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.

Spectrum Health United (NPI 1538436852)

Spectrum Health United is a rural health clinic/center provider located in Greenville, Michigan. This profile covers 0 Medicare and 81 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	Spectrum Health United
Address	1202 W Oak St
City	Greenville
State	MI
ZIP	48838
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	December 1, 2011

Payer Source	Total Paid
Medicaid	$6.6M
Medicare	$0

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

81 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	78,410	$60	$4.4M
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…	1,290	$890	$1.1M
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…	34,650	$10	$207.9K
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…	16,670	$10	$166.7K
J1050	Injection, medroxyprogesterone acetate, 1 mg	1,650	$50	$85.5K
59430	For this service, the provider or nonphysician healthcare professional provides care to the patient in the outpatient setting following the delivery. Routine postpartum care can involve one or more…	1,070	$70	$76.1K
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…	3,750	$20	$63.7K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	2,160	$20	$49.7K
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…	4,010	$10	$48.1K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	2,650	$10	$34.4K

Showing 1–10 of 81

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

Spectrum Health United — 3 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

81 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	5	290	5,950	$50	$689.7K
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…	119	130	200	$750	$636K
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…	24	160	260	$820	$506.6K
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…	1,775	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…	868	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…	207	4,380	1,000	$70	$289.9K
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…	127	4,770	1,060	$50	$247.8K
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…	114	670	730	$60	$140K
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…	100	590	850	$50	$134.5K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	151	240	1,040	$50	$133.3K

Showing 1–10 of 81

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Spectrum Health United	MI	General Acute Care Hospital	$0	$20.9M
Yuanbin Chen	FL	Medical Oncology Physician	$2.7M	$0
Brett Brinker	MI	Hematology & Oncology Physician	$794.9K	$0
Charles Crellin	MI	Orthopaedic Surgery Physician	$131.2K	$0
Kenneth Minks	MI	Surgery Physician	$17.4K	$0
Kirsten Oosterbaan	MI	Medical Physician Assistant	$20	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cherry Street Services Inc	MI	Federally Qualified Health Center (FQHC)	$0	$5.4M
Tejinder Mander	MI	Cardiovascular Disease Physician	$315K	$0
Lisa Pullum	MI	Interventional Pain Medicine Physician	$188.9K	$0
William Fabricius	MI	Hematology & Oncology Physician	$67.1K	$0
Victor Hajjar	MI	Cardiovascular Disease Physician	$63.9K	$0
Domenico Ausiello	MI	Family Medicine Physician	$57.3K	$2.1K

Spectrum Health United — 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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