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 Wisconsin for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Wisconsin 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. Wisconsin (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.

Aspirus Medical Group, Inc. (NPI 1720177371)

Aspirus Medical Group, Inc. is a clinic/center provider located in Weston, Wisconsin. This profile covers 0 Medicare and 44 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	Aspirus Medical Group, Inc.
Address	4005 Community Center Dr
City	Weston
State	WI
ZIP	54476
Taxonomy	Clinic/Center
NPI Enumerated	October 12, 2006

Payer Source	Total Paid
Medicaid	$2.5M
Medicare	$0

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

44 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	24,230	$40	$944.8K
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…	17,750	$30	$479.3K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	9,690	$50	$475K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	1,070	$130	$133.5K
Q3014	Telehealth originating site facility fee	5,790	$20	$98.5K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	7,880	$10	$94.5K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	420	$130	$52.9K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	670	$60	$38.9K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	450	$90	$38.7K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	2,630	$10	$36.8K

Showing 1–10 of 44

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.

Claims Volume vs. Wisconsin Distribution

Aspirus Medical Group, Inc. — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

44 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	29	80	650	$110	$244.4K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	160	260	3,590	$20	$232.2K
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…	54	1,630	270	$40	$205.3K
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…	77	1,760	250	$40	$173.2K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	19	350	300	$50	$157.9K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	373	900	410	$70	$130.4K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	188	220	2,770	$20	$120.2K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	383	790	400	$40	$109.6K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	178	260	750	$40	$99K
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…	275	350	210	$60	$95.8K

Showing 1–10 of 44

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Aky Md, LLC	OK	Pediatrics Physician	$0	$42.2M
Aspirus Wausau Hospital, Inc.	WI	General Acute Care Hospital	$0	$16.3M
Aspirus Merrill Hospital & Clinics, Inc.	WI	Critical Access Hospital	$0	$11.1M
Aspirus Riverview Hospital & Clinics, Inc.	WI	General Acute Care Hospital	$0	$10.9M
Aspirus Wausau Hospital, Inc.	WI	Land Ambulance	$4M	$6.1M
Aspirus Wausau Hospital, Inc.	WI	Clinical Medical Laboratory	$0	$6.9M
Aspirus Riverview Hospital & Clinics, Inc.	WI	Rural Health Clinic/Center	$0	$4.7M
Deepak Sambhara	WI	Ophthalmology Physician	$4.3M	$0
Eric Berkowitz	NY	Vascular & Interventional Radiology Physician	$2.6M	$1.2M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mchs Hospitals Inc	WI	General Acute Care Hospital	$0	$6.4M
Todd Johnson	WI	General Practice Dentistry	$0	$3.8M
Alexis Powell	WI	Behavior Analyst	$0	$3.2M
D.c. Everest Area Schools	WI	Local Education Agency (LEA)	$0	$2.4M
Compass Counseling Wausau, LLC	WI	Group Psychotherapy Psychologist	$0	$2.2M
Mchs Hospitals Inc	WI	Clinic/Center	$0	$1.2M
Glenn Dym	WI	Clinical Cardiac Electrophysiology Physician	$264.1K	$0
Chong Lee	WI	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$183.3K	$0
Dan Gavrila	WI	Interventional Cardiology Physician	$131.2K	$40
Adedayo Onitilo	WI	Hematology & Oncology Physician	$125.3K	$0

Aspirus Medical Group, Inc. — Billing Profile & Reimbursement Data

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Aspirus Medical Group, Inc. — 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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