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

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

Prime Healthcare Services - Garden City LLC (NPI 1043625940)

Prime Healthcare Services - Garden City LLC is a general acute care hospital provider located in Garden City, Michigan. This profile covers 0 Medicare and 264 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	Prime Healthcare Services - Garden City LLC
Address	6245 Inkster Rd
City	Garden City
State	MI
ZIP	48135
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 30, 2014

Payer Source	Total Paid
Medicaid	$31.2M
Medicare	$0

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

264 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	28,960	$300	$8.7M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	36,460	$180	$6.7M
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.	49,200	$140	$6.6M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	21,880	$80	$1.8M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	15,970	$30	$526.9K
96360	The provider introduces a catheter intravenously for supplementation of fluid and electrolytes for 31 minutes to one hour to treat severe cases of dehydration.	5,190	$80	$436K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	5,770	$70	$427.2K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	3,260	$130	$413.6K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	12,320	$30	$394.3K
G0378	Hospital observation service, per hour	2,450	$150	$369.8K

Showing 1–10 of 264

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Prime Healthcare Services - Garden City LLC — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

264 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	94	150	5,330	$50	$2.8M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	57	400	1,510	$190	$2.6M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	56	480	1,350	$110	$1.7M
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.	33	450	1,540	$90	$1.3M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	34	150	7,610	$90	$1.2M
G0378	Hospital observation service, per hour	53	100	2,820	$180	$1.1M
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…	11	10	190	$180	$910.5K
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…	49	160	2,720	$60	$546.6K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	96	230	2,380	$90	$490K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	134	270	510	$140	$395.2K

Showing 1–10 of 264

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Money Minders Plus, LLC	MI	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$139.4M
Pappalardo Alternative Placements, Inc.	MI	Private Vehicle	$0	$7.6M
James Armstrong	MI	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$1.1M	$0
Chelsea Duggan	MI	Dermatology Physician	$477.4K	$0
Randy Balmforth	MI	Diagnostic Radiology Physician	$98.2K	$178.4K
Ihab Deebajah	MI	Pulmonary Disease Physician	$261.7K	$0
Amine Zein	MI	Cardiovascular Disease Physician	$248.9K	$0
Roger Gonda	MI	Diagnostic Radiology Physician	$226.2K	$0
Adam Chornoby	MI	Cardiovascular Disease Physician	$222.4K	$0
Lisa Govila	MI	Diagnostic Radiology Physician	$166K	$0

Prime Healthcare Services - Garden City LLC — Billing Profile & Reimbursement Data

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Prime Healthcare Services - Garden City 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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