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 Ohio for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Ohio 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. Ohio (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.

Northern Ohio Medical Specialists LLC (NPI 1225085855)

Northern Ohio Medical Specialists LLC is a internal medicine physician provider located in Sandusky, Ohio. This profile covers 0 Medicare and 210 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	Northern Ohio Medical Specialists LLC
Address	3004 Hayes Ave
City	Sandusky
State	OH
ZIP	44870
Taxonomy	Internal Medicine Physician
NPI Enumerated	May 28, 2006

Payer Source	Total Paid
Medicaid	$16.4M
Medicare	$0

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

210 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…	88,330	$50	$4.5M
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…	126,940	$40	$4.4M
11721	The provider surgically debrides (debulks or removes) 6 or more abnormal, diseased, or infected nails.	50,730	$10	$558K
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…	9,780	$50	$440K
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…	21,950	$20	$417.1K
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…	21,490	$20	$408.2K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	10,080	$40	$393.1K
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…	4,920	$70	$334.8K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	10,960	$20	$263K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	3,060	$70	$207.9K

Showing 1–10 of 210

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Ohio providers billing the same CPT/HCPCS codes.

Claims Volume vs. Ohio Distribution

Northern Ohio Medical Specialists LLC — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

210 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	45	80	100	$860	$719.1K
J0585	Injection, onabotulinumtoxina, 1 unit	24	60	250	$730	$707.7K
J2357	Injection, omalizumab, 5 mg	10	10	380	$1,250	$681.9K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	611	2,640	620	$90	$408.2K
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…	50	4,510	500	$60	$377.8K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	228	270	8,700	$10	$353.7K
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…	43	5,080	560	$40	$323.9K
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…	280	430	560	$60	$303.2K
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…	341	480	450	$70	$292.9K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	93	270	420	$90	$276K

Showing 1–10 of 210

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Jonathan Zahler	OH	Ophthalmology Physician	$456.3K	$0
Chase Scarbrough	OH	Dermatology Physician	$416.6K	$0
Michael Powers	OH	Orthopaedic Surgery Physician	$364K	$0
Todd Rambasek	OH	Allergy & Immunology Physician	$358.9K	$0
Steven Benedict	OH	Neurology Physician	$347.4K	$0
Emily Petitti	OH	Dermatology Physician	$324.7K	$0
Michael Shaughnessy	OH	Ophthalmology Physician	$269.6K	$0
Saba Sheik	OH	Internal Medicine Physician	$249.6K	$0
Jason Brown	OH	Orthopaedic Surgery Physician	$244.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Firelands Regional Medical Center	OH	General Acute Care Hospital	$0	$37.5M
Cambridge Home Health Care, Inc.	OH	Home Health Agency	$0	$19.4M
Firelands Regional Medical Center	OH	Multi-Specialty Clinic/Center	$0	$17.5M
Stein Hospice Services, Inc	OH	Community Based Hospice Care Agency	$0	$11.1M
Erie County Office Of Auditor	OH	Federally Qualified Health Center (FQHC)	$0	$7.5M
Erie County Office Of Auditor	OH	Substance Use Disorder Rehabilitation Hospital Unit	$0	$7M
Family Health Services Of Erie County	OH	Federally Qualified Health Center (FQHC)	$0	$6.9M
Brian Murphy	OH	Hematology & Oncology Physician	$2.8M	$0
Sandusky City Office Of Treasurer	OH	Land Ambulance	$345.9K	$1.1M
Surgery Center Of Sandusky LLC	OH	Ambulatory Surgical Clinic/Center	$974.7K	$0

Northern Ohio Medical Specialists LLC — Billing Profile & Reimbursement Data

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Northern Ohio Medical Specialists LLC — 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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