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.

Southwestern Michigan Neonatology, P.C. (NPI 1962522771)

Field	Value
Entity Type	Organization
Organization	Southwestern Michigan Neonatology, P.C.
Address	601 John St
City	Kalamazoo
State	MI
ZIP	49007
Taxonomy	Neonatal-Perinatal Medicine Physician
NPI Enumerated	March 29, 2007

Payer Source	Total Paid
Medicaid	$7.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

12 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.	7,220	$350	$2.5M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	21,690	$110	$2.3M
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	17,470	$100	$1.8M
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.	540	$780	$426.5K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	2,100	$60	$130.1K
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.	310	$330	$103.3K
99477	The provider performs the initial day of inpatient hospital evaluation and management for a neonate, age 28 days or younger, who requires intensive care and observation as well as frequent…	330	$300	$98.5K
99478	The provider directs the care of a recovering low birthweight infant, whose current weight is less than 1500 grams.	300	$110	$33.3K
94772	The provider uses a special machine to measure the infant patient’s breathing, heart rate, and oxygen levels during sleep over 12 to 24 hours.	490	$40	$18.7K
54150	The provider performs a circumcision, a surgical procedure that removes the foreskin of the penis, using a clamp or other device and regional anesthesia consisting of a dorsal penile or ring block.	200	$60	$12K

Showing 1–10 of 12

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

Southwestern Michigan Neonatology, P.C. — 0 of 12 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

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	11	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.	6	20	2,940	$340	$1.8M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	3	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.	10	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.	3	20	1,120	$100	$636.6K
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…	4,110	4,770	1,060	$50	$247.8K
99477	The provider performs the initial day of inpatient hospital evaluation and management for a neonate, age 28 days or younger, who requires intensive care and observation as well as frequent…	5	10	130	$280	$149.6K
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…	631	760	240	$100	$121.4K
99478	The provider directs the care of a recovering low birthweight infant, whose current weight is less than 1500 grams.	5	10	400	$110	$82.8K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	52	310	190	$60	$82.5K

Showing 1–10 of 12

Nearby Providers

Other providers in the same ZIP code as Southwestern Michigan Neonatology, P.C., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bronson Methodist Hospital	MI	General Acute Care Hospital	$0	$109.1M
Bronson Methodist Hospital	MI	Hospitalist Physician	$0	$64.8M
Family Health Center Inc	MI	Federally Qualified Health Center (FQHC)	$0	$35.8M
Interact Of Michigan, Inc	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$27.3M
Southwestern Michigan Emergency Services, PC	MI	Emergency Medical Services (Emergency Medicine) Physician	$0	$26.4M
Life Ems Of Kalamazoo, Inc	MI	Land Ambulance	$2.3M	$20.5M
Bethany House Recovery House	MI	Substance Abuse Rehabilitation Facility	$0	$15.5M
Forensic Fluids Laboratories Inc.	MI	Clinical Medical Laboratory	$928.6K	$10.2M
Genemarkers LLC	MI	Clinical Medical Laboratory	$17.7K	$1.1M
Mazen Mislmani	MI	Radiation Oncology Physician	$472.8K	$0

Southwestern Michigan Neonatology, P.C. — Billing Profile & Reimbursement Data

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Southwestern Michigan Neonatology, P.C. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References