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.

Northwestern Michigan Emergency Physicians PC (NPI 1073597944)

Northwestern Michigan Emergency Physicians PC is a emergency medicine physician provider located in Traverse City, Michigan. This profile covers 0 Medicare and 20 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	Northwestern Michigan Emergency Physicians PC
Address	1105 6th St
City	Traverse City
State	MI
ZIP	49684
Taxonomy	Emergency Medicine Physician
NPI Enumerated	December 2, 2005

Payer Source	Total Paid
Medicaid	$7.5M
Medicare	$0

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

20 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.	38,130	$70	$2.5M
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.	38,640	$60	$2.2M
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.	28,090	$60	$1.7M
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…	4,510	$120	$523.3K
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.	3,310	$60	$185.6K
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…	2,640	$50	$131.9K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	25,430	$1	$101.7K
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…	1,000	$80	$75K
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…	1,260	$40	$55.2K
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…	1,100	$40	$39.6K

Showing 1–10 of 20

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

Northwestern Michigan Emergency Physicians PC — 0 of 19 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

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	46	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.	50	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.	60	450	1,540	$90	$1.3M
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…	47	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.	114	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…	1,355	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…	2,351	4,770	1,060	$50	$247.8K
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…	501	760	240	$100	$121.4K
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…	439	1,860	220	$90	$96.9K
99281	The provider sees a patient for the lowest level emergency department visit.	117	150	860	$50	$89.3K

Showing 1–10 of 20

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Brian Gelb	MI	Emergency Medical Services (Emergency Medicine) Physician	$226.8K	$0
Michael Seidman	FL	Otolaryngology/Facial Plastic Surgery Physician	$74.7K	$0
Marc Krakow	MI	Emergency Medical Services (Emergency Medicine) Physician	$21.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northern Lakes Community Mental Health Authority	MI	Community/Behavioral Health Agency	$0	$148.6M
Munson Medical Center	MI	General Acute Care Hospital	$0	$44.1M
Grand Traverse Radiologists PC	MI	Diagnostic Radiology Physician	$0	$7.3M
Northern Michigan Pediatric Dentistry	MI	Dental Clinic/Center	$0	$7M
Grand Traverse Womens Clinic PLLC	MI	Obstetrics Physician	$0	$6.7M
Northern Lakes Community Mental Health Authority	MI	Case Management Agency	$0	$5.9M
Northwest Michigan Surgery Center LLC	MI	Ambulatory Surgical Clinic/Center	$2.9M	$1.5M
Alliance Surgery Center, LLC	MI	Ambulatory Surgical Clinic/Center	$3M	$0
Michael Mawby	MI	Rheumatology Physician	$628.2K	$0
Surgery Center Plc	MI	Ambulatory Surgical Clinic/Center	$584.8K	$0

Northwestern Michigan Emergency Physicians PC — Billing Profile & Reimbursement Data

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Northwestern Michigan Emergency Physicians PC — 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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