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.

William Beaumont Hospital (NPI 1689653305)

Field	Value
Entity Type	Organization
Organization	William Beaumont Hospital
Address	3601 W 13 Mile Rd
City	Royal Oak
State	MI
ZIP	48073
Taxonomy	General Acute Care Hospital
NPI Enumerated	January 11, 2006

Payer Source	Total Paid
Medicaid	$162.4M
Medicare	$0

Key Findings

WILLIAM BEAUMONT HOSPITAL is effectively a Medicaid-centric provider: Medicare revenue is listed as none (no Medicare billing on file) while total Medicaid revenue is $162.4M, indicating a heavy single-payer dependence on Medicaid for its reported public-payer activity. This payer concentration implies financial exposure to Medicaid policy and rate changes in Michigan.

Revenue is highly concentrated in a small number of service lines: the precomputed top three Medicaid codes — 99285 ($40.9M, 38.0%), G0463 ($16.9M, 15.7%), and 99284 ($8.8M, 8.2%) — together account for 61.9% of the provider’s total Medicaid revenue. Those three codes point to a blend of high-acuity emergency care and outpatient clinic management driving the bulk of Medicaid receipts.

Emergency department services are a primary revenue driver: 99285 (high-acuity ED E/M) alone generates $40.9M and is ranked #13 of 404 providers in-state (97th percentile), described as notably above typical state volume for this code. Lower-acuity ED codes such as 99284 ($8.8M, 8.2%) and 99283 ($4.2M, 3.9%) also appear on the top list, which together indicate a large, high-volume ED practice handling a broad spectrum of acuity.

The facility functions as a major diagnostic and laboratory hub for Medicaid: multiple lab and panel codes are labeled as extreme outliers or near-extreme in state volume — examples include 80061 (195.5K claims, $2.5M, rank #3 of 274, 99th percentile, extreme outlier), 82306 (138.3K claims, $2.4M, rank #2 of 182, 99th percentile, extreme outlier), 84443 (186.6K claims, $1.9M, rank #3 of 229, 99th percentile, extreme outlier), 87491 and 87591 (each ~90K claims, $1.9M–$1.8M, rank #3 of their peer groups, 99th percentile, extreme outlier) and 80053 (295K claims, $1.5M, rank #3 of 254, 99th percentile, extreme outlier). These patterns suggest centralized lab processing and high throughput testing volume for Medicaid patients.

The provider shows unusually high relative volume for certain specialized tests and respiratory pathogen detection: 87633 (respiratory virus testing) is ranked #1 of 61 providers in-state (100th percentile) and described as an extreme outlier, while U0003 (SARS-CoV-2 testing) and other infectious-disease NAATs (e.g., 87491, 87591) are in very high percentiles. This profile supports the conclusion that the hospital has invested capacity in high-volume molecular testing and pandemic-era diagnostics.

Outpatient therapeutic and rehab services are also significant: 97110 (therapeutic exercise) appears with 83.3K claims and $2M revenue (1.9%), ranked #8 of 547 providers in-state (99th percentile, extreme outlier), and 97530 (therapeutic activities) shows strong volume as well. High-volume billing across these PT codes indicates a sizable rehabilitation/therapy program serving Medicaid beneficiaries.

Imaging and cardiac diagnostics contribute meaningfully to Medicaid revenue and show above-typical volume: 93306 (echocardiography) yields $2.2M (2.0%) and ranks #14 of 310 providers (96th percentile, notably above typical), while CT abdomen/pelvis (74177) and cardiac SPECT (78452) each contribute over $1M. These ranks and dollar contributions indicate the hospital maintains substantial radiology and cardiac testing capacity for Medicaid patients.

The provider is an established operator with long tenure: NPI enumeration date is 2006-01-11 (~20 years ago), which aligns with the scale and breadth of services observed across ED, outpatient clinic, lab, imaging, and rehabilitation lines. Combined with frequent top-percentile rankings across many Medicaid codes, this longevity supports a conclusion that WILLIAM BEAUMONT HOSPITAL is a major in-state provider for Medicaid-covered acute, diagnostic, and rehabilitative services.

Medicaid: Complete Services Breakdown

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

842 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.	93,570	$440	$40.9M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	249,000	$70	$16.9M
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.	42,860	$210	$8.8M
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.	30,920	$140	$4.2M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	43,290	$80	$3.5M
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	195,530	$10	$2.5M
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	138,330	$20	$2.4M
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	11,330	$190	$2.2M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	53,890	$40	$2.2M
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…	83,290	$20	$2M

Showing 1–10 of 842

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

William Beaumont Hospital — 17 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

842 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	8	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.	13	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.	42	480	1,350	$110	$1.7M
Q5103	Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg	6	10	440	$970	$1.4M
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.	56	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.	8	150	7,610	$90	$1.2M
G0378	Hospital observation service, per hour	3	100	2,820	$180	$1.1M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	7	10	290	$1,440	$1M
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	14	50	150	$1,300	$889.5K
J0585	Injection, onabotulinumtoxina, 1 unit	33	40	260	$510	$684.9K

Showing 1–10 of 842

Related Providers

Other providers that share a Tax Identification Number (TIN) with William Beaumont Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
William Beaumont Hospital	MI	Hospitalist Physician	$0	$167.9M
Oakwood Healthcare, Inc.	MI	General Acute Care Hospital	$0	$165.3M
William Beaumont Hospital	MI	General Acute Care Hospital	$0	$84.8M
Botsford General Hospital	MI	General Acute Care Hospital	$0	$72.1M
William Beaumont Hospital	MI	General Acute Care Hospital	$0	$61.5M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Wellstreet Urgent Care Of Michigan	MI	Urgent Care Clinic/Center	$0	$37.5M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Sandeep Randhawa	MI	Retina Specialist (Ophthalmology) Physician	$7M	$0
William Beaumont Hospital	MI	Home Health Agency	$0	$5.3M

Nearby Providers

Other providers in the same ZIP code as William Beaumont Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Judson Center, Inc.	MI	Community/Behavioral Health Agency	$0	$21.2M
Associated Retinal Consultants, PC	MI	Ophthalmology Physician	$0	$21.1M
Allergy & Asthma Associates Of Mi PC	MI	Allergy & Immunology Physician	$0	$15.9M
Community Homes, Inc.	MI	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$7.5M
American Anesthesiology Of Michigan PC	MI	Anesthesiology Physician	$0	$5.7M
Joshua Robinson	MI	Ophthalmology Physician	$3.7M	$0
Jeremy Wolfe	MI	Retina Specialist (Ophthalmology) Physician	$3.7M	$0
Tamer Mahmoud	MI	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
George Williams	MI	Retina Specialist (Ophthalmology) Physician	$2.7M	$0
Kimberly Drenser	MI	Retina Specialist (Ophthalmology) Physician	$2.7M	$0

William Beaumont 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