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.

Mercy Specialty Services (NPI 1629010384)

Mercy Specialty Services is a internal medicine physician provider located in Muskegon, Michigan. This profile covers 0 Medicare and 39 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	Mercy Specialty Services
Address	1150 E Sherman Blvd Ste 2400
City	Muskegon
State	MI
ZIP	49444
Taxonomy	Internal Medicine Physician
NPI Enumerated	June 10, 2006

Payer Source	Total Paid
Medicaid	$5.3M
Medicare	$0

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

39 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	36,390	$40	$1.3M
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	10,650	$100	$1M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	13,030	$50	$703.5K
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…	4,010	$120	$461.4K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	6,860	$60	$383.9K
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…	7,190	$30	$244.6K
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…	4,860	$50	$242.8K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	3,500	$40	$129.4K
98927	The provider performs controlled manual pressure in five to six body regions to treat somatic and nonsomatic disorders.	4,490	$30	$116.8K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	1,590	$70	$108.1K

Showing 1–10 of 39

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

Mercy Specialty Services — 5 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

39 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	52	270	510	$140	$395.2K
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…	848	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…	783	4,770	1,060	$50	$247.8K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	29	630	430	$60	$180.4K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	19	950	740	$40	$166.5K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	14	760	240	$100	$121.4K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	851	1,170	170	$90	$107.9K
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…	325	1,860	220	$90	$96.9K
99220	N/A	37	170	160	$100	$87.9K
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…	1,861	2,000	260	$60	$84.2K

Showing 1–10 of 39

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Muhammad Ahmad	OH	Internal Medicine Physician	$101.8K	$0
Courtney Garlick	MI	Diagnostic Radiology Physician	$90.3K	$0
Amgad Bissada	MI	Internal Medicine Physician	$80.5K	$0
Lajide Lawoyin	GA	Hospitalist Physician	$67.8K	$0
Conrad Kozlowski	MI	Sleep Medicine (Internal Medicine) Physician	$50K	$0
Mehdi Djekidel	FL	Nuclear Imaging & Therapy Physician	$39.1K	$0
Katie Alfredson	MI	Nurse Practitioner	$22.8K	$0
Donovan Jeffcoat	MI	Neuromusculoskeletal Medicine & OMM Physician	$22.8K	$0
Ryan Gzym	MI	Physician Assistant	$12.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Moka Corporation	MI	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$126.2M
Mercy Health Partners	MI	General Acute Care Hospital	$0	$98.1M
Senior Resources Of West Michigan	MI	Case Management Agency	$0	$31.5M
Mgh Family Health Center	MI	Federally Qualified Health Center (FQHC)	$0	$24.4M
Hackley Community Care Center Inc	MI	Federally Qualified Health Center (FQHC)	$0	$23.1M
Orthopaedic Associates Of Muskegon, PC	MI	Orthopaedic Surgery Physician	$0	$7.1M
Port City Pediatrics	MI	Pediatrics Physician	$0	$5.9M
Radiology Muskegon PC	MI	Diagnostic Radiology Physician	$0	$5.9M
Paul Raphaelian	MI	Retina Specialist (Ophthalmology) Physician	$1.5M	$0
Muskegon Sc, LLC	MI	Ambulatory Surgical Clinic/Center	$967.6K	$68.1K

Mercy Specialty Services — Billing Profile & Reimbursement Data

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Mercy Specialty Services — 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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