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.

Mclaren Bay Region (NPI 1508131087)

Mclaren Bay Region is a family medicine physician provider located in Bay City, Michigan. This profile covers 0 Medicare and 165 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	Mclaren Bay Region
Address	1900 Columbus Ave
City	Bay City
State	MI
ZIP	48708
Taxonomy	Family Medicine Physician
NPI Enumerated	March 15, 2012

Payer Source	Total Paid
Medicaid	$9.3M
Medicare	$0

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

165 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…	29,720	$50	$1.6M
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…	40,420	$40	$1.5M
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…	23,140	$40	$832.9K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	5,260	$90	$494K
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…	4,000	$90	$363.9K
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…	4,580	$80	$361.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3,440	$90	$323.5K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	4,590	$60	$293.8K
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…	5,040	$50	$272.2K
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…	4,450	$60	$257.8K

Showing 1–10 of 165

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

Mclaren Bay Region — 6 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

165 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0585	Injection, onabotulinumtoxina, 1 unit	21	40	260	$510	$684.9K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	167	230	2,380	$90	$490K
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…	109	270	510	$140	$395.2K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	212	290	300	$240	$336.5K
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…	90	4,380	1,000	$70	$289.9K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	109	140	870	$130	$261.1K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	157	230	1,810	$50	$250.6K
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…	99	4,770	1,060	$50	$247.8K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	53	310	850	$90	$215.4K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	128	190	1,210	$70	$181.6K

Showing 1–10 of 165

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Mclaren Bay Region	MI	General Acute Care Hospital	$0	$31.8M
Saginaw Valley Centers, Inc.	MI	Professional Counselor	$0	$11.8M
Mark Le	FL	Diagnostic Radiology Physician	$10.7M	$0
Artin Aharonian	MD	Diagnostic Radiology Physician	$1M	$0
Ryan Jean-baptiste	CA	Diagnostic Radiology Physician	$517K	$47K
Thomas Giancarlo	MI	Neurology Physician	$458.1K	$0
Muhammad Khan	MI	Vascular & Interventional Radiology Physician	$455.8K	$0
Muwaffaq Salameh	MI	Nephrology Physician	$392.1K	$0
Michael Bischoff	MI	Diagnostic Radiology Physician	$352.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bay-arenac Behavioral Health	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$78.6M
Premier Care Assisted Living	MI	Foster Care Agency	$0	$13.4M
Liberty Living Inc	MI	Adult Care Home Facility	$0	$10.9M
Recovery Pathways, LLC	MI	Medical Specialty Clinic/Center	$0	$8.1M
In Your Golden Years, LLC	MI	Home Health Agency	$0	$7.7M
Paramount Rehabilitation Services, PC	MI	Physical Therapist	$0	$5.5M
Japhet Joseph	MI	Cardiovascular Disease Physician	$414.3K	$16.3K
Richard Horbal	MI	Allergy & Immunology Physician	$424.8K	$0
Robert Graham	MI	Ophthalmology Physician	$358.5K	$0
Seth Craft	MI	Foot & Ankle Surgery Podiatrist	$239.3K	$0

Mclaren Bay Region — Billing Profile & Reimbursement Data

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Mclaren Bay Region — 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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