Physician
Capstone Health Services Foundation PC
Capstone Health Services Foundation PC was paid $12.43M by Medicaid between Jan 2018 and Dec 2024, across 104 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 27% of everything it billed.
33Billing provider infoCAPSTONE HEALTH SERVICES FOUNDATION PC
TUSCALOOSA, AL 35401
TUSCALOOSA, AL 35401
33aNPI1740397751assigned 08/24/2006
33bProvider typeFamily Medicine Physician
28Total paid$12.43M
24GClaims303,975
24DCodes billed104
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in Alabama
Rank by total paid#3 of 455
Median peer was paid$57K
This provider vs. median218×
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 | 44,949 | $1.51M | |
| 2019 | 51,565 | $1.91M | |
| 2020 | 38,804 | $1.49M | |
| 2021 | 50,063 | $1.94M | |
| 2022 | 47,176 | $1.83M | |
| 2023 | 43,349 | $2.30M | |
| 2024incomplete | 28,069 | $1.45M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 27% | 52,134 | 48,077 | $3.31M |
| 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 | 21% | 31,648 | 29,097 | $2.59M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 7.9% | 14,616 | 14,215 | $983K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 7.9% | 14,445 | 14,103 | $981K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 3.3% | 6,323 | 6,087 | $412K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 2.9% | 8,112 | 3,669 | $366K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 2.5% | 26,586 | 26,069 | $316K |
| 87801 | Infectious agent detection by nucleic acid; amplified probe, multiple organisms | 2.3% | 6,026 | 5,405 | $287K |
| 90686 | 1.9% | 13,067 | 12,749 | $231K | |
| 99238 | Hospital discharge day management, 30 minutes or less | 1.8% | 3,354 | 3,123 | $223K |
| 99460 | 1.7% | 2,476 | 2,266 | $215K | |
| 90670 | 1.7% | 11,112 | 10,870 | $212K |
92 more codes
| 99232 | Hospital visit by a doctor, follow-up day | 1.6% | 8,770 | $197K |
| 99223 | Prolong inpt eval add15 m | 1.4% | 1,851 | $176K |
| 90698 | 1.4% | 9,069 | $172K | |
| 90680 | 1.3% | 8,840 | $163K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 1.2% | 5,997 | $155K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 1.1% | 2,646 | $131K |
| 99381 | <1% | 1,762 | $117K | |
| 90633 | <1% | 5,742 | $104K | |
| 90744 | <1% | 4,311 | $80K | |
| 90461 | <1% | 1,266 | $73K | |
| 90697 | <1% | 3,934 | $70K | |
| 90671 | <1% | 2,907 | $68K | |
| 87428 | <1% | 1,304 | $64K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 939 | $62K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 3,437 | $44K |
| 59400 | Routine obstetric care including antepartum care, vaginal delivery, and postpartum care | <1% | 51 | $44K |
| 90651 | <1% | 821 | $39K | |
| 92551 | <1% | 6,187 | $36K | |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 873 | $29K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 581 | $28K |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 2,770 | $26K |
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | <1% | 271 | $26K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 2,531 | $25K |
| 99173 | <1% | 5,761 | $25K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 5,319 | $21K |
| 99462 | <1% | 541 | $20K | |
| 90656 | <1% | 1,099 | $20K | |
| 90716 | <1% | 935 | $18K | |
| 90707 | <1% | 966 | $18K | |
| 90734 | <1% | 313 | $17K | |
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | <1% | 101 | $16K |
| 99349 | <1% | 377 | $15K | |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 1,871 | $14K |
| D1206 | Topical application of fluoride varnish | <1% | 729 | $13K |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | <1% | 298 | $13K |
| H1000 | Prenatal care, at-risk assessment | <1% | 166 | $13K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 885 | $11K |
| 0001A | <1% | 275 | $10K | |
| G9357 | Post-partum screenings, evaluations and education performed | <1% | 116 | $10K |
| 0002A | <1% | 240 | $10K | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 431 | $8K |
| 90696 | <1% | 391 | $7K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 776 | $7K |
| 90710 | <1% | 380 | $7K | |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 119 | $7K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 508 | $6K |
| 90715 | <1% | 232 | $6K | |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 128 | $6K |
| 0071A | <1% | 123 | $5K | |
| 0072A | <1% | 123 | $5K | |
| 85027 | <1% | 976 | $4K | |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 118 | $4K |
| 99307 | <1% | 459 | $4K | |
| 96127 | <1% | 929 | $3K | |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | <1% | 162 | $3K |
| 0012A | <1% | 64 | $2K | |
| 0011A | <1% | 65 | $2K | |
| 90674 | <1% | 254 | $2K | |
| 87481 | <1% | 82 | $2K | |
| 87081 | <1% | 308 | $2K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 367 | $2K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 12 | $2K |
| 36416 | <1% | 756 | $2K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 18 | $2K |
| 54150 | <1% | 19 | $2K | |
| 82950 | <1% | 281 | $2K | |
| 81025 | <1% | 572 | $1K | |
| 87661 | Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe | <1% | 41 | $839.67 |
| 99305 | <1% | 41 | $839.30 | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 294 | $816.00 |
| 85660 | <1% | 169 | $735.54 | |
| 76830 | Ultrasound, transvaginal | <1% | 13 | $710.00 |
| 80053 | Comprehensive metabolic panel | <1% | 66 | $681.76 |
| 80061 | Lipid panel | <1% | 49 | $618.32 |
| 90685 | <1% | 29 | $554.12 | |
| 0004A | <1% | 14 | $520.00 | |
| 59426 | <1% | 87 | $491.00 | |
| 90380 | <1% | 32 | $389.06 | |
| 95819 | <1% | 58 | $237.62 | |
| 90381 | <1% | 28 | $216.00 | |
| 87807 | <1% | 12 | $123.10 | |
| 87400 | <1% | 30 | $120.00 | |
| 85014 | <1% | 90 | $96.00 | |
| 85018 | <1% | 90 | $96.00 | |
| 81002 | <1% | 6,740 | $51.10 | |
| 97802 | <1% | 58 | $36.00 | |
| 1159F | 0% | 365 | $0.00 | |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | 0% | 40 | $0.00 |
| 3078F | 0% | 28 | $0.00 | |
| 59430 | 0% | 125 | $0.00 | |
| 3074F | 0% | 59 | $0.00 | |
| 3079F | 0% | 13 | $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 officialARENDALE, ALLISON (DIRECTOR FINANCIAL AFFAIRS)
| Provider | Location | Paid |
|---|---|---|
| Capstone Health Services Foundation PC | Northport, AL | $1.02M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.