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.

William Beaumont Hospital (NPI 1306825997)

Key Findings

Field	Value
Entity Type	Organization
Organization	William Beaumont Hospital
Address	44201 Dequindre Rd
City	Troy
State	MI
ZIP	48085
Taxonomy	General Acute Care Hospital
NPI Enumerated	January 11, 2006

Payer Source	Total Paid
Medicaid	$84.8M
Medicare	$0

WILLIAM BEAUMONT HOSPITAL reports no Medicare billing on file and $84.8M in lifetime Medicaid revenue, making its public billing footprint effectively single‑payer dominated by Medicaid rather than a mix of Medicare and Medicaid. This concentration means analyses of payer-facing risk, utilization, and negotiated rates should be focused on Medicaid performance and volumes rather than Medicare comparisons.

Revenue concentration is high: the top three Medicaid codes (99285, 99284, and G0463) account for 63.0% of the provider’s total Medicaid revenue. The single largest contributor is 99285 ($26.7M, 41.5% of Medicaid revenue), followed by 99284 ($7.6M, 11.9%) and G0463 ($6.2M, 9.6%), indicating a small number of services drive the majority of billed Medicaid dollars.

Clinical/service-line mix is emergency‑department centric. High counts and dollar volumes for 99285 (64.8K claims, $412 avg paid/claim, $26.7M revenue) and 99284 (34.1K claims, $224 avg paid/claim, $7.6M revenue) show the hospital handles substantial ED throughput with a meaningful share of high‑acuity visits, while G0463 (84.3K claims, $73 avg paid/claim, $6.2M revenue) signals large hospital outpatient clinic assessment volume supporting that emergency and ambulatory intake.

Competitive standing on high‑acuity emergency care is strong in‑state: 99285 ranks #20 of 404 providers in-state (95th percentile; notably above typical state volume for this code), indicating the hospital is a top‑tier provider of high‑complexity ED visits in Michigan. By contrast, 99284 ranks #62 of 477 providers in-state (87th percentile; typical, unremarkable volume for this code), suggesting leadership is concentrated in the highest‑acuity ED encounters rather than across all ED complexity levels.

The hospital shows notable specialty procedural volume in gastroenterology and endoscopy: 43239 ($2.9M, ranks #7 of 216 providers in-state, 97th percentile; notably above typical state volume) and 45380 ($1.6M, ranks #9 of 153 providers in-state, 95th percentile; notably above typical state volume) indicate above‑typical state activity for upper endoscopy with biopsy and colonoscopy with biopsy/polypectomy, implying an active inpatient/outpatient GI program that materially contributes to Medicaid revenue.

Rehabilitation, imaging, and infusion services are also meaningful revenue contributors and point to broad ancillary capacity. High volumes in therapeutic codes such as 97112 (39.6K claims, $910.6K revenue; ranks #11 of 355 providers in-state, 97th percentile; notably above typical state volume) and 97110 (46.4K claims, $835.5K revenue; ranks #23 of 547 providers in-state, 96th percentile; notably above typical state volume) alongside imaging and infusion codes (e.g., 74177, 93306, 96374) reflect a full-service hospital mix that extends beyond emergency care into rehab, diagnostic imaging, and IV medication administration.

Several codes associated with observation and short‑stay services (G0378, 18.7K claims, $580.4K revenue; ranks #11 of 100 providers in-state, 90th percentile; notably above typical state volume for this code) and hospital outpatient clinic visits (G0463) reinforce a care model built around ED throughput plus observation and same‑day outpatient management, which explains the concentration of Medicaid revenue in a small set of high‑volume, ED‑related codes.

The NPI enumeration date (2006-01-11, ~20 years ago) shows the hospital has an established presence; combined with the Medicaid revenue scale and the high percentiles on multiple codes, this suggests a longstanding, high‑volume Medicaid provider role in the region rather than a new or transient operation.

Medicaid: Complete Services Breakdown

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

561 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	64,830	$410	$26.7M
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.	34,120	$220	$7.6M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	84,280	$70	$6.2M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	35,300	$80	$2.9M
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.	7,090	$410	$2.9M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	19,860	$140	$2.8M
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	2,940	$550	$1.6M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	9,090	$120	$1.1M
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…	5,650	$190	$1.1M
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	23,340	$40	$956.9K

Showing 1–10 of 561

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

William Beaumont Hospital — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

561 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	28	150	5,330	$50	$2.8M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	20	400	1,510	$190	$2.6M
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.	62	480	1,350	$110	$1.7M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	87	450	1,540	$90	$1.3M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	18	150	7,610	$90	$1.2M
G0378	Hospital observation service, per hour	11	100	2,820	$180	$1.1M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	34	160	2,720	$60	$546.6K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	38	230	2,380	$90	$490K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	17	160	2,030	$60	$407.6K
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…	269	270	510	$140	$395.2K

Showing 1–10 of 561

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
3 Doves Home Assistance	MI	In Home Supportive Care Agency	$0	$7.9M
Mitchell Folbe	MI	Hematology & Oncology Physician	$517.9K	$0
Mark Zohoury	MI	Internal Medicine Physician	$313K	$89.5K
Jason Peter	MI	Pain Medicine Physician	$352.5K	$0
Mahmoud Al-shami	MI	Internal Medicine Physician	$349K	$0
Martin Glowacki	MI	Interventional Pain Medicine Physician	$344.7K	$0
Mohammad Chisti	MI	Hematology & Oncology Physician	$310.9K	$0
Mark Friedland Md PC	MI	Vascular Surgery Physician	$296.9K	$0
Norah Duncan	MI	Family Medicine Physician	$235.8K	$5.3K
Sara Sarwar Riaz	MI	Hematology & Oncology Physician	$229K	$0

William Beaumont Hospital — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
William Beaumont Hospital	MI	Hospitalist Physician	$0	$167.9M
Oakwood Healthcare, Inc.	MI	General Acute Care Hospital	$0	$165.3M
William Beaumont Hospital	MI	General Acute Care Hospital	$0	$162.4M
Botsford General Hospital	MI	General Acute Care Hospital	$0	$72.1M
William Beaumont Hospital	MI	General Acute Care Hospital	$0	$61.5M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Wellstreet Urgent Care Of Michigan	MI	Urgent Care Clinic/Center	$0	$37.5M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Sandeep Randhawa	MI	Retina Specialist (Ophthalmology) Physician	$7M	$0
William Beaumont Hospital	MI	Home Health Agency	$0	$5.3M