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.

Memorial Hospital (NPI 1316008006)

Memorial Hospital is a general practice physician provider located in Owosso, Michigan. This profile covers 0 Medicare and 168 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	Memorial Hospital
Address	826 W King St
City	Owosso
State	MI
ZIP	48867
Taxonomy	General Practice Physician
NPI Enumerated	December 13, 2006

Payer Source	Total Paid
Medicaid	$17.3M
Medicare	$0

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

168 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…	84,870	$50	$4.6M
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…	104,770	$40	$3.9M
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…	10,950	$80	$820.9K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	1,010	$740	$740.1K
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…	10,200	$70	$734.5K
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…	16,250	$50	$731K
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	1,060	$690	$728.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	8,240	$70	$609.7K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	7,490	$70	$532.1K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	8,180	$60	$507.2K

Showing 1–10 of 168

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

Memorial Hospital — 14 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

168 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.	403	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.	330	450	1,540	$90	$1.3M
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	36	130	200	$750	$636K
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	36	160	260	$820	$506.6K
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…	781	1,960	870	$100	$376.5K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	511	950	610	$80	$328.2K
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…	19	4,380	1,000	$70	$289.9K
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.	57	220	440	$180	$249.7K
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…	18	4,770	1,060	$50	$247.8K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	48	50	450	$170	$240.3K

Showing 1–10 of 168

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Covenant Medical Center, Inc.	MI	General Acute Care Hospital	$0	$96.6M
St Joseph Mercy Hospital-smhc	MI	General Acute Care Hospital	$0	$51.8M
Memorial Hospital	MI	General Acute Care Hospital	$0	$39M
Covenant Medical Center, Inc	MI	Family Medicine Physician	$0	$19.3M
Covenant Medical Center, Inc.	MI	Emergency Medicine Physician	$0	$14.7M
Covenant Medical Center, Inc.	MI	Urgent Care Clinic/Center	$0	$10.9M
Mark Le	FL	Diagnostic Radiology Physician	$10.7M	$0
Covenant Medical Center, Inc.	MI	Family Medicine Physician	$0	$6M
Mujahed Abbas	MI	Critical Care Medicine (Internal Medicine) Physician	$649.8K	$0
Assad Sattar	MI	Interventional Cardiology Physician	$630.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shiawassee County Community Mental Health Authority	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$49M
Richard Schulz	MI	Surgery Physician	$174.5K	$0
Patrick Wegman	MI	Dermatology Physician	$130.8K	$0
Paul Wiese	MI	Psychologist	$83.4K	$0
Mustafa Huseini	MI	Gastroenterology Physician	$37.6K	$0
Daniel Barnas	MI	Surgery Physician	$23.2K	$0
Marie Spiess	MI	Physician Assistant	$12.2K	$0
Allison Blaksmith	MI	Physician Assistant	$5.8K	$0

Memorial Hospital — Billing Profile & Reimbursement Data

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Memorial Hospital — 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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