Physician
NPI deactivated
Avalon Medical Group
Avalon Medical Group was paid $685K by Medicaid between Jan 2018 and Dec 2024, across 51 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 78% of everything it billed.
33Billing provider infoAVALON MEDICAL GROUP
MUSCLE SHOALS, AL 35661
MUSCLE SHOALS, AL 35661
33aNPI1730149071assigned 03/23/2006
33bProvider typeFamily Medicine Physician
28Total paid$685K
24GClaims46,435
24DCodes billed51
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in Alabama
Rank by total paid#65 of 455
Median peer was paid$57K
This provider vs. median12×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 9,184 | $84K | |
| 2019 | 7,999 | $75K | |
| 2020 | 5,443 | $62K | |
| 2021 | 7,057 | $115K | |
| 2022 | 5,741 | $128K | |
| 2023 | 7,480 | $141K | |
| 2024incomplete | 3,531 | $81K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 78% | 11,925 | 10,787 | $533K |
| 80053 | Comprehensive metabolic panel | 3.5% | 3,985 | 3,853 | $24K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 3.2% | 669 | 601 | $22K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 3.2% | 4,374 | 4,190 | $22K |
| 80061 | Lipid panel | 2.6% | 2,694 | 2,630 | $18K |
| G0481 | 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 not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed | 2.4% | 435 | 424 | $17K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 1.9% | 2,322 | 2,042 | $13K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 1.5% | 322 | 180 | $10K |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 656 | 618 | $4K |
| 90674 | <1% | 356 | 338 | $4K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 739 | 729 | $4K |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 230 | 218 | $2K |
39 more codes
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 531 | $2K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 71 | $2K |
| J1040 | Injection, methylprednisolone acetate, 80 mg | <1% | 151 | $1K |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 192 | $1K |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 978 | $1K |
| 82607 | <1% | 180 | $816.00 | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 12 | $799.44 |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 12 | $579.48 |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 13 | $566.93 |
| 99457 | <1% | 42 | $493.38 | |
| 85004 | <1% | 217 | $335.00 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 122 | $315.00 |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 15 | $240.00 |
| 81001 | <1% | 189 | $224.00 | |
| 90661 | <1% | 13 | $210.00 | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 75 | $197.67 |
| 84439 | <1% | 69 | $180.00 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 176 | $152.93 |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 101 | $99.00 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | <1% | 48 | $70.29 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 759 | $59.86 |
| 99453 | <1% | 12 | $46.50 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 568 | $2.00 |
| 3074F | 0% | 3,103 | $0.00 | |
| 3079F | 0% | 1,094 | $0.00 | |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 205 | $0.00 |
| 3075F | 0% | 162 | $0.00 | |
| 3044F | 0% | 126 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 119 | $0.00 |
| 3080F | 0% | 13 | $0.00 | |
| 3008F | 0% | 14 | $0.00 | |
| 1160F | 0% | 3,925 | $0.00 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 719 | $0.00 |
| 3078F | 0% | 2,723 | $0.00 | |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 738 | $0.00 |
| 1159F | 0% | 136 | $0.00 | |
| 3077F | 0% | 56 | $0.00 | |
| 99487 | Ccm add 20min | 0% | 31 | $0.00 |
| 99080 | 0% | 18 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialMCCOY, LOREN (PRESIDENT)