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 North Specialty Care LLC (NPI 1306468418)

Mercy Health Physicians North Specialty Care LLC is a surgery physician provider located in Toledo, Ohio. This profile covers 0 Medicare and 191 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 North Specialty Care LLC
Address	2200 Jefferson Ave
City	Toledo
State	OH
ZIP	43604
Taxonomy	Surgery Physician
NPI Enumerated	May 12, 2020

Payer Source	Total Paid
Medicaid	$13.1M
Medicare	$0

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

191 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…	82,820	$40	$3.1M
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…	46,590	$40	$2M
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…	83,380	$20	$1.8M
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…	8,190	$70	$532.3K
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…	6,080	$60	$383.3K
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…	5,870	$60	$358.3K
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…	9,710	$30	$291.2K
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…	6,160	$50	$277.3K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	8,530	$30	$238.9K
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…	5,290	$40	$217.1K

Showing 1–10 of 191

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 North Specialty Care LLC — 7 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

191 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	590	660	460	$90	$1.5M
J0585	Injection, onabotulinumtoxina, 1 unit	39	60	250	$730	$707.7K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	25	30	620	$130	$428.2K
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…	1,195	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…	99	4,510	500	$60	$377.8K
95720	A physician or other QHCP reviews recorded events and analyzes spike and seizure detection of a continuous electroencephalography, a study of the electrical activity of the brain. A video is…	14	30	1,060	$120	$372K
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…	68	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…	265	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…	271	480	450	$70	$292.9K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	43	280	570	$250	$276.5K

Showing 1–10 of 191

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Mercy Health Youngstown LLC	OH	General Acute Care Hospital	$0	$36.6M
Mercy Health Physicians Youngstown Specialty Care LLC	OH	Surgery Physician	$0	$11.8M
Jonathan Wiesen	VA	Internal Medicine Physician	$2.4M	$0
Dinesh Sundarakumar	TX	Diagnostic Radiology Physician	$916K	$0
Ahed Nahhas	OH	Cardiovascular Disease Physician	$375.9K	$0
Ghiath Yazji	OH	Cardiovascular Disease Physician	$366.6K	$0
Reema Taneja	OH	Internal Medicine Physician	$360.9K	$5.1K
William Woods	OH	Orthopaedic Surgery Physician	$357K	$0
Shaju Shamsuddin	OH	Radiation Oncology Physician	$333.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rfs Charitable Foundation	OH	Community/Behavioral Health Agency	$0	$49.6M
Mercy Health Physicians-north LLC	OH	Family Medicine Physician	$0	$42.1M
Promedica Central Physicians	OH	Family Medicine Physician	$0	$40.9M
Pathology Laboratories, Inc.	OH	Clinical Medical Laboratory	$3.1M	$25M
Primary Care Solutions Of Ohio Incorporated	OH	Community/Behavioral Health Agency	$0	$17.6M
A Renewed Mind	OH	Community/Behavioral Health Agency	$0	$15.3M
Promedica Central Corporation Of Michigan	OH	Family Medicine Physician	$0	$14.2M
A Renewed Mind	OH	Community/Behavioral Health Agency	$0	$13.4M
Mercy Health - Life Flight Network LLC	OH	Ambulance	$3.3M	$3.2M
Lucas County Auditor	OH	Ambulance	$811.6K	$4.6M

Mercy Health Physicians North Specialty Care LLC — Billing Profile & Reimbursement Data

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Mercy Health Physicians North Specialty Care 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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