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.

Epmg Southwest Michigan PLLC (NPI 1316405103)

Field	Value
Entity Type	Organization
Organization	Epmg Southwest Michigan PLLC
Address	1234 Napier Ave
City	Saint Joseph
State	MI
ZIP	49085
Taxonomy	Emergency Medicine Physician
NPI Enumerated	March 11, 2019

Payer Source	Total Paid
Medicaid	$11.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

27 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	68,560	$60	$4M
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.	53,140	$70	$3.5M
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.	48,820	$60	$3M
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…	3,250	$120	$396.4K
99236	The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…	1,770	$120	$213.9K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	3,410	$60	$190.8K
99220	N/A	1,350	$100	$129.2K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	16,760	$1	$67K
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…	570	$100	$58.6K
99217	N/A	1,160	$40	$44K

Showing 1–10 of 27

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

Epmg Southwest Michigan PLLC — 1 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

27 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	29	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.	24	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.	34	450	1,540	$90	$1.3M
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…	56	270	510	$140	$395.2K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	110	260	2,670	$70	$348.7K
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…	263	760	240	$100	$121.4K
76705	An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code…	114	210	950	$30	$103.6K
99236	The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…	6	40	340	$120	$93.3K
99281	The provider sees a patient for the lowest level emergency department visit.	80	150	860	$50	$89.3K
99220	N/A	34	170	160	$100	$87.9K

Showing 1–10 of 27

Related Providers

Other providers that share a Tax Identification Number (TIN) with Epmg Southwest Michigan PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Angela Blomgren	MI	Physician Assistant	$5.7K	$0

Nearby Providers

Other providers in the same ZIP code as Epmg Southwest Michigan PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lakeland Hospitals At Niles And St Joseph, Inc	MI	General Acute Care Hospital	$0	$78.1M
Region Iv Area Agency On Aging, Inc	MI	Case Management Agency	$0	$36.3M
Hsh Senior Services, LLC	MI	Home Health Agency	$0	$35.6M
Lakeland Medical Practices	MI	Internal Medicine Physician	$0	$20.9M
Jason So	MI	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
Benjamin Nicholson	MI	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
Great Lakes Surgery Center LLC	MI	Ambulatory Surgical Clinic/Center	$1.3M	$51.3K
David Brown	MI	Ophthalmology Physician	$1.1M	$0
Erick Rivas	MI	Family Medicine Physician	$245.1K	$306.6K
Thomas Pow	MI	Interventional Cardiology Physician	$247.1K	$0

Epmg Southwest Michigan PLLC — Billing Profile & Reimbursement Data

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Epmg Southwest Michigan PLLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References