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.

M&m Quality Care (NPI 1386207868)

Field	Value
Entity Type	Organization
Organization	M&m Quality Care
Address	6411 Bella Vista Dr Ne Ste 1
City	Rockford
State	MI
ZIP	49341
Taxonomy	Home Health Agency
NPI Enumerated	April 19, 2019

Payer Source	Total Paid
Medicaid	$5.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

1 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2015	Comprehensive community support services, per 15 minutes	44,310	$120	$5.2M

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

M&m Quality Care — 0 of 1 code 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

1 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2015	Comprehensive community support services, per 15 minutes	175	610	14,740	$90	$6M

Nearby Providers

Other providers in the same ZIP code as M&m Quality Care, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rockford Ambulance Inc	MI	Land Ambulance	$890.7K	$4.3M
Timothy Anderson	MI	Optometrist	$634.2K	$0
Luke Nicholas	MI	MOHS-Micrographic Surgery Physician	$178.7K	$0
Michael Kelley	MI	Podiatrist	$28.5K	$18.1K

M&m Quality Care — Billing Profile & Reimbursement Data

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M&m Quality Care — Billing Profile & Reimbursement Data

Sign up for M&m Quality Care — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References