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 Wisconsin for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Wisconsin 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. Wisconsin (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.

Lakeshore Medical Clinic, LLC (NPI 1003861188)

Lakeshore Medical Clinic, LLC is a family medicine physician provider located in Saint Francis, Wisconsin. This profile covers 0 Medicare and 152 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	Lakeshore Medical Clinic, LLC
Address	2000 E Layton Ave Ste 100
City	Saint Francis
State	WI
ZIP	53235
Taxonomy	Family Medicine Physician
NPI Enumerated	May 24, 2006

Payer Source	Total Paid
Medicaid	$8.4M
Medicare	$0

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

152 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	77,980	$40	$3M
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…	69,630	$30	$1.9M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	5,150	$60	$303.6K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	4,150	$60	$244.8K
98941	The provider applies manipulation to influence joint and neurophysiological function by a variety of techniques and modalities in three to four spinal regions.	12,580	$20	$226.4K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	16,090	$10	$225.2K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	3,170	$60	$177.5K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	4,510	$30	$144.2K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	5,530	$20	$127.3K
99000	Use this code for the in office preparation of a specimen for lab analysis and or its transport from the office to the outside testing laboratory.	31,410	$1	$125.6K

Showing 1–10 of 152

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.

Claims Volume vs. Wisconsin Distribution

Lakeshore Medical Clinic, LLC — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

152 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	152	260	3,590	$20	$232.2K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	123	190	620	$40	$226.6K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	23	1,630	270	$40	$205.3K
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…	25	1,760	250	$40	$173.2K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	365	500	3,140	$20	$148.9K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	244	630	2,500	$20	$135.5K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	81	150	440	$70	$131.9K
94640	The provider administers oxygen under pressure or not under pressure to open obstructed air passages. He uses any of the listed devices to treat a patient with an acute obstruction of the airway that…	96	120	1,090	$40	$124.7K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	165	220	2,770	$20	$120.2K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	24	190	370	$60	$107.4K

Showing 1–10 of 152

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aurora Medical Group, Inc.	WI	Certified Registered Nurse Anesthetist	$2.2K	$139.2M
West Allis Memorial Hospital, Inc.	WI	General Acute Care Hospital	$0	$23.3M
Aurora Health Care North, Inc.	WI	General Acute Care Hospital	$0	$6.8M
Aurora Health Care Southern Lakes, Inc.	WI	General Acute Care Hospital	$0	$4.5M
Jeffrey Bahr	WI	Internal Medicine Physician	$3.1M	$356.4K
Aurora Medical Group, Inc.	WI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3.2M
Aurora Health Care Metro, Inc.	WI	Clinic/Center	$0	$2.1M
Reed Mitchell	VA	Hematology & Oncology Physician	$1M	$0
Topeka Physician Group, LLC	KS	Internal Medicine Physician	$0	$963.7K
Jessica Kot	IL	Family Nurse Practitioner	$849.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ltc Dental	WI	Dental Clinic/Center	$0	$1.2M
Sarah Reimer	WI	Diagnostic Radiology Physician	$234.1K	$0
Mack Karnes	WI	Diagnostic Radiology Physician	$207.2K	$150
Orlin Hadjiev	WI	Diagnostic Radiology Physician	$177.8K	$0
Rupesh Patel	WI	Diagnostic Radiology Physician	$151.3K	$320
Anand Brahmamdam	WI	Diagnostic Radiology Physician	$138.6K	$0
Ryan Hilbelink	WI	Diagnostic Radiology Physician	$131.8K	$0
Kari Kluessendorf	WI	Diagnostic Radiology Physician	$130K	$0
Daniel Peterson	WI	Diagnostic Radiology Physician	$124.5K	$0
Xue Wang	WI	Diagnostic Radiology Physician	$120.2K	$0

Lakeshore Medical Clinic, LLC — Billing Profile & Reimbursement Data

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Lakeshore Medical Clinic, LLC — 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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