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.

Henry Ford Health St. John Hospital (NPI 1912965088)

Henry Ford Health St. John Hospital is a internal medicine physician provider located in Detroit, Michigan. This profile covers 0 Medicare and 201 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	Henry Ford Health St. John Hospital
Address	22101 Moross Rd
City	Detroit
State	MI
ZIP	48236
Taxonomy	Internal Medicine Physician
NPI Enumerated	May 1, 2006

Payer Source	Total Paid
Medicaid	$41.8M
Medicare	$0

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

201 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	12,740	$330	$4.2M
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…	67,630	$50	$3.7M
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…	83,420	$40	$3.1M
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…	64,530	$40	$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.	7,440	$340	$2.5M
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	3,070	$750	$2.3M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	19,710	$100	$2M
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…	17,730	$110	$1.9M
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	21,420	$80	$1.6M
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	15,560	$100	$1.5M

Showing 1–10 of 201

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

Henry Ford Health St. John 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

201 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	108	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.	360	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.	6	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.	3	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.	459	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.	386	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.	4	20	3,450	$100	$916.9K
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.	3	20	540	$770	$650.1K
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	4	20	1,120	$100	$636.6K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	12	130	200	$750	$636K

Showing 1–10 of 201

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Henry Ford Health St. John Hospital	IL	General Acute Care Hospital	$0	$159.7M
Henry Ford Health Genesys Hospital	MI	General Acute Care Hospital	$0	$31.4M
Mercy Health System Corporation	WI	Multi-Specialty Clinic/Center	$0	$13.2M
Henry Ford Macomb Hospital Corporation	MI	Family Medicine Physician	$0	$9.2M
Adli Yakan	MI	Medical Oncology Physician	$1.7M	$0
Andrew Muskovitz	MI	Hematology & Oncology Physician	$1.2M	$0
Riad Dali Ahmad	MI	Infectious Disease Physician	$1.1M	$0
Srinivas Koneru	MI	Cardiovascular Disease Physician	$984.1K	$0
Lokesh Nagori	MI	Medical Oncology Physician	$719.1K	$0
Amir Kaki	MI	Interventional Cardiology Physician	$492.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Emergency Department Physicians, P.C.	MI	Emergency Medicine Physician	$0	$41.2M
Toothworks PC	MI	General Practice Dentistry	$0	$21.1M
Eastpointe Radiologists, P.C.	MI	Diagnostic Radiology Physician	$0	$9.3M
Brightstar Counseling PLLC	MI	Psychiatry Physician	$0	$6.3M
Amr Aref	MI	Radiation Oncology Physician	$342.3K	$0
Eric Krutel	MI	Internal Medicine Physician	$236.1K	$0
Paul Chuba	MI	Radiation Oncology Physician	$230.5K	$0
Youssef Rizk	MI	Vascular Surgery Physician	$217.2K	$0
Douglas Piernick	MI	MOHS-Micrographic Surgery Physician	$177.2K	$0
Joseph Arbanas	MI	Foot & Ankle Surgery Podiatrist	$175.4K	$0

Henry Ford Health St. John Hospital — Billing Profile & Reimbursement Data

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Henry Ford Health St. John Hospital — 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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