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

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

Michumi PLLC (NPI 1255388021)

Michumi PLLC is a emergency medicine physician provider located in Williamsburg, Virginia. This profile covers 0 Medicare and 45 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	Michumi PLLC
Address	120 Monticello Ave
City	Williamsburg
State	VA
ZIP	23185
Taxonomy	Emergency Medicine Physician
NPI Enumerated	May 27, 2006

Payer Source	Total Paid
Medicaid	$12.4M
Medicare	$0

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

45 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	63,730	$60	$3.6M
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…	41,630	$80	$3.2M
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…	29,390	$70	$2.1M
0241U	N/A	10,200	$110	$1.2M
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…	6,630	$110	$716.5K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	10,610	$40	$371.5K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	9,060	$30	$253.6K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	18,400	$10	$239.1K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	17,510	$10	$227.6K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	1,910	$50	$95.7K

Showing 1–10 of 45

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Michumi PLLC — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

45 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
0241U	N/A	10	90	1,840	$80	$306.3K
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…	51	3,520	370	$70	$280.7K
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…	31	4,010	290	$50	$199.8K
94640	The provider administers oxygen under pressure or not under pressure to open obstructed air passages. He uses any of the listed devices to treat a patient with an acute obstruction of the airway that…	104	210	390	$50	$106.2K
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…	25	970	100	$100	$87.1K
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…	5	1,000	100	$70	$81.1K
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,…	126	980	140	$70	$70.9K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	60	230	300	$40	$65.4K
E0114	Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips	15	20	910	$30	$65.3K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	9	200	370	$30	$58.8K

Showing 1–10 of 45

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Riverside Hospital Inc	VA	General Acute Care Hospital	$0	$136.7M
Riverside Physician Services, Inc.	VA	Family Medicine Physician	$0	$44.7M
Shore Health Services Inc.	VA	Rural Acute Care Hospital	$0	$24.7M
Riverside Middle Peninsula Hospital Inc	VA	General Acute Care Hospital	$0	$19M
Riverside Physician Services Inc	VA	Emergency Medicine Physician	$0	$17.3M
Doctors' Hospital Of Williamsburg	VA	General Acute Care Hospital	$0	$12M
Riverside Hospital Inc.	VA	Family Medicine Physician	$0	$7.7M
Matthew Reed	VA	Ophthalmology Physician	$4.6M	$0
Brian Keel	VA	Ophthalmology Physician	$2.7M	$0
Anthony Farah	VA	Ophthalmology Physician	$653.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Colonial Behavioral Health	VA	Community/Behavioral Health Agency	$0	$21.6M
Connect Youth And Family Services	VA	Community/Behavioral Health Agency	$0	$6M
Elena Flagg	VA	Rheumatology Physician	$3.8M	$0
Laila Rahbar	VA	Rheumatology Physician	$3.2M	$0
James City County Board Of Supervisors	VA	Ambulance	$1.2M	$822.4K
Misty White	VA	Family Nurse Practitioner	$1.2M	$0
Zantha Marcuson	VA	MOHS-Micrographic Surgery Physician	$886K	$0
Eric Karlin	VA	Allergy & Immunology Physician	$564.6K	$1.6K
Emily Himes	VA	Dermatology Physician	$463.4K	$0
Krystal Ainsley	VA	Internal Medicine Physician	$444.5K	$0

Michumi PLLC — Billing Profile & Reimbursement Data

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Michumi PLLC — 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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