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.

Three Rivers Health System, Inc (NPI 1568739423)

Three Rivers Health System, Inc is a general acute care hospital provider located in Three Rivers, Michigan. This profile covers 0 Medicare and 222 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	Three Rivers Health System, Inc
Address	701 S Health Parkway
City	Three Rivers
State	MI
ZIP	49093
Taxonomy	General Acute Care Hospital
NPI Enumerated	November 21, 2011

Payer Source	Total Paid
Medicaid	$13.4M
Medicare	$0

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

222 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	24,180	$180	$4.4M
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.	13,200	$120	$1.6M
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.	3,540	$350	$1.2M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	6,340	$100	$615.2K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	7,680	$60	$460.7K
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.	2,660	$150	$404.5K
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…	17,440	$20	$401.2K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	2,700	$90	$238K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	2,720	$70	$201.1K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	5,340	$40	$197.7K

Showing 1–10 of 222

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

Three Rivers Health System, Inc — 0 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

222 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	69	150	5,330	$50	$2.8M
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.	164	400	1,510	$190	$2.6M
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.	81	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.	122	450	1,540	$90	$1.3M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	82	150	7,610	$90	$1.2M
G0378	Hospital observation service, per hour	79	100	2,820	$180	$1.1M
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	43	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…	61	130	200	$750	$636K
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.	112	230	2,380	$90	$490K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	14	20	90	$2,020	$489.9K

Showing 1–10 of 222

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cameron Yau	DE	Orthopaedic Surgery Physician	$252K	$0
Lokesh Kebbehundi Marigowda	NC	Internal Medicine Physician	$164.5K	$0
Sohaib Aleem	IN	Allergy & Immunology Physician	$128K	$0
Christopher Price	MI	Family Medicine Physician	$59.7K	$0
Matthew Deere	IN	Surgery Physician	$48.2K	$0
Michael Maskill	MI	Foot & Ankle Surgery Podiatrist	$47.3K	$0
Michael Cell	MI	Family Nurse Practitioner	$18.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
City Of Three Rivers	MI	Land Ambulance	$242.6K	$687.5K
Anthony Janas	MI	Family Medicine Physician	$84.4K	$6K
Sheri Carpenter	MI	Chiropractor	$50.8K	$0
Venkata Madeti	MI	Physician Assistant	$36.9K	$0

Three Rivers Health System, Inc — Billing Profile & Reimbursement Data

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Three Rivers Health System, 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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