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.

Ascension Borgess Lee Hospital (NPI 1194771030)

Ascension Borgess Lee Hospital is a critical access hospital provider located in Dowagiac, 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	Ascension Borgess Lee Hospital
Address	420 West High Street
City	Dowagiac
State	MI
ZIP	49047
Taxonomy	Critical Access Hospital
NPI Enumerated	May 25, 2006

Payer Source	Total Paid
Medicaid	$6.9M
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
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.	11,830	$160	$1.9M
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.	6,370	$230	$1.4M
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.	3,620	$370	$1.3M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	3,830	$120	$448.6K
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.	2,780	$90	$250K
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.	1,910	$120	$231.4K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	6,210	$30	$180K
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.	2,750	$40	$110K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	4,030	$30	$100.8K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	1,030	$90	$94.6K

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

Ascension Borgess Lee Hospital — 0 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
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.	161	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.	173	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.	132	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.	97	150	7,610	$90	$1.2M
G0378	Hospital observation service, per hour	100	100	2,820	$180	$1.1M
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…	120	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.	126	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…	255	270	510	$140	$395.2K
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.	95	140	5,720	$40	$381.8K
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.	126	260	2,670	$70	$348.7K

Showing 1–10 of 128

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mark Le	FL	Diagnostic Radiology Physician	$10.7M	$0
Jonathan Breslau	MN	Diagnostic Radiology Physician	$1.3M	$0
Linda Armstrong	GA	Diagnostic Radiology Physician	$643.9K	$175.1K
Neil Anand	MN	Diagnostic Radiology Physician	$529.9K	$58.1K
Kyung Yoo	IL	Diagnostic Radiology Physician	$280.5K	$238.4K
Wesley Pruett	MN	Diagnostic Radiology Physician	$441.3K	$770
Muhammad Hameed	MI	Medical Oncology Physician	$348.5K	$0
Mark Ellis	MN	Specialist	$337.9K	$0
Robert Gardner	CA	Diagnostic Radiology Physician	$335.5K	$0
Johnathan Hays	VA	Diagnostic Radiology Physician	$275K	$32K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Living Alternatives For The Developmentally Disabled, Inc.	MI	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$135.4M
Pokagon Band Of Potawatomi Indians	MI	Federally Qualified Health Center (FQHC)	$0	$11.5M
Living Alternatives For The Developmentally Disabled, Inc.	MI	In Home Supportive Care Agency	$0	$5.7M
Michelle Cockey	MI	Family Nurse Practitioner	$11.5K	$0
Marcy Parisi	MI	Family Nurse Practitioner	$8.4K	$0

Ascension Borgess Lee 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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