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 Ohio for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Ohio 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. Ohio (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.

Promedica Central Corporation Of Michigan (NPI 1588624696)

Promedica Central Corporation Of Michigan is a family medicine physician provider located in Toledo, Ohio. This profile covers 0 Medicare and 170 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	Promedica Central Corporation Of Michigan
Address	100 Madison Ave
City	Toledo
State	OH
ZIP	43604
Taxonomy	Family Medicine Physician
NPI Enumerated	March 23, 2006

Payer Source	Total Paid
Medicaid	$14.2M
Medicare	$0

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

170 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	68,360	$50	$3.7M
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…	43,500	$80	$3.3M
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…	820	$770	$629.7K
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…	6,270	$100	$601.9K
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…	6,940	$60	$437.4K
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…	6,010	$70	$432.9K
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…	480	$860	$411.9K
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…	5,000	$80	$400K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	4,500	$80	$378K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	3,660	$90	$344.4K

Showing 1–10 of 170

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Ohio providers billing the same CPT/HCPCS codes.

Claims Volume vs. Ohio Distribution

Promedica Central Corporation Of Michigan — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

170 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	401	530	7,190	$70	$1.5M
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	24	80	100	$860	$719.1K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	30	40	100	$850	$680.6K
0241U	N/A	81	90	1,960	$120	$464.3K
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…	667	2,640	620	$90	$408.2K
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…	113	4,510	500	$60	$377.8K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	234	270	8,700	$10	$353.7K
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…	89	5,080	560	$40	$323.9K
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…	59	430	560	$60	$303.2K
00170	The provider performs anesthesia services for a patient undergoing an intraoral procedure, including biopsy.	51	90	320	$110	$293.3K

Showing 1–10 of 170

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kristie Jones	MI	Physician Assistant	$471.3K	$0
Jihad Abbas	OH	Vascular Surgery Physician	$150.2K	$0
Saadia Mian	MI	Endocrinology, Diabetes & Metabolism Physician	$101.6K	$0
William Cosgrove	MI	Anesthesiology Physician	$92.1K	$0
Rahul Chakravarty	OH	Anesthesiology Physician	$30.4K	$0
Taufiek Alhadi	MI	Anesthesiology Physician	$29.8K	$0
Donald Neirink	MI	Anesthesiology Physician	$15.5K	$0
Sarah Waggoner	OH	Certified Registered Nurse Anesthetist	$5.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rfs Charitable Foundation	OH	Community/Behavioral Health Agency	$0	$49.6M
Mercy Health Physicians-north LLC	OH	Family Medicine Physician	$0	$42.1M
Promedica Central Physicians	OH	Family Medicine Physician	$0	$40.9M
Pathology Laboratories, Inc.	OH	Clinical Medical Laboratory	$3.1M	$25M
Primary Care Solutions Of Ohio Incorporated	OH	Community/Behavioral Health Agency	$0	$17.6M
A Renewed Mind	OH	Community/Behavioral Health Agency	$0	$15.3M
A Renewed Mind	OH	Community/Behavioral Health Agency	$0	$13.4M
Mercy Health Physicians North Specialty Care LLC	OH	Surgery Physician	$0	$13.1M
Mercy Health - Life Flight Network LLC	OH	Ambulance	$3.3M	$3.2M
Lucas County Auditor	OH	Ambulance	$811.6K	$4.6M

Promedica Central Corporation Of Michigan — 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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