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.

Botsford General Hospital (NPI 1336183367)

Field	Value
Entity Type	Organization
Organization	Botsford General Hospital
Address	28050 Grand River Ave
City	Farmington Hills
State	MI
ZIP	48336
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 16, 2006

Payer Source	Total Paid
Medicaid	$72.1M
Medicare	$0

Key Findings

BOTSFORD GENERAL HOSPITAL has no Medicare billing on file and reports $72.1M in lifetime Medicaid revenue, making its public billing footprint effectively single‑payer Medicaid. Its NPI was enumerated 2006-06-16 (~20 years ago), indicating roughly two decades of continuous enrollment and operational tenure in the state system.

Revenue is highly concentrated in a small set of outpatient and emergency visit codes: the top three Medicaid codes (99285, 99284, G0463) account for 58.6% of the provider's total Medicaid revenue. Specifically, 99285 accounts for $19.3M (35.3%), 99284 for $6.9M (12.5%), and G0463 for $5.9M (10.8%), signaling that a majority of dollars flow from ED and hospital outpatient clinic encounters.

The code mix and volumes point to an emergency-department–centric operating model supplemented by a large hospital outpatient clinic. High claim counts for ED codes (99285: 61.8K claims; 99284: 37.3K claims; 99283: 30K claims) together with 100.3K claims for G0463 (hospital outpatient clinic visits) indicate day-to-day throughput dominated by urgent and ambulatory assessment and management services.

State competitive standing for core ED services is substantial by percentile and rank: 99285 ranks #24 of 404 providers in-state (94th percentile; the dataset annotates this as typical, unremarkable volume for the code), while 99284 ranks #53 of 477 (89th percentile). These placements show the hospital is a high-volume ED participant statewide even where the data editorializes those volumes as “typical, unremarkable.”

There is a meaningful infusion/oncology component alongside emergency care. Codes tied to IV medication and chemotherapy—96365 ($1.6M, 17K claims; ranks #6 of 165, 97th percentile, described as notably above typical state volume) and 96413 ($1.5M, 9.3K claims; ranks #7 of 93, 93rd percentile)—along with J9271 (pembrolizumab, $567.3K) indicate a staffed infusion/oncology capability and above-typical statewide activity for initial infusion billing.

The hospital also bills a broad set of ancillary diagnostic and therapy services that support both ED and outpatient volumes: 80061 lipid panels (49.5K claims, $693.5K, ranks #10 of 274, 97th percentile), 74177 CT abdomen/pelvis ($824.4K), and 93975 duplex ultrasound ($743K). This spread of imaging and lab billing indicates integrated diagnostics and therapy workflows that align with high ambulatory and ED throughput.

Operational scale is evident from very large claim counts that sustain the revenue base: G0463 (100.3K claims, $5.9M) plus tens of thousands of ED visits (e.g., 99285 61.8K claims) and substantial observation use (G0378: 6.5K claims, $594.4K) together imply heavy daily patient flow and reliance on short-stay observation and clinic throughput. These volumes are consistent with a community hospital functioning as a regional access point for acute and ambulatory care.

The provider’s heavy concentration in ED and outpatient clinic revenue (top 3 codes = 58.6% of Medicaid revenue) creates both strategic leverage and exposure: changes in Medicaid ED/outpatient reimbursement, utilization management, or local referral patterns would materially affect revenue. That concentration also identifies the ED/outpatient clinic lines as primary negotiation and quality-monitoring levers for payers and partners evaluating this facility.

Medicaid: Complete Services Breakdown

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

509 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.	61,790	$310	$19.3M
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.	37,320	$180	$6.9M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	100,250	$60	$5.9M
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.	30,040	$120	$3.7M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	35,500	$90	$3.3M
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.	16,970	$100	$1.6M
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	9,310	$160	$1.5M
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.	12,660	$80	$1M
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…	30,400	$30	$972.8K
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…	17,300	$50	$864.8K

Showing 1–10 of 509

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

Botsford General Hospital — 2 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

509 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	Injection, pembrolizumab, 1 mg	7	10	90	$6,340	$5.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	22	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.	24	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.	53	480	1,350	$110	$1.7M
Q5103	Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg	7	10	440	$970	$1.4M
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.	57	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.	17	150	7,610	$90	$1.2M
G0378	Hospital observation service, per hour	30	100	2,820	$180	$1.1M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	5	10	290	$1,440	$1M
J2505	Injection, pegfilgrastim, 6 mg	5	10	130	$2,420	$942.2K

Showing 1–10 of 509

Related Providers

Other providers that share a Tax Identification Number (TIN) with Botsford General Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
William Beaumont Hospital	MI	General Acute Care Hospital	$0	$162.4M
William Beaumont Hospital	MI	General Acute Care Hospital	$0	$84.8M
Wellstreet Urgent Care Of Michigan	MI	Urgent Care Clinic/Center	$0	$37.5M
Steven Katzman	MI	Internal Medicine Physician	$1.5M	$0
Brian Kopitzki	MI	Dermatology Physician	$305.5K	$0
Michael Mahon	MI	Dermatology Physician	$211.2K	$0
Theodore Ruza	MI	Psychiatry Physician	$179.8K	$0
Gassan Alaouie	MI	Cardiovascular Disease Physician	$148.4K	$0
David Gowman	MI	Cardiovascular Disease Physician	$131.6K	$0
Anthony Lutz	MI	Cardiovascular Disease Physician	$131.4K	$0

Nearby Providers

Other providers in the same ZIP code as Botsford General Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Independent Community Care Services	MI	Home Health Agency	$0	$67.7M
Midwest Health Care Inc.	MI	Home Health Agency	$0	$27.2M
Rgrps, Inc.	MI	Contractor	$0	$24M
Excellacare	MI	Home Health Agency	$0	$21.8M
Community Living Centers, Inc	MI	Voluntary or Charitable Agency	$0	$10.8M
Farmington Emergency Medicine Associates PLLC	MI	Emergency Medicine Physician	$0	$10.1M
City Of Farmington Hills	MI	Land Ambulance	$656.5K	$1.3M
Ali Alsaadi	MI	Internal Medicine Physician	$591.4K	$0
Joshua Similuk	MI	Diagnostic Radiology Physician	$428.2K	$0
Fawad Rizvi	MI	Pain Medicine Physician	$270.9K	$0

Botsford General 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