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.

Michigan Pain Consultants PC (NPI 1467418574)

Michigan Pain Consultants PC is a pain medicine (anesthesiology) physician provider located in Grand Rapids, Michigan. This profile covers 0 Medicare and 63 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	Michigan Pain Consultants PC
Address	2060 East Paris Ave Se
City	Grand Rapids
State	MI
ZIP	49546
Taxonomy	Pain Medicine (Anesthesiology) Physician
NPI Enumerated	April 26, 2006

Payer Source	Total Paid
Medicaid	$9.9M
Medicare	$0

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

63 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
64483	This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral).	12,610	$100	$1.2M
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…	23,500	$50	$1.2M
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…	24,660	$30	$789K
64493	The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance…	7,690	$90	$668.9K
62323	The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)…	6,900	$80	$544.9K
64635	Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue.	2,390	$230	$537.5K
27096	The provider performs an injection in the joint between the sacrum and ilium on one side of the body, with the aid of imaging equipment to locate the injection site. He injects an anesthetic to…	6,380	$80	$484.5K
62321	The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the cervical (neck) or thoracic (upper and middle back)…	5,560	$90	$483.4K
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…	6,200	$70	$458.4K
64490	The provider injects a diagnostic or therapeutic substance into a single cervical or thoracic paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging…	4,050	$90	$352.6K

Showing 1–10 of 63

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

Michigan Pain Consultants PC — 23 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

63 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0585	Injection, onabotulinumtoxina, 1 unit	20	40	260	$510	$684.9K
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…	130	4,380	1,000	$70	$289.9K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	77	390	1,660	$40	$281.8K
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…	225	4,770	1,060	$50	$247.8K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	326	550	2,350	$30	$240.6K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	355	360	1,410	$20	$136.3K
64635	Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue.	1	30	140	$240	$129.4K
64483	This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral).	1	70	190	$150	$122.9K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	157	430	2,070	$20	$107.7K
64493	The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance…	1	70	160	$150	$97K

Showing 1–10 of 63

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ju Gao	OH	Pain Medicine Physician	$154K	$66.2K
Lisa Pullum	MI	Interventional Pain Medicine Physician	$188.9K	$0
John Birgiolas	MI	Interventional Pain Medicine Physician	$172.8K	$0
Mark Juska	MI	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$162.9K	$0
Adam Powell	MI	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$149.6K	$0
Schuyler Rogg	MI	Interventional Pain Medicine Physician	$108.8K	$0
Charles Bray	MI	Physician Assistant	$47.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Reliance Community Care Partners	MI	Case Management Agency	$0	$145.4M
Dental Group Associates PC	MI	Pediatric Dentistry	$0	$16.1M
Pediatric Dental Specialists Of West Michigan	MI	Pediatric Dentistry	$0	$11M
Mitten Kids Dentistry Cascade Plc	MI	Pediatric Dentistry	$0	$7.2M
Carepoint Dental Anesthesia Group Of Michigan, PLLC	MI	Dental Anesthesiology	$0	$6.4M
Retina Specialists Of Michigan PC	MI	Retina Specialist (Ophthalmology) Physician	$0	$5.5M
Kathleen Dehorn	MI	Ophthalmology Physician	$1.7M	$0
Jeffrey Zheutlin	MI	Ophthalmology Physician	$1.5M	$0
Nathan Pezda	MI	Retina Specialist (Ophthalmology) Physician	$1.1M	$0
East Paris Surgical Center, LLC	MI	Ambulatory Surgical Clinic/Center	$968.8K	$30.6K

Michigan Pain Consultants PC — Billing Profile & Reimbursement Data

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Michigan Pain Consultants PC — 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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