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.

University Physician Group (NPI 1447299797)

Key Findings

Field	Value
Entity Type	Organization
Organization	University Physician Group
Address	400 Mack Ave Ste 2
City	Detroit
State	MI
ZIP	48201
Taxonomy	Internal Medicine Physician
NPI Enumerated	June 5, 2006

Payer Source	Total Paid
Medicaid	$87.4M
Medicare	$0

UNIVERSITY PHYSICIAN GROUP has no Medicare billing on file and reports $87.4M in lifetime Medicaid revenue, making its financial footprint effectively single‑payer (Medicaid) based on the available data. Analysts should treat Medicaid as the primary payer when assessing revenue risk and contracting exposure for this entity.

Revenue is highly concentrated in a small set of evaluation & management (E/M) codes: the precomputed top three Medicaid codes account for 37.2% of Medicaid revenue, driven by 99214 ($11.3M; 18.0%), 99232 ($6.7M; 10.6%), and 99213 ($5.4M; 8.6%). This concentration indicates that a large share of the provider’s Medicaid income depends on routine and follow‑up clinical encounters.

The mix of high‑revenue codes points to a blended ambulatory and hospitalist operating model: top codes include office/outpatient visits (99214, 99213) alongside subsequent inpatient/observation care codes (99232, 99233, 99222, 99223). The presence of substantial claims for both outpatient E/M and inpatient E/M suggests the provider delivers both clinic‑based primary care and significant inpatient services to the Medicaid population.

OB/maternal services are a meaningful service line for this provider: 59409 generated $3.3M (5.2%) from 4.4K claims, 59514 contributed $1.7M (2.8%), and 59426 $1.3M (2.1%). These codes indicate ongoing delivery and antepartum service volume that augment the core E/M business and diversify Medicaid revenue streams.

Several codes rank at or near the top of statewide peers, signaling dominant competitive standing in multiple service lines. Examples include 99214 (rank #6 of 4380; 100th percentile; extreme outlier), 99232 (rank #2 of 947; 100th percentile; extreme outlier), 88307 (rank #1 of 83; 100th percentile; extreme outlier), and 99222 (rank #3 of 639; 100th percentile; extreme outlier), which together indicate the provider is a major Medicaid participant across several specialties.

Specialty and ancillary services are also significant: pathology codes 88305 ($2.4M) and 88307 ($1.7M), ophthalmology codes 92014 ($1.7M) and 92004 ($1.3M), and radiation therapy 77427 ($664.1K) appear in the top code list, suggesting either integrated multispecialty operations or centralized billing under this group. These non‑E/M lines imply additional downstream revenue drivers beyond primary care and inpatient E/M.

Claim volumes for core E/M codes are very large and indicate high throughput—99214 has 182.8K claims, 99232 has 162.8K claims, and 99213 has 129.7K claims—pointing to sustained daily clinical volume and corresponding operational scale. For payers and network planners, these volumes translate into meaningful utilization exposure and a need to understand referral and capacity patterns.

High‑acuity and critical care activity is present in Medicaid billing: 99291 ($2M), 99233 ($4.3M), 99222 ($2M), and 99223 ($1.7M) show the group provides substantial critical and initial inpatient evaluation services. This mix elevates clinical complexity and suggests the provider manages a significant share of higher‑acuity Medicaid cases alongside routine ambulatory care.

Medicaid: Complete Services Breakdown

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

378 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	182,820	$60	$11.3M
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…	162,790	$40	$6.7M
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…	129,720	$40	$5.4M
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…	73,110	$60	$4.3M
99204	The provider sees a new 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 provider…	39,490	$90	$3.5M
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…	4,380	$750	$3.3M
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…	29,550	$80	$2.5M
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	62,290	$40	$2.4M
J0178	Injection, aflibercept, 1 mg	1,940	$1,040	$2M
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…	16,550	$120	$2M

Showing 1–10 of 378

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

University Physician Group — 21 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

378 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	43	40	288,630	$10	$4.4M
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.	210	400	1,510	$190	$2.6M
J0178	Injection, aflibercept, 1 mg	6	20	1,170	$1,140	$2.1M
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.	122	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.	155	450	1,540	$90	$1.3M
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…	4	130	200	$750	$636K
36512	Apheresis (also known as pheresis or therapeutic pheresis) is a medical procedure utilizing specialized equipment to remove selected blood constituents (plasma, leukocytes, platelets, or cells) from…	2	10	1,680	$300	$611.1K
59514	The provider admits the patient to the hospital for delivery, delivers the fetus and placenta via an abdominal incision, and provides care immediately after delivery on the same date of service. This…	5	50	230	$760	$523.3K
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	11	160	260	$820	$506.6K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	3	20	90	$2,020	$489.9K

Showing 1–10 of 378

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Asheesh Tewari	MI	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
University Physician Group	MI	Counselor	$57.7K	$1.4M
Anthony Parendo	WI	Retina Specialist (Ophthalmology) Physician	$1.2M	$0
Patrick Murphy	MI	Ophthalmology Physician	$581.3K	$0
Brett Malbin	MI	Ophthalmology Physician	$477.6K	$0
Xihui Lin	MI	Ophthalmology Physician	$376.6K	$0
Darius Mehregan	MI	Dermatopathology Physician	$351.7K	$0
Rajiv Shah	NC	Ophthalmology Physician	$328.3K	$0
Yahya Murad	MI	Geriatric Medicine (Internal Medicine) Physician	$297.7K	$0
Gabriel Sosne	MI	Ophthalmology Physician	$250.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vhs Childrens Hospital Of Michigan Inc	MI	Children's Hospital	$0	$180.4M
University Pediatricians	MI	Pediatrics Physician	$0	$106.9M
Vhs Harper-hutzel Hospital Inc	MI	General Acute Care Hospital	$0	$76.6M
The Children's Center Of Wayne Co., Inc.	MI	Community/Behavioral Health Agency	$0	$74.3M
Vhs Detroit Receiving Hospital Inc	MI	General Acute Care Hospital	$0	$60.6M
Medical Center Emergency Services	MI	Emergency Medical Services (Emergency Medicine) Physician	$0	$44.1M
Barbara Ann Karmanos Cancer Hospital	MI	General Acute Care Hospital	$0	$42.5M
Detroit Central City Community Mental Health Inc.	MI	Federally Qualified Health Center (FQHC)	$0	$29.2M
Vhs University Laboratories Inc	MI	Clinical Medical Laboratory	$677.7K	$26.3M
Vhs Rehabilitation Institute Of Michigan Inc	MI	Rehabilitation Hospital	$0	$24.1M

University Physician Group — 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