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.

Spectrum Health Primary Care Partners (NPI 1821422007)

Spectrum Health Primary Care Partners is a urgent care clinic/center provider located in Grand Rapids, Michigan. This profile covers 0 Medicare and 77 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	Spectrum Health Primary Care Partners
Address	80 68th St Se
City	Grand Rapids
State	MI
ZIP	49548
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	August 24, 2013

Payer Source	Total Paid
Medicaid	$14.5M
Medicare	$0

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

77 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…	119,150	$50	$5.8M
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…	64,610	$60	$4M
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…	39,910	$60	$2.4M
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…	4,600	$90	$418.1K
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.	30,470	$10	$396.1K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	7,980	$30	$231.4K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	6,330	$40	$227.9K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	4,400	$40	$176K
12001	This CPT code is used for the simple repair of superficial wounds to the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including the hands and feet) that are 2.5 cm or less in…	1,780	$50	$90.5K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	9,890	$10	$79.1K

Showing 1–10 of 77

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

Spectrum Health Primary Care Partners — 10 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

77 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…	34	4,380	1,000	$70	$289.9K
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…	15	4,770	1,060	$50	$247.8K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	146	520	710	$20	$112K
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…	372	1,170	170	$90	$107.9K
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…	83	1,860	220	$90	$96.9K
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…	5	2,000	260	$60	$84.2K
82947	The lab analyst performs a test to measure the amount of glucose in a patient's blood using a method other than a reagent strip.	49	200	550	$20	$69.3K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	91	1,420	590	$20	$57.1K
90739	This code represents an adult–dosage vaccine product administered intramuscularly to protect against the liver disease hepatitis B. The product has a synthetic DNA called CpG added to improve the…	20	20	70	$110	$50.4K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	23	470	300	$30	$48.6K

Showing 1–10 of 77

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Spectrum Health Hospitals	MI	General Acute Care Hospital	$0	$243.2M
Spectrum Health Primary Care Partners	MI	Internal Medicine Physician	$0	$219.9M
Spectrum Health Hospitals	MI	Hospitalist Physician	$0	$25.2M
Spectrum Health Hospitals	MI	Air Ambulance	$413.8K	$1.1M
Bachar Hamad	IL	Gastroenterology Physician	$325.3K	$829.9K
Zhe Liang	MI	Rheumatology Physician	$1M	$14.6K
Jeremiah Johns	MI	Emergency Medicine Physician	$432.1K	$0
Fadi Delly	MI	Interventional Pain Medicine Physician	$431.8K	$0
Zakari Tata	MI	Family Medicine Physician	$398K	$0
Nawaf Murshed	MI	Neurology Physician	$397.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pine Rest Christian Mental Health Services	MI	Psychiatric Hospital	$0	$54.8M
Carelinc Medical Equipment & Supply Co LLC	MI	Durable Medical Equipment & Medical Supplies	$0	$20M
Hope Network West Michigan	MI	Rehabilitation Clinic/Center	$0	$7.2M
Shawn Mccomb	MI	Occupational Therapist	$44.1K	$0
Nagy Youssef	MI	Psychiatry Physician	$16.4K	$0

Spectrum Health Primary Care Partners — 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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