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.

Advantage Health Saint Mary's Medical Group (NPI 1952340911)

Field	Value
Entity Type	Organization
Organization	Advantage Health Saint Mary's Medical Group
Address	200 Jefferson Se
City	Grand Rapids
State	MI
ZIP	49503
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	June 5, 2006

Payer Source	Total Paid
Medicaid	$21.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

217 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…	80,620	$50	$4.4M
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…	62,450	$40	$2.5M
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…	58,820	$40	$2.1M
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…	14,400	$100	$1.4M
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…	22,710	$60	$1.2M
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…	12,070	$70	$881.4K
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…	10,830	$80	$845.1K
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…	6,610	$120	$760.5K
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…	7,700	$70	$516.1K
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	680	$750	$511.4K

Showing 1–10 of 217

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

Advantage Health Saint Mary's Medical Group — 13 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

217 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	371	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.	302	480	1,350	$110	$1.7M
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	288	290	5,550	$70	$1.4M
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.	211	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.	14	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.	16	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.	14	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…	66	130	200	$750	$636K
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	49	160	260	$820	$506.6K
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	270	510	$140	$395.2K

Showing 1–10 of 217

Related Providers

Other providers that share a Tax Identification Number (TIN) with Advantage Health Saint Mary's Medical Group, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Mary's Health Services	MI	General Acute Care Hospital	$0	$92M
Bronson Methodist Hospital	MI	Hospitalist Physician	$0	$64.8M
Jane Pauley Community Health Center Inc	IN	Federally Qualified Health Center (FQHC)	$0	$30.1M
Advantage Health/saint Mary's Medical Group	MI	Multi-Specialty Clinic/Center	$0	$17M
Bronson Battle Creek Hospital	MI	Internal Medicine Physician	$0	$9.8M
Mercy Health Partners - Physician Specialist	MI	Internal Medicine Physician	$0	$5.3M
Maryann Shango	MI	Hematology & Oncology Physician	$443.1K	$0
Eyad Abu-isa	MI	Radiation Oncology Physician	$409K	$0
Michael Bishop	MI	Radiation Oncology Physician	$324.3K	$0
Richard Martin	MI	Rheumatology Physician	$284.5K	$0

Nearby Providers

Other providers in the same ZIP code as Advantage Health Saint Mary's Medical Group, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Spectrum Health Hospitals	MI	General Acute Care Hospital	$0	$243.2M
Kent County Cmh Authority	MI	Community/Behavioral Health Agency	$0	$97.6M
Cancer & Hematology Centers Of Western Mi, P.C.	MI	Specialist	$0	$59.5M
Cherry Street Services, Inc.	MI	Federally Qualified Health Center (FQHC)	$0	$50.9M
Ecs Western Michigan PC	MI	Emergency Medicine Physician	$0	$50.6M
Neo Natal Associates Plc	MI	Neonatal-Perinatal Medicine Physician	$0	$27.7M
Spectrum Health Hospitals	MI	Hospitalist Physician	$0	$25.2M
Life Ems Inc	MI	Land Ambulance	$3.1M	$22M
Cherry Street Services, Inc.	MI	Federally Qualified Health Center (FQHC)	$0	$24.6M
Paramed Inc	MI	Ambulance	$1.8M	$21.1M

Advantage Health Saint Mary's Medical Group — Billing Profile & Reimbursement Data

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Advantage Health Saint Mary's Medical Group — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References