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.

Emergency Care Specialists PC (NPI 1093766958)

Emergency Care Specialists PC is a emergency medicine physician provider located in Grand Rapids, Michigan. This profile covers 0 Medicare and 28 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	Emergency Care Specialists PC
Address	100 Michigan Ne
City	Grand Rapids
State	MI
ZIP	49503
Taxonomy	Emergency Medicine Physician
NPI Enumerated	May 15, 2006

Payer Source	Total Paid
Medicaid	$5.4M
Medicare	$0

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

28 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	43,970	$50	$2M
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.	34,990	$50	$1.7M
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.	16,260	$60	$1M
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.	6,380	$50	$299.8K
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…	1,620	$110	$181.9K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	14,110	$1	$56.5K
12001	This CPT code is used for the simple repair of superficial wounds to the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including the hands and feet) that are 2.5 cm or less in…	870	$30	$23.5K
10061	The provider incises the area of abscess and drains the collection of pus, such as those related to a carbuncle, hidradenitis, cyst, furuncle, or paronychia, with the help of surgical instruments. A…	290	$80	$21.4K
12011	This CPT code is used for the simple repair of superficial wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes, that are 2.5 cm or less in size.	630	$30	$20.6K
64400	The provider injects an anesthetic agent and/or steroid close to each branch of fifth cranial nerve, also called the trigeminal nerve, a mixed cranial nerve that is composed of three large branches —…	390	$40	$15.3K

Showing 1–10 of 28

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

Emergency Care Specialists PC — 0 of 24 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

28 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.	78	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.	59	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.	37	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…	91	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.	66	260	2,670	$70	$348.7K
76705	An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code…	169	210	950	$30	$103.6K
99292	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…	30	40	380	$80	$65.1K
10061	The provider incises the area of abscess and drains the collection of pus, such as those related to a carbuncle, hidradenitis, cyst, furuncle, or paronychia, with the help of surgical instruments. A…	16	40	60	$100	$44.2K
10060	The provider incises the area of abscess and drains the collection of pus from a lesion, such as a carbuncle, hidradenitis, cyst, furuncle, or paronychia, with the help of surgical instruments. A…	44	110	250	$70	$39.9K
31500	The provider inserts a flexible tube into the trachea (windpipe) typically via the mouth in an emergency situation to maintain an open airway in a patient with a compromised airway.	21	40	130	$80	$38.9K

Showing 1–10 of 28

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Spectrum Health Hospitals	MI	General Acute Care Hospital	$0	$243.2M
Kent County Cmh Authority	MI	Community/Behavioral Health Agency	$0	$97.6M
Saint Mary's Health Services	MI	General Acute Care Hospital	$0	$92M
Cancer & Hematology Centers Of Western Mi, P.C.	MI	Specialist	$0	$59.5M
Cherry Street Services, Inc.	MI	Federally Qualified Health Center (FQHC)	$0	$50.9M
Ecs Western Michigan PC	MI	Emergency Medicine Physician	$0	$50.6M
Neo Natal Associates Plc	MI	Neonatal-Perinatal Medicine Physician	$0	$27.7M
Spectrum Health Hospitals	MI	Hospitalist Physician	$0	$25.2M
Life Ems Inc	MI	Land Ambulance	$3.1M	$22M
Cherry Street Services, Inc.	MI	Federally Qualified Health Center (FQHC)	$0	$24.6M

Emergency Care Specialists PC — Billing Profile & Reimbursement Data

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Emergency Care Specialists 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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