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.

Mclaren Oakland (NPI 1053463778)

Mclaren Oakland is a family medicine physician provider located in Pontiac, Michigan. This profile covers 0 Medicare and 128 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	Mclaren Oakland
Address	50 N Perry St
City	Pontiac
State	MI
ZIP	48342
Taxonomy	Family Medicine Physician
NPI Enumerated	January 16, 2007

Payer Source	Total Paid
Medicaid	$5.7M
Medicare	$0

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

128 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…	30,160	$70	$2M
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…	34,590	$40	$1.4M
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…	4,010	$80	$324.6K
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…	2,810	$100	$272.3K
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…	2,880	$90	$245.1K
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…	5,070	$40	$192.5K
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…	2,580	$50	$128.8K
99203	The provider sees a new 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 provider…	2,420	$50	$128K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	1,350	$90	$120K
99205	The provider sees a new 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 provider…	990	$110	$105.7K

Showing 1–10 of 128

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

Mclaren Oakland — 2 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

128 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	132	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.	227	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.	237	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.	224	450	1,540	$90	$1.3M
G0482	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…	24	70	680	$100	$604K
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…	137	160	2,720	$60	$546.6K
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…	198	270	510	$140	$395.2K
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.	238	260	2,670	$70	$348.7K
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	4,380	1,000	$70	$289.9K
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…	129	4,770	1,060	$50	$247.8K

Showing 1–10 of 128

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mclaren Oakland	MI	General Acute Care Hospital	$0	$39.2M
Mohammad Chisti	MI	Hematology & Oncology Physician	$310.9K	$0
Fadi Alkhankan	WV	Pulmonary Disease Physician	$277.5K	$0
Emad Shehada	MI	Pulmonary Disease Physician	$265.6K	$0
Renny Abraham	MI	Internal Medicine Physician	$228.9K	$0
Victor Hunyadi	MI	Cardiovascular Disease Physician	$172.3K	$0
Melissa Ianitelli	MI	Cardiovascular Disease Physician	$157.4K	$0
Hassan Almaat	MI	Geriatric Psychiatry Physician	$151.3K	$0
Jay Mohan	MI	Interventional Cardiology Physician	$133K	$0
Matthew Prince	MI	Orthopaedic Surgery Physician	$132.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Miles Grubb Associates LLC	MI	Land Ambulance	$1.8M	$12.4M
Completion House, Inc. Dba Turning Point Recovery Centers	MI	Substance Abuse Rehabilitation Facility	$0	$7.8M
Vasimahmed Lala	MI	Internal Medicine Physician	$3.7M	$0
R Hemby	MI	Emergency Medical Services (Emergency Medicine) Physician	$116.4K	$283.2K
Binh Nguyen	MI	Cardiovascular Disease Physician	$135.9K	$180.8K
Kevin Carter	MI	Diagnostic Radiology Physician	$188.3K	$0
Kelly Welsh	MI	Emergency Medicine Physician	$116.3K	$0
Fadi Salloum	MI	Internal Medicine Physician	$101.2K	$0
Robert Howard	MI	Orthopaedic Surgery Physician	$42.6K	$0
Paul Urbanowski	MI	Anesthesiology Physician	$34.3K	$0

Mclaren Oakland — Billing Profile & Reimbursement Data

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Mclaren Oakland — 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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