 49

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aaron Shinkle	AL	Interventional Pain Medicine Physician	$868K	$0
Joshua Iyegha	AL	Physical Therapist	$144.2K	$0
Marilyn Hepperle	AL	Specialist	$132.7K	$0
Edwin Grice	AL	Physical Therapist	$127.3K	$0
Kendra Harris	AL	Family Nurse Practitioner	$94.8K	$0
Michael Betsayad	AL	Family Medicine Physician	$90.8K	$0
Holli Johnson	AL	Family Nurse Practitioner	$84.7K	$0
Troy Zimbelman	AL	Foot Surgery Podiatrist	$67.4K	$0
Leigh Ann Grooms	AL	Physical Therapist	$54.9K	$0
Lisa Oswald	AL	Physical Therapist	$53.2K	$0

State Of Alabama Department Of Public Health — Billing Profile & Reimbursement Data

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State Of Alabama Department Of Public Health — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
State Of Alabama Department Of Public Health	AL	Home Health Agency	$0	$6.9M
State Of Alabama Department Of Public Health	AL	Home Health Agency	$0	$1.3M
Shelby Nesbitt	AL	Acute Care Nurse Practitioner	$71.2K	$0