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.

Metropolitan Hospital (NPI 1619923919)

Key Findings

Field	Value
Entity Type	Organization
Organization	Metropolitan Hospital
Address	5900 Byron Center Ave Sw
City	Wyoming
State	MI
ZIP	49519
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 26, 2006

Payer Source	Total Paid
Medicaid	$101M
Medicare	$0

METROPOLITAN HOSPITAL is effectively single‑payer in our dataset: Total Medicare revenue is none (no Medicare billing on file) while Total Medicaid revenue is $101M, so all documented public-payor activity in this profile is driven by Medicaid. This concentration means payor-policy or rate changes at the state Medicaid level would materially affect the provider's top-line public reimbursement.

Revenue is highly concentrated in a few outpatient E/M and clinic visit codes — the precomputed top 3 Medicaid codes account for 43.0% of the provider's total Medicaid revenue. Specifically, G0463 generated $10.3M (16.0%), 99213 generated $8.7M (13.6%), and 99214 generated $8.6M (13.4%), indicating those three ambulatory visit codes together underpin nearly half of Medicaid receipts.

The code mix and high volumes point to a dominant ambulatory and primary-care orientation within the hospital’s Medicaid business line: G0463 (hospital outpatient clinic visit), 99213 and 99214 (established patient office visits) are the top revenue drivers. High counts for preventive visit codes such as 99392, 99391, 99393, 99395 and 99394 across pediatric and adult age bands further support that METROPOLITAN operates substantial longitudinal and well‑visit clinics in addition to general outpatient assessment services.

METROPOLITAN shows clear statewide dominance on several ambulatory measures: 99213 ranks #3 of 4766 providers in-state (100th percentile; extreme outlier, far above typical state volume) and 99214 ranks #9 of 4380 providers in-state (100th percentile; extreme outlier, far above typical state volume). Multiple preventive visit codes are also at or near the top of state rankings (for example 99393 is #1 of 724; 99395 is #2 of 858), signaling an outsized share of in‑state preventive and primary care Medicaid volume.

Emergency department activity is a meaningful but less dominant revenue stream: 99284 contributed $5M (7.9%) and 99283 contributed $3.9M (6.1%), with ED code ranks in the middle-to-high percentiles (e.g., 99284 at the 85th percentile and 99283 at the 89th percentile), which indicates a steady, typical ED caseload for a general acute care hospital rather than an extreme outlier. This pattern suggests the hospital operates both high-volume outpatient clinics and a routinely busy ED.

Procedural and ancillary services provide a secondary but material Medicaid revenue base: notable items include 74177 at $1.4M, 93306 at $1.1M, 45380 at $998.1K, 43239 at $895.4K and 11042 at $1M (11042 ranks #1 of 139 providers in-state). These line items indicate in‑house imaging, endoscopy, cardiac echo, and procedural/surgical capability that complement the facility’s ambulatory and acute care volumes.

From a competitive-risk perspective, the provider’s Medicaid dependence and revenue concentration create sensitivity to policy or utilization shifts that affect outpatient clinic and established‑visit reimbursement. With no Medicare billing on file, METROPOLITAN lacks diversification into federal fee‑for‑service Medicare revenue in this dataset, amplifying exposure to state Medicaid changes and local market competition for ambulatory care.

METROPOLITAN has a long enrollment history in the NPI registry (enumerated 2006-05-26, ~20 years ago), which supports interpretation that its high Medicaid volumes and statewide ranking reflect an established operating presence and sustained payer relationships rather than a short‑term reporting spike.

Medicaid: Complete Services Breakdown

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

654 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	311,310	$30	$10.3M
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…	207,430	$40	$8.7M
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…	143,040	$60	$8.6M
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.	27,060	$190	$5M
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.	32,840	$120	$3.9M
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.	9,440	$380	$3.6M
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…	39,270	$50	$1.9M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	20,780	$90	$1.8M
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…	40,150	$50	$1.8M
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.	24,980	$70	$1.8M

Showing 1–10 of 654

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

Metropolitan Hospital — 15 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

654 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	5	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.	103	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.	73	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.	51	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.	37	150	7,610	$90	$1.2M
G0378	Hospital observation service, per hour	41	100	2,820	$180	$1.1M
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	26	50	150	$1,300	$889.5K
J0585	Injection, onabotulinumtoxina, 1 unit	8	40	260	$510	$684.9K
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…	30	130	200	$750	$636K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	26	160	2,720	$60	$546.6K

Showing 1–10 of 654

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Brett Brinker	MI	Hematology & Oncology Physician	$794.9K	$0
Penny Vroman	TX	Nuclear Radiology Physician	$546.1K	$0
Shawn Ahmed	MN	Diagnostic Radiology Physician	$505K	$0
Maryann Shango	MI	Hematology & Oncology Physician	$443.1K	$0
Wesley Pruett	MN	Diagnostic Radiology Physician	$441.3K	$770
William Feske	CA	Diagnostic Radiology Physician	$364.7K	$0
Noah Smith	WI	Dermatology Physician	$364K	$0
Robert Gardner	CA	Diagnostic Radiology Physician	$335.5K	$0
Mershed Alsamara	MI	Internal Medicine Physician	$296.2K	$0
Howard Francois	NV	Diagnostic Radiology Physician	$273.5K	$19.5K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Airway Oxygen Inc	MI	Oxygen Equipment & Supplies (DME)	$0	$8.3M
Great Lakes Healthcare Resources, LLC	MI	Home Health Agency	$0	$6.8M
Certified Emergency Medicine Specialists, PC	MI	Emergency Medical Services (Emergency Medicine) Physician	$0	$6.7M
Great Lakes Healthcare Resources-lakeshore LLC	MI	Home Health Agency	$0	$6.5M
Allan Coates	MI	Gastroenterology Physician	$175.4K	$0
Paul Dwyer	MI	Emergency Medicine Physician	$125.2K	$0
Eric Kozfkay	MI	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$72.1K	$0
Kyle Pfeifer	MI	Diagnostic Radiology Physician	$17K	$50.1K
John Key	MI	Cardiovascular Disease Physician	$61.7K	$0
Michael Sumners	MI	Internal Medicine Physician	$53.3K	$0

Metropolitan Hospital — Billing Profile & Reimbursement Data

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Metropolitan Hospital — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References