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.

Pulmonary Associates, PC (NPI 1669428926)

Pulmonary Associates, PC is a pulmonary disease physician provider located in Flint, Michigan. This profile covers 0 Medicare and 24 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	Pulmonary Associates, PC
Address	G3252 Beecher Rd
City	Flint
State	MI
ZIP	48532
Taxonomy	Pulmonary Disease Physician
NPI Enumerated	May 26, 2006

Payer Source	Total Paid
Medicaid	$6.3M
Medicare	$0

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
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…	26,500	$120	$3M
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…	24,220	$60	$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…	3,210	$100	$318.2K
95811	During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.	1,530	$180	$280.6K
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…	3,150	$80	$242.6K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	1,240	$180	$226.2K
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…	3,150	$60	$186K
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…	3,580	$40	$132.6K
94726	The provider performs a pulmonary function test, or PFT, to determine the patient’s lung volumes, such as total lung capacity, residual volume, and functional residual capacity. The testing also may…	4,550	$20	$109.1K
94729	In this add on procedure, the provider tests the lungs’ diffusing capacity, the ability to exchange gases, moving oxygen into the bloodstream and letting in carbon dioxide from the bloodstream.	4,320	$30	$108K

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

Pulmonary Associates, PC — 6 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
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	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…	1,204	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…	4,095	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…	16	630	430	$60	$180.4K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	20	130	200	$270	$178.1K
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…	234	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…	57	760	240	$100	$121.4K
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…	186	520	710	$20	$112K
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…	96	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…	536	1,860	220	$90	$96.9K

Showing 1–10 of 24

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sam Hamade	MI	Pulmonary Disease Physician	$177.1K	$0
Ibrahim Al-sanouri	WI	Pulmonary Disease Physician	$158K	$0
James Vyskocil	WI	Critical Care Medicine (Internal Medicine) Physician	$12.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Alternative Community Living, Inc.	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$63.3M
Hope Network S E	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$48.6M
Mclaren Flint	MI	General Acute Care Hospital	$0	$43.4M
Alternative Community Living, Inc.	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$30.5M
Bio-med Behavioral Health Services	MI	Addiction (Substance Use Disorder) Counselor	$0	$15.4M
Flint Neurological Centre PC	MI	Specialist	$0	$10.7M
Pediatric & Adolescent Advance Care PLLC	MI	Pediatrics Physician	$0	$10.1M
Homes Of Opportunity Incorporated	MI	Community/Behavioral Health Agency	$0	$9.8M
Mclaren Flint	MI	General Practice Physician	$0	$7.3M
Sacred Heart Rehabilitation Center, Inc	MI	Community/Behavioral Health Agency	$0	$6.6M

Pulmonary Associates, PC — Billing Profile & Reimbursement Data

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Pulmonary Associates, PC — 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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