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.

Abdiel Ramos Mercado (NPI 1265975742)

Field	Value
Entity Type	Individual
Organization	Abdiel Ramos Mercado
Address	1 Woodward Ave Fl 14
City	Detroit
State	MI
ZIP	48226
Taxonomy	Infectious Disease Physician
NPI Enumerated	December 1, 2016

Payer Source	Total Paid
Medicare	$192.7K
Medicaid	$0

Key Findings

This provider is an Infectious Disease Physician by taxonomy and has an NPI enumerated on 2016-12-01 (~10 years ago), indicating roughly a decade of Medicare billing history to evaluate. The lifetime Medicare revenue on file is $192.7K and there is no Medicaid billing on file, making this effectively a Medicare-only billing profile.

Revenue is highly concentrated in a very small set of inpatient E/M codes: the precomputed top 3 Medicare codes account for 92.0% of this provider's total Medicare revenue. Those top three are 99232 ($129.3K, 66.8% of Medicare revenue), 99223 ($24.9K, 12.9%), and 99233 ($23.9K, 12.3%), showing the practice’s revenue is almost entirely driven by hospital inpatient evaluation-and-management services.

The single largest driver is 99232, with 2K claims and $66 avg paid/claim generating $129.3K in revenue; this code alone represents 66.8% of the provider’s Medicare revenue and the provider ranks #1397 of 177383 nationally for 99232 (99th percentile), which the data labels an "extreme outlier". That combination of high claim count and top-percentile ranking indicates the provider is far above typical national volume for subsequent inpatient/observation care visits.

The other two high-value inpatient codes show a different competitive profile: 99223 produced $24.9K from 173 claims at $144 avg paid/claim and ranks #11060 of 139583 (92th percentile) while 99233 produced $23.9K from 241 claims at $99 avg paid/claim and ranks #26063 of 128818 (80th percentile). Both codes are characterized in the source as "typical, unremarkable volume," suggesting that beyond the pronounced 99232 activity the provider’s volumes for initial high-complexity and high-level subsequent inpatient visits are within expected peer ranges.

Operationally, the code mix points to a hospital-based, inpatient-focused practice model: 99232, 99223, and 99233 are all inpatient/observation E/M services with moderate to high levels of medical decision making or extended encounter time, implying the provider spends most of their billed time on inpatient consultations and follow-ups rather than outpatient clinic visits. The prominence of subsequent inpatient visits (99232) relative to initial or lower-complexity follow-ups reinforces a workflow concentrated on ongoing inpatient management.

Payer mix is essentially single-payer Medicare: lifetime Medicare revenue is $192.7K and there is explicitly "no Medicaid billing on file," so analysts should treat this entity as not participating in Medicaid based on available data. That absence of Medicaid activity limits any Medicaid-based competitive or access conclusions within Michigan and means comparisons should focus on Medicare peer benchmarks.

The profile shows a mix of statistical signals: one clear extreme outlier (99232) and multiple codes that are described as "typical, unremarkable volume" despite some high percentile ranks. For downstream analysis this suggests a focused service-line where one procedure type dominates activity and warrants deeper operational review (e.g., hospital privileges, unit coverage, or consult service role) while other billed services align more closely with peer norms.

For competitive positioning, the provider is a dominant national outlier for 99232 specifically but otherwise appears as a modest participant for other common inpatient E/M codes. The national rank of #1397/177383 for 99232 positions the provider far above most peers on that code, while ranks for 99223 and 99233 (92th and 80th percentiles respectively) indicate above-average but not extraordinary presence on those service lines.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	1,960	$70	$129.3K
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…	170	$140	$24.9K
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…	240	$100	$23.9K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	340	$40	$14.1K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	10	$110	$1.3K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Michigan Distribution

Abdiel Ramos Mercado — 2 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99233	15	4,220	70	$90	$12.3K
99232	1	6,730	90	$60	$12K
99223	7	4,880	40	$130	$8.3K
99222	135	4,810	30	$100	$5K
99231	1	2,000	40	$40	$2.6K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Abdiel Ramos Mercado, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Henry Ford Health St. John Hospital	IL	General Acute Care Hospital	$0	$159.7M
Henry Ford Health St. John Hospital	MI	Internal Medicine Physician	$0	$41.8M
Detroit Central City Community Mental Health Inc.	MI	Federally Qualified Health Center (FQHC)	$0	$29.2M
Henry Ford Macomb Hospital Corporation	MI	Family Medicine Physician	$0	$9.2M
Adli Yakan	MI	Medical Oncology Physician	$1.7M	$0
Andrew Muskovitz	MI	Hematology & Oncology Physician	$1.2M	$0
Srinivas Koneru	MI	Cardiovascular Disease Physician	$984.1K	$0
Lokesh Nagori	MI	Medical Oncology Physician	$719.1K	$0
Amir Kaki	MI	Interventional Cardiology Physician	$492.4K	$0
Hernan Pabon	FL	Psychiatry Physician	$333.5K	$144.8K

Nearby Providers

Other providers in the same ZIP code as Abdiel Ramos Mercado, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
City Of Detroit	MI	Ambulance	$2.4M	$52.4M
Wayne County Jail Pharmacy	MI	Prison Health Clinic/Center	$0	$16.3M
Wayne County Jail	MI	Psychiatric Hospital	$0	$11.5M
Sandra Johnson-gamlin	MI	Psychologist	$3.1K	$0

Abdiel Ramos Mercado — Billing Profile & Reimbursement Data

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Abdiel Ramos Mercado — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References