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.

Mercy Health Physicians Lima, LLC (NPI 1225292865)

Mercy Health Physicians Lima, LLC is a family medicine physician provider located in Lima, Ohio. This profile covers 0 Medicare and 148 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	Mercy Health Physicians Lima, LLC
Address	830 W High St Ste 206
City	Lima
State	OH
ZIP	45801
Taxonomy	Family Medicine Physician
NPI Enumerated	July 14, 2008

Payer Source	Total Paid
Medicaid	$9.1M
Medicare	$0

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

148 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…	75,860	$50	$3.8M
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…	96,630	$30	$3.1M
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…	25,470	$10	$356.5K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	28,880	$10	$259.9K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	2,350	$60	$145.5K
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…	3,450	$40	$144.8K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	23,930	$10	$119.6K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	5,750	$20	$115K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	3,760	$30	$101.6K
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…	1,500	$70	$98.9K

Showing 1–10 of 148

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

Mercy Health Physicians Lima, LLC — 3 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

148 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0585	Injection, onabotulinumtoxina, 1 unit	51	60	250	$730	$707.7K
J0574	Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine	28	40	5,650	$20	$435.4K
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…	2,154	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…	63	4,510	500	$60	$377.8K
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…	59	5,080	560	$40	$323.9K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	65	330	630	$80	$231.5K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	78	170	240	$360	$217K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	446	480	280	$70	$181.7K
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	40	80	1,450	$50	$176.7K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	219	700	210	$60	$154.1K

Showing 1–10 of 148

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Health-st Ritas Medical Center LLC	OH	General Acute Care Hospital	$0	$48.1M
Zoheir Abdelbaki	OH	Nuclear Cardiology Physician	$478.7K	$0
Julius Kato	OH	Cardiovascular Disease Physician	$238.7K	$0
Irfan Ahmed	OH	Psychiatry Physician	$185.7K	$52.7K
Mandy Klass	OH	Family Medicine Physician	$223.1K	$0
Bekele Ayele	OH	Cardiovascular Disease Physician	$217.8K	$0
Bernard Hynes	OH	Clinical Cardiac Electrophysiology Physician	$168.2K	$0
Mukti Patel-prineas	CT	Family Medicine Physician	$144K	$0
Adel Shaheen	OH	Cardiovascular Disease Physician	$114.7K	$170
Ali Almudallal	OH	Neurology Physician	$108.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lima-urban Minority Alcoholism And Drug Abuse Outreach Program., Inc	OH	Community Health Clinic/Center	$0	$14.8M
Health Partners Of Western Ohio	OH	Federally Qualified Health Center (FQHC)	$0	$14.6M
Health Partners Of Western Ohio	OH	Federally Qualified Health Center (FQHC)	$0	$11.4M
Specialized Alternatives For Families And Youth Of Ohio, Inc.	OH	Community/Behavioral Health Agency	$0	$6.9M
Bryan Gray	OH	Dermatology Physician	$2.4M	$499.2K
New Vision Medical Laboratories, LLC	OH	Clinical Medical Laboratory	$889.8K	$1.5M
Vivian Hobayan	OH	Specialist	$1.7M	$0
Michael Heaphy	OH	Dermatology Physician	$660.9K	$0
James Wolery	OH	Cardiovascular Disease Physician	$288.4K	$2.2K
Anil Muddada	OH	Nephrology Physician	$283.9K	$0

Mercy Health Physicians Lima, LLC — Billing Profile & Reimbursement Data

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Mercy Health Physicians Lima, 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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