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 1811044878)

Key Findings

Field	Value
Entity Type	Organization
Organization	William Beaumont Hospital
Address	3601 W 13 Mile Rd
City	Royal Oak
State	MI
ZIP	48073
Taxonomy	Hospitalist Physician
NPI Enumerated	January 4, 2007

Payer Source	Total Paid
Medicaid	$167.9M
Medicare	$0

This provider has no Medicare billing on file and all recorded government payer revenue is Medicaid ($167.9M), making its public-payer footprint effectively single-payer and heavily Medicaid-dependent. That concentration implies the organization’s financial performance and payer negotiations will be driven primarily by state Medicaid policy and reimbursement trends rather than Medicare dynamics.

Revenue is materially concentrated in a few evaluation-and-management codes: the precomputed top-three Medicaid codes account for 35.3% of the provider’s Medicaid revenue, led by 99214 ($16.4M, 14.0%), 99285 ($13.6M, 11.6%), and 99284 ($11.2M, 9.6%). This concentration indicates that a relatively small set of high-volume E/M services drives a large share of reported Medicaid dollars.

The code mix points to a full-service acute-care hospital operation with high emergency, inpatient, and critical care activity. High Medicaid revenue for 99285 ($13.6M), 99284 ($11.2M), 99223 ($5.4M), 99233 ($7.7M) and 99291 ($4.2M) is consistent with a large ED, substantial inpatient census, and significant critical-care throughput.

Obstetrics and neonatal services are a meaningful business line: 59409 ($3.5M), 59426 ($2.4M), and 59514 ($1.7M) appear alongside neonatal critical-care codes 99472 ($2.5M), 99469 ($2.1M) and 99479 ($1.7M). These code-level revenues and their high state ranks suggest a sizeable maternity service and NICU presence rather than incidental obstetrical volume.

The provider also reports very large ambulatory and preventive visit volumes — 99214 ($16.4M; 244.9K claims) and 99213 ($9.7M; 206.4K claims) together with preventive visit codes 99396 ($2.3M) and 99395 ($1.9M) — indicating substantial outpatient clinic throughput in addition to inpatient care. Ancillary services are supported internally, as shown by pathology 88305 ($2.2M) and CT 74177 ($2.0M) revenue, consistent with in-house diagnostic and lab capacity.

Across many high-revenue codes this provider ranks at or near the top statewide and is repeatedly labeled an extreme outlier or notably above typical state volume. Examples include 99214 (rank #3 of 4,380; 100th percentile; extreme outlier), 99233 (rank #1 of 625; 100th percentile; extreme outlier), and 99291 (rank #2 of 274; 100th percentile; extreme outlier), characterizing the organization as a dominant Medicaid provider across multiple service lines in Michigan.

Claim counts for key codes demonstrate very high throughput: 99214 has 244.9K claims, 99213 has 206.4K claims, and 99285 has 174.2K claims, signaling substantial operational scale and persistent patient volume across ambulatory and emergency settings. These volumes imply staffing, bed capacity, and ancillary resource usage consistent with a large regional hospital system.

The NPI was enumerated on 2007-01-04 (~19 years ago), indicating a long-tenured presence in the market. Combined with the code-level dominance and Medicaid concentration, the provider appears to be an established, high-volume Medicaid-focused hospital where changes in state Medicaid policy or reimbursement would have outsized impact on revenue streams.

Medicaid: Complete Services Breakdown

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

671 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…	244,930	$70	$16.4M
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.	174,210	$80	$13.6M
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.	184,420	$60	$11.2M
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…	206,390	$50	$9.7M
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…	130,300	$60	$7.7M
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…	52,120	$100	$5.4M
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…	58,530	$90	$5M
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…	117,040	$40	$4.8M
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…	56,960	$80	$4.7M
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…	33,940	$120	$4.2M

Showing 1–10 of 671

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 — 22 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

671 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	127	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.	7	400	1,510	$190	$2.6M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	5	20	1,000	$340	$2.5M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	8	20	2,940	$340	$1.8M
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.	7	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.	22	450	1,540	$90	$1.3M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	7	20	3,450	$100	$916.9K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	23	50	150	$1,300	$889.5K
J0585	Injection, onabotulinumtoxina, 1 unit	35	40	260	$510	$684.9K
99468	The provider evaluates and manages the initial care of a newborn or infant less than 28 days of age in a neonatal critical care setting.	11	20	540	$770	$650.1K

Showing 1–10 of 671

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Oakwood Healthcare, Inc.	MI	General Acute Care Hospital	$0	$165.3M
William Beaumont Hospital	MI	General Acute Care Hospital	$0	$162.4M
William Beaumont Hospital	MI	General Acute Care Hospital	$0	$84.8M
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
Jeremy Wolfe	MI	Retina Specialist (Ophthalmology) Physician	$3.7M	$0

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
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
Alan Ruby	MI	Ophthalmology Physician	$2.4M	$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