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.

Physician Coverage Services PC (NPI 1669567806)

Physician Coverage Services PC is a internal medicine physician provider located in Flint, Michigan. This profile covers 0 Medicare and 172 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	Physician Coverage Services PC
Address	2700 Robert T Longway Blvd Ste B
City	Flint
State	MI
ZIP	48503
Taxonomy	Internal Medicine Physician
NPI Enumerated	October 4, 2006

Payer Source	Total Paid
Medicaid	$16.6M
Medicare	$0

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

172 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…	101,140	$60	$5.7M
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…	70,840	$80	$5.6M
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…	17,070	$40	$631.5K
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…	5,380	$100	$510.6K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	5,770	$90	$501.6K
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…	9,070	$60	$498.7K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	4,330	$100	$411.6K
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…	4,210	$80	$328.7K
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…	2,080	$120	$254.1K
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…	4,560	$60	$251K

Showing 1–10 of 172

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

Physician Coverage Services PC — 7 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

172 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	29	4,380	1,000	$70	$289.9K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	328	390	1,660	$40	$281.8K
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…	19	4,770	1,060	$50	$247.8K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	262	550	2,350	$30	$240.6K
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…	45	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…	43	950	740	$40	$166.5K
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…	238	670	730	$60	$140K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	246	360	1,410	$20	$136.3K
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…	266	590	850	$50	$134.5K
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…	30	760	240	$100	$121.4K

Showing 1–10 of 172

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hurley Medical Center	MI	General Acute Care Hospital	$0	$118.2M
Mott Children's Health Center	MI	Multi-Specialty Clinic/Center	$0	$20.9M
Hurley Medical Center	MI	Emergency Medicine Physician	$0	$18.9M
Eden Prairie Residential Care Services, LLC	MI	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$16.7M
Merakey Midwest	MI	Community/Behavioral Health Agency	$0	$15.9M
Hurley Medical Center	MI	Obstetrics & Gynecology Physician	$0	$8.4M
Genesee Health System	MI	Federally Qualified Health Center (FQHC)	$0	$7.7M
Rizwan Danish	MI	Hematology & Oncology Physician	$1.1M	$0
Paul Kocheril	MI	Radiation Oncology Physician	$475K	$0
Mark Wilkerson	MI	Emergency Medical Services (Emergency Medicine) Physician	$440.1K	$0

Physician Coverage Services PC — Billing Profile & Reimbursement Data

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Physician Coverage Services 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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