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.

Vhs Sinai-grace Hospital Inc (NPI 1760794044)

Field	Value
Entity Type	Organization
Organization	Vhs Sinai-grace Hospital Inc
Address	6071 W Outer Dr
City	Detroit
State	MI
ZIP	48235
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 2, 2010

Payer Source	Total Paid
Medicaid	$96.7M
Medicare	$0

Key Findings

This provider is effectively Medicaid‑focused: there is no Medicare billing on file and reported lifetime Medicaid revenue is $96.7M, so the organization operates as a single‑payer (Medicaid) billing entity in the available data. That concentration of payer exposure should shape risk and reimbursement analyses rather than a mixed Medicare/Medicaid strategy.

Revenue is highly concentrated in emergency department evaluation-and-management (E/M) services: the top three Medicaid codes (99285, 99284, 99283) together account for 60.5% of this provider's total Medicaid revenue. Individually those codes generate $21.4M (25.2%), $16.2M (19.1%), and $13.8M (16.3%) respectively, indicating ED throughput is the dominant revenue driver.

The code mix points to a high‑volume acute care and emergency operations model. Large claim counts for 99283/99284/99285 (112.4K, 80.3K, 48.7K claims respectively) combined with substantial observation services (G0378: 16.8K claims, $6.7M revenue) and hospital outpatient clinic visits (G0463: 123.6K claims, $7.3M revenue) indicate sustained ED patient flow and downstream observation/clinic utilization.

State competitive standing is strongest for lower‑ and mid‑acuity ED visits: 99283 ranks #11 of 447 providers in-state (98th percentile; labeled an extreme outlier) and 99284 ranks #20 of 477 (96th percentile; notably above typical). By contrast, 99285 is still high volume but closer to peers (ranks #34 of 404, 92th percentile; described as typical), so the hospital is a major in‑state provider for moderate and low acuity ED visits in particular.

The hospital also shows focused GI procedure volume and screening activity beyond ED care. G0121 (colorectal cancer screening colonoscopy) is an extreme outlier in-state (ranks #1 of 41, 100th percentile) with $1.1M revenue, and diagnostic upper endoscopy 43239 posts $1.9M revenue and ranks #12 of 216 (95th percentile; notably above typical). This suggests a meaningful procedural endoscopy service line supporting both screening and diagnostic demand.

Imaging and ancillary services contribute materially but less dominantly to revenue: CT abdomen/pelvis 74177 (7.2K claims, $2M revenue) and CT head 70450 (13K claims, $1.1M revenue) appear alongside high volumes of basic radiography (71045: 35K claims, $979.9K revenue). These service lines align with the ED and observation emphasis, supplying diagnostic throughput for acute presentations.

There is evidence of broad ED case mix across acuity levels: 99281 (lowest acuity) ranks #2 of 145 providers in-state (99th percentile; notably above typical) with 10.5K claims and $629.4K revenue, while the facility simultaneously records extreme volumes of 99283. Taken together, this indicates the ED handles a wide spectrum of presentations and is a central access point for care.

The provider has an established presence in the market: the NPI was enumerated on 2010-07-02 (~16 years ago), signaling long tenure. Combined with the concentrated Medicaid revenue base and the high state percentiles on multiple codes, the data support characterization of an established, Medicaid‑serving acute care hospital with particularly strong in‑state ED and endoscopy throughput.

Medicaid: Complete Services Breakdown

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

430 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.	48,710	$440	$21.4M
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.	80,310	$200	$16.2M
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.	112,410	$120	$13.8M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	123,630	$60	$7.3M
G0378	Hospital observation service, per hour	16,810	$400	$6.7M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	38,190	$70	$2.8M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	7,170	$280	$2M
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	5,450	$350	$1.9M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	15,340	$80	$1.3M
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	2,300	$490	$1.1M

Showing 1–10 of 430

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

Vhs Sinai-grace Hospital Inc — 6 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

430 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1017	Targeted case management, each 15 minutes	124	180	10,890	$210	$8.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	17	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.	34	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.	20	480	1,350	$110	$1.7M
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.	11	450	1,540	$90	$1.3M
H0032	Mental health service plan development by non-physician	91	180	2,030	$170	$1.2M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	13	150	7,610	$90	$1.2M
H0031	Mental health assessment, by non-physician	113	180	1,290	$250	$1.1M
G0378	Hospital observation service, per hour	13	100	2,820	$180	$1.1M
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	54	70	680	$100	$604K

Showing 1–10 of 430

Related Providers

Other providers that share a Tax Identification Number (TIN) with Vhs Sinai-grace Hospital Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Noah Stern	MI	Facial Plastic Surgery Physician	$61.9K	$0

Nearby Providers

Other providers in the same ZIP code as Vhs Sinai-grace Hospital Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Precise Health Care Services	MI	Home Health Agency	$0	$34.5M
Dental Care Management, Inc.	MI	Dental Clinic/Center	$0	$7.3M
Daniel Zuckerbrod	MI	Ophthalmology Physician	$333.1K	$111.1K
Chadi Saad	MI	Nephrology Physician	$311.1K	$0
Arif Hakim	MI	Cardiovascular Disease Physician	$262.4K	$0
Wasim Qazi	MI	Internal Medicine Physician	$142.8K	$0
Aaron Brody	MI	Emergency Medicine Physician	$94.6K	$0
Sulaiman Alhassan	MI	Internal Medicine Physician	$83.1K	$0
Praise Matemavi	MI	Surgery Physician	$76.6K	$0
Duy Bui	MI	Diagnostic Radiology Physician	$69.8K	$0

Vhs Sinai-grace Hospital Inc — Billing Profile & Reimbursement Data

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Vhs Sinai-grace Hospital Inc — 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