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.

Dlp Marquette Physician Practices Inc (NPI 1487902995)

Dlp Marquette Physician Practices Inc is a obesity medicine (internal medicine) physician provider located in Marquette, Michigan. This profile covers 0 Medicare and 182 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	Dlp Marquette Physician Practices Inc
Address	1414 W Fair Ave
City	Marquette
State	MI
ZIP	49855
Taxonomy	Obesity Medicine (Internal Medicine) Physician
NPI Enumerated	August 15, 2012

Payer Source	Total Paid
Medicaid	$17.8M
Medicare	$0

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

182 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…	63,510	$80	$4.8M
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…	60,640	$50	$3.2M
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.	15,930	$60	$907.9K
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.	13,980	$60	$880.6K
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…	6,760	$100	$642.3K
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.	6,550	$90	$556.8K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	7,400	$80	$555.1K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	6,780	$70	$467.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,550	$80	$421.5K
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…	4,270	$90	$401.1K

Showing 1–10 of 182

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

Dlp Marquette Physician Practices Inc — 4 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

182 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	128	400	1,510	$190	$2.6M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	14	20	2,940	$340	$1.8M
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.	112	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.	104	450	1,540	$90	$1.3M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	21	20	3,450	$100	$916.9K
99468	The provider evaluates and manages the initial care of a newborn or infant less than 28 days of age in a neonatal critical care setting.	13	20	540	$770	$650.1K
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	12	20	1,120	$100	$636.6K
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…	170	270	510	$140	$395.2K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	1,073	1,960	870	$100	$376.5K
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…	63	90	1,270	$120	$367.8K

Showing 1–10 of 182

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dlp Marquette General Hospital LLC	MI	General Acute Care Hospital	$0	$16.3M
Sean Rooney	MI	Ophthalmology Physician	$843.7K	$0
Alice Fecko	MI	Internal Medicine Physician	$517.4K	$0
Yazan Khouri	TX	Cardiovascular Disease Physician	$468.2K	$0
Terence Ryan	MI	Family Medicine Physician	$441.3K	$0
Michael Cappelli	AL	Radiation Oncology Physician	$291.6K	$0
Raj Chinnappan	IL	Diagnostic Radiology Physician	$102.8K	$97.7K
John Harb	MI	Urology Physician	$190.2K	$0
Khurshaid Alam	MI	Vascular & Interventional Radiology Physician	$181K	$0
Bradley Rosenberg	MI	Urology Physician	$169.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pathways	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$89.1M
Adult Learning Systems-u.p.	MI	Intellectual Disabilities Intermediate Care Facility	$0	$65.8M
Great Lakes Recovery Centers	MI	Substance Use Disorder Rehabilitation Clinic/Center	$0	$8M
Prac Holdings, Inc.	MI	In Home Supportive Care Agency	$0	$6M
Upper Michigan Associates LLC	MI	Ambulatory Surgical Clinic/Center	$1.4M	$0
Nelson Winkler	MI	Ophthalmology Physician	$1M	$0
Zachary Leonard	MI	Orthopaedic Surgery Physician	$220.4K	$0
Keith Connolly	MI	Orthopaedic Surgery Physician	$197.8K	$0
John Sullivan	MI	Diagnostic Radiology Physician	$149.5K	$4.8K
Hannah Wilson	MI	Physician Assistant	$139.7K	$0

Dlp Marquette Physician Practices Inc — Billing Profile & Reimbursement Data

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Dlp Marquette Physician Practices Inc — 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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