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.

Lakeland Medical Practices (NPI 1538397120)

Lakeland Medical Practices is a internal medicine physician provider located in Saint Joseph, Michigan. This profile covers 0 Medicare and 212 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	Lakeland Medical Practices
Address	1234 Napier Ave
City	Saint Joseph
State	MI
ZIP	49085
Taxonomy	Internal Medicine Physician
NPI Enumerated	June 23, 2009

Payer Source	Total Paid
Medicaid	$20.9M
Medicare	$0

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

212 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…	66,780	$70	$4.5M
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…	67,240	$50	$3.2M
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…	32,590	$40	$1.4M
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…	13,520	$80	$1M
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…	9,290	$90	$854.5K
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…	8,750	$90	$779K
99203	The provider sees a new 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 provider…	11,850	$60	$722.8K
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…	5,800	$120	$707.4K
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…	5,970	$110	$638.6K
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…	9,810	$60	$578.6K

Showing 1–10 of 212

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

Lakeland Medical Practices — 12 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

212 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	17	50	150	$1,300	$889.5K
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…	84	130	200	$750	$636K
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…	38	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…	114	1,960	870	$100	$376.5K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	621	950	610	$80	$328.2K
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…	33	4,380	1,000	$70	$289.9K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	106	220	440	$180	$249.7K
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…	46	4,770	1,060	$50	$247.8K
47562	The provider removes the gallbladder through a laparoscope, a tubular instrument with a light source and camera inserted through the abdominal wall, to treat gallbladder disease.	10	50	60	$1,120	$238.2K
01967	The provider performs neuraxial anesthesia services for a patient undergoing a planned vaginal delivery.	67	70	1,040	$120	$226.6K

Showing 1–10 of 212

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bronson Methodist Hospital	MI	General Acute Care Hospital	$0	$109.1M
Lakeland Hospitals At Niles And St Joseph, Inc	MI	General Acute Care Hospital	$0	$78.1M
Bronson Methodist Hospital	MI	Hospitalist Physician	$0	$64.8M
Munson Medical Center	MI	General Acute Care Hospital	$0	$44.1M
Goshen Health System Inc	IN	Family Medicine Physician	$0	$12M
Lakeland Community Hospital Watervliet	MI	General Acute Care Hospital	$0	$9.8M
Bronson Battle Creek Hospital	MI	Internal Medicine Physician	$0	$9.8M
Lakeland Community Hospital Watervliet	MI	Rural Health Clinic/Center	$0	$9.1M
Aqeel Khan	IL	Psychiatry Physician	$2.2M	$3.5M
Mujahed Abbas	MI	Critical Care Medicine (Internal Medicine) Physician	$649.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Region Iv Area Agency On Aging, Inc	MI	Case Management Agency	$0	$36.3M
Hsh Senior Services, LLC	MI	Home Health Agency	$0	$35.6M
Epmg Southwest Michigan PLLC	MI	Emergency Medicine Physician	$0	$11.9M
Jason So	MI	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
Benjamin Nicholson	MI	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
Great Lakes Surgery Center LLC	MI	Ambulatory Surgical Clinic/Center	$1.3M	$51.3K
David Brown	MI	Ophthalmology Physician	$1.1M	$0
Erick Rivas	MI	Family Medicine Physician	$245.1K	$306.6K
Thomas Pow	MI	Interventional Cardiology Physician	$247.1K	$0
Stanley Pletcher	MI	Ophthalmology Physician	$230.7K	$0

Lakeland Medical Practices — Billing Profile & Reimbursement Data

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Lakeland Medical Practices — 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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