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.

Western Michigan University School Of Medicine (NPI 1316212343)

Western Michigan University School Of Medicine is a multi-specialty clinic/center provider located in Kalamazoo, Michigan. This profile covers 0 Medicare and 164 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	Western Michigan University School Of Medicine
Address	1000 Oakland Dr
City	Kalamazoo
State	MI
ZIP	49008
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	March 8, 2012

Payer Source	Total Paid
Medicaid	$16.4M
Medicare	$0

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

164 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…	75,250	$60	$4.2M
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…	27,450	$70	$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…	17,980	$60	$1M
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…	10,870	$70	$739.1K
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…	10,300	$70	$710.6K
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…	9,050	$80	$696.9K
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…	9,650	$70	$656.1K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	6,540	$100	$634.6K
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…	5,280	$110	$554.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,740	$80	$442.3K

Showing 1–10 of 164

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

Western Michigan University School Of Medicine — 11 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

164 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	88	130	200	$750	$636K
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…	785	1,960	870	$100	$376.5K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	221	290	300	$240	$336.5K
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…	501	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…	102	4,380	1,000	$70	$289.9K
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	4,770	1,060	$50	$247.8K
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	18	20	150	$270	$233.6K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	149	780	140	$190	$192.4K
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…	38	630	430	$60	$180.4K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	124	130	200	$270	$178.1K

Showing 1–10 of 164

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ismail Jimada	GA	Infectious Disease Physician	$93.9K	$0
Sarah Shewayish	ID	Infectious Disease Physician	$90.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Braintrust Behavioral Health, LLC	MI	Community/Behavioral Health Agency	$0	$13.8M
Western Michigan University Center For Disability Services	MI	Developmentally Disabled Services Day Training Agency	$0	$10.4M
Care N Assist LLC	MI	In Home Supportive Care Agency	$0	$6.1M
Kalamazoo Anesthesiology P C	MI	Anesthesiology Physician	$0	$5.3M
Daniel Zindrick	MI	Emergency Medicine Physician	$43.8K	$400.8K
Michael Chafty	MI	Pain Medicine (Anesthesiology) Physician	$83.2K	$11K
Timothy Ryan	MI	Student in an Organized Health Care Education/Training Program	$60.4K	$0
Benjamin Cramer	MI	Emergency Medicine Physician	$51.8K	$0
Melinda Abernethy	MI	Reproductive Endocrinology Physician	$45.3K	$0
James Rosenbaum	MI	Anesthesiology Physician	$19.1K	$0

Western Michigan University School Of Medicine — Billing Profile & Reimbursement Data

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Western Michigan University School Of Medicine — 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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