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.

Munson Healthcare Otsego Memorial Hospital (NPI 1164628426)

Munson Healthcare Otsego Memorial Hospital is a rural health clinic/center provider located in Gaylord, Michigan. This profile covers 0 Medicare and 75 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	Munson Healthcare Otsego Memorial Hospital
Address	829 N Center Ave
City	Gaylord
State	MI
ZIP	49735
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	June 25, 2007

Payer Source	Total Paid
Medicaid	$6.2M
Medicare	$0

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

75 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	88,240	$40	$3.9M
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	1,170	$520	$610.2K
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…	33,010	$20	$495.1K
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…	22,590	$20	$474.3K
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…	4,650	$30	$144.2K
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…	5,170	$20	$103.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,950	$30	$88.6K
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…	3,040	$20	$69.9K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	1,940	$40	$67.8K
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	$30	$58.5K

Showing 1–10 of 75

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

Munson Healthcare Otsego Memorial Hospital — 3 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

75 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	4	290	5,950	$50	$689.7K
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	32	160	260	$820	$506.6K
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…	137	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…	143	4,770	1,060	$50	$247.8K
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…	88	670	730	$60	$140K
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…	73	590	850	$50	$134.5K
59430	For this service, the provider or nonphysician healthcare professional provides care to the patient in the outpatient setting following the delivery. Routine postpartum care can involve one or more…	53	150	190	$170	$104K
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…	239	1,860	220	$90	$96.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	112	720	420	$60	$93.9K
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…	217	2,000	260	$60	$84.2K

Showing 1–10 of 75

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Munson Healthcare Otsego Memorial Hospital	MI	General Acute Care Hospital	$0	$14.2M
Robert Kennedy	MI	Clinical Cardiac Electrophysiology Physician	$124.1K	$0
Michael Vanwagner	MI	Orthopaedic Surgery Physician	$114K	$0
Jacob Maclean	MI	Family Medicine Physician	$97K	$0
Paul Reynolds	MI	Surgery Physician	$39K	$0
Lynne Mccormick	MI	Urology Physician	$33.1K	$0
Robert Wedge	MI	Certified Registered Nurse Anesthetist	$26.7K	$0
Megan Spicer	MI	Acute Care Nurse Practitioner	$23K	$0
Lindsay Harden	MI	Surgery Physician	$22.7K	$0
Dominic Monterosso	MI	Anesthesiology Physician	$21.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Home & Health Services LLC	MI	Home Health Agency	$0	$10.3M
Northern Michigan Substance Abuse Services, Inc.	MI	Substance Use Disorder Rehabilitation Clinic/Center	$93.2K	$9.7M
Otsego County Ambulance Corps, Inc.	MI	Land Ambulance	$510.8K	$1.3M
Jeffrey Chaulk	MI	Ophthalmology Physician	$529.6K	$0
Michael Habryl	MI	Ophthalmology Physician	$271.4K	$0
Guardian Flight LLC	MI	Air Ambulance	$203.7K	$0
Adam Moffatt	MI	Physician Assistant	$141.5K	$0
Donald Cousineau	MI	General Practice Physician	$130.6K	$0
Rosanne Freeman Paz	MI	Internal Medicine Physician	$106.4K	$0
Kristine Bobish	MI	Cardiovascular Disease Physician	$80.2K	$0

Munson Healthcare Otsego Memorial Hospital — Billing Profile & Reimbursement Data

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Munson Healthcare Otsego Memorial Hospital — 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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