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.

Macomb Emergency Physicians PLLC (NPI 1609235217)

Field	Value
Entity Type	Organization
Organization	Macomb Emergency Physicians PLLC
Address	1000 Harrington St
City	Mount Clemens
State	MI
ZIP	48043
Taxonomy	Emergency Medicine Physician
NPI Enumerated	February 11, 2016

Payer Source	Total Paid
Medicaid	$8.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

24 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	47,250	$80	$3.8M
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.	39,230	$60	$2.4M
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.	22,190	$60	$1.3M
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…	2,970	$120	$367.8K
99220	N/A	2,690	$100	$269K
99217	N/A	2,390	$40	$93.2K
99236	The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…	720	$120	$86.5K
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.	1,130	$50	$61K
99218	N/A	200	$50	$11K
31500	The provider inserts a flexible tube into the trachea (windpipe) typically via the mouth in an emergency situation to maintain an open airway in a patient with a compromised airway.	110	$80	$8.8K

Showing 1–10 of 24

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

Macomb Emergency Physicians PLLC — 1 of 24 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

24 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	38	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.	49	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.	77	450	1,540	$90	$1.3M
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…	60	270	510	$140	$395.2K
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.	167	260	2,670	$70	$348.7K
76705	An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code…	142	210	950	$30	$103.6K
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	255	290	730	$40	$98.6K
99236	The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…	13	40	340	$120	$93.3K
99220	N/A	18	170	160	$100	$87.9K
93970	The provider performs an ultrasound scanning procedure called a duplex scan to characterize the pattern and direction of blood flow in extremity veins (arms or legs). This is a complete, bilateral…	145	160	380	$50	$60.5K

Showing 1–10 of 24

Nearby Providers

Other providers in the same ZIP code as Macomb Emergency Physicians PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mclaren Macomb	MI	General Acute Care Hospital	$0	$56.7M
Macomb Residential Opportunities, Inc.	MI	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$39.8M
Svs Vision Inc	MI	Optometrist	$0	$30.9M
Life Skills Centers, Inc.	MI	Developmentally Disabled Services Day Training Agency	$0	$28M
Mclaren Macomb	MI	Internal Medicine Physician	$0	$19.2M
Allergy And Asthma Physicians Of Commerce Township	MI	Allergy & Immunology Physician	$0	$5.4M
County Of Macomb	MI	Public Health or Welfare Agency	$207.7K	$1.8M
Thomas Giancarlo	MI	Neurology Physician	$458.1K	$0
Henry Ford Macomb Ancillary Services	MI	Clinical Medical Laboratory	$147.1K	$66K
Pulin Patel	MI	Allergy & Immunology Physician	$198.6K	$2.4K

Macomb Emergency Physicians PLLC — Billing Profile & Reimbursement Data

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Macomb Emergency Physicians PLLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References