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.

Aspirus Keweenaw (NPI 1326115569)

Aspirus Keweenaw is a critical access hospital provider located in Laurium, Michigan. This profile covers 0 Medicare and 135 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	Aspirus Keweenaw
Address	205 Osceola Street
City	Laurium
State	MI
ZIP	49913
Taxonomy	Critical Access Hospital
NPI Enumerated	November 30, 2006

Payer Source	Total Paid
Medicaid	$6M
Medicare	$0

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

135 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.	7,960	$150	$1.2M
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.	11,780	$100	$1.2M
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	3,650	$190	$697.7K
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.	6,150	$80	$516.6K
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.	1,290	$280	$361K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	2,260	$130	$287K
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	1,250	$150	$183.8K
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.	1,220	$140	$166.5K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	1,180	$120	$140.9K
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	2,100	$50	$94.4K

Showing 1–10 of 135

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

Aspirus Keweenaw — 0 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

135 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	119	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.	215	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.	160	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.	133	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.	111	150	7,610	$90	$1.2M
G0378	Hospital observation service, per hour	96	100	2,820	$180	$1.1M
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	23	60	1,310	$130	$1.1M
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	26	70	680	$100	$604K
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…	112	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.	140	230	2,380	$90	$490K

Showing 1–10 of 135

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Eric Berkowitz	NY	Vascular & Interventional Radiology Physician	$2.6M	$1.2M
Sean Whalen	NY	Nuclear Medicine Physician	$555.5K	$0
Kevin Lee	CA	Diagnostic Radiology Physician	$284.6K	$0
Rania Saleh	IL	Infectious Disease Physician	$130.7K	$139K
Balaji Shanmugam	FL	Interventional Cardiology Physician	$257.1K	$0
Jonathan Lehman	NM	Diagnostic Radiology Physician	$216.8K	$0
Elias Issa	GA	Internal Medicine Physician	$216.4K	$0
Marcus Sublette	WI	Interventional Cardiology Physician	$192.2K	$0
Timothy Jarvi	MI	Ophthalmology Physician	$189.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Ems, Inc.	MI	Land Ambulance	$381K	$827.5K
Bonnie Hafeman	MI	Family Medicine Physician	$142.5K	$0
Ethelbert Lara	MI	Diagnostic Radiology Physician	$39.7K	$0
Clint Pakkala	MI	Nurse Practitioner	$15.9K	$0

Aspirus Keweenaw — Billing Profile & Reimbursement Data

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Aspirus Keweenaw — 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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