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

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

Mercy Health Physicians Lorain, LLC (NPI 1023347192)

Mercy Health Physicians Lorain, LLC is a family medicine physician provider located in Lorain, Ohio. This profile covers 0 Medicare and 187 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	Mercy Health Physicians Lorain, LLC
Address	3700 Kolbe Rd
City	Lorain
State	OH
ZIP	44053
Taxonomy	Family Medicine Physician
NPI Enumerated	December 18, 2009

Payer Source	Total Paid
Medicaid	$12.5M
Medicare	$0

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

187 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…	87,710	$50	$4.6M
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…	101,520	$40	$3.9M
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…	33,710	$20	$573K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	20,050	$20	$300.7K
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…	4,060	$50	$210.9K
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…	3,270	$60	$189.8K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	28,240	$10	$169.5K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	3,050	$50	$158.4K
99204	The provider sees a new 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 provider…	1,890	$70	$134.2K
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…	5,830	$20	$134K

Showing 1–10 of 187

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

Mercy Health Physicians Lorain, LLC — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

187 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	422	480	4,510	$90	$1.8M
T1015	Clinic visit/encounter, all-inclusive	528	530	7,190	$70	$1.5M
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.	207	230	2,200	$100	$530.1K
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…	52	4,510	500	$60	$377.8K
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…	57	5,080	560	$40	$323.9K
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…	86	430	560	$60	$303.2K
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…	103	480	450	$70	$292.9K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	124	280	570	$250	$276.5K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	213	270	420	$90	$276K
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…	57	330	630	$80	$231.5K

Showing 1–10 of 187

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Health-regional Medical Center LLC	OH	General Acute Care Hospital	$0	$42.4M
Riveon Mental Health And Recovery	OH	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$30.4M
Lorain County Alcohol & Drug Abuse Services, Inc.	OH	Substance Abuse Rehabilitation Facility	$0	$26M
Silver Maple Recovery, LLC	OH	Substance Use Disorder Rehabilitation Clinic/Center	$0	$17.6M
Sprenger Hospice, Inc.	OH	Community Based Hospice Care Agency	$0	$11.9M
Mercy Health-regional Medical Center LLC	OH	Community Based Hospice Care Agency	$0	$7.4M
Emergency Medical Services Of Lorain, Inc.	OH	Emergency Medicine Physician	$0	$6.9M
Kasra Karamlou	OH	Hematology & Oncology Physician	$1.5M	$0
Aimee Haber	OH	Ophthalmology Physician	$335.7K	$0
Heather Scullin	OH	Physical Medicine & Rehabilitation Physician	$232.3K	$0

Mercy Health Physicians Lorain, LLC — Billing Profile & Reimbursement Data

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Mercy Health Physicians Lorain, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wes Holiday	OH	Interventional Cardiology Physician	$202.7K	$0
Daniel Basinski	OH	Physician Assistant	$66.3K	$0
Richard White	OH	Family Medicine Physician	$56.4K	$0