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 Indiana for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Indiana 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. Indiana (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.

Privia Medical Group Indiana, LLC (NPI 1013912286)

Privia Medical Group Indiana, LLC is a multi-specialty clinic/center provider located in Elkhart, Indiana. This profile covers 0 Medicare and 110 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	Privia Medical Group Indiana, LLC
Address	303 S Nappanee St
City	Elkhart
State	IN
ZIP	46514
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	June 15, 2005

Payer Source	Total Paid
Medicaid	$2.6M
Medicare	$0

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

110 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…	41,040	$40	$1.6M
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…	12,940	$30	$401.1K
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…	1,260	$50	$59.2K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	1,570	$40	$55K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	25,820	$1	$51.6K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	13,180	$1	$39.5K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	9,110	$1	$36.4K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	3,780	$10	$30.3K
84481	The lab analyst performs a test to measure free T3 in patient blood.	2,950	$10	$29.5K
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…	430	$50	$21.9K

Showing 1–10 of 110

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Indiana providers billing the same CPT/HCPCS codes.

Claims Volume vs. Indiana Distribution

Privia Medical Group Indiana, LLC — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

110 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0585	Injection, onabotulinumtoxina, 1 unit	21	30	280	$820	$992.2K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	130	130	3,770	$60	$617.7K
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…	68	2,120	870	$60	$450.6K
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…	292	2,380	920	$50	$376.8K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	22	70	750	$120	$276.6K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	102	130	360	$280	$234.4K
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…	504	530	740	$30	$210K
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…	263	270	470	$30	$171.9K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	50	80	340	$70	$139.8K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	622	690	360	$70	$110.9K

Showing 1–10 of 110

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gordon Hughes	IN	Rheumatology Physician	$2M	$0
James Jin	IN	Medical Oncology Physician	$1.2M	$0
Ahsanul Haque	IN	Hematology & Oncology Physician	$831K	$0
Pavan Ahuja	IN	Internal Medicine Physician	$501.5K	$0
William Buckley	IN	Internal Medicine Physician	$381.3K	$0
Wai Lee	IN	Cardiovascular Disease Physician	$381.3K	$0
Kamran Siddiqui	IN	Internal Medicine Physician	$326.8K	$0
Carolyn Hudson	IN	Internal Medicine Physician	$314.7K	$0
Minnie Enriquez	IN	Internal Medicine Physician	$270.4K	$0
Sam Borrelli	IN	Family Medicine Physician	$191K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Elkhart General Hospital, Inc.	IN	General Acute Care Hospital	$0	$25.6M
Elite Emergency Physicians Inc	IN	Emergency Medicine Physician	$0	$21.5M
Beacon Medical Group, Inc.	IN	Critical Care Medicine (Internal Medicine) Physician	$0	$4.6M
Orthopedic And Sports Medicine Center Of Northern Indiana, Inc	IN	Orthopaedic Surgery Physician	$0	$3.1M
Asc Surgical Ventures, LLC	IN	Ambulatory Surgical Clinic/Center	$1.5M	$17.2K
Whitney Boling	IN	Ophthalmology Physician	$724K	$0
Roger Moore	IN	Dermatology Physician	$693.9K	$0
Edith Cullen	IN	Sports Medicine (Family Medicine) Physician	$676.7K	$0
Northern Indiana Ambulatory Surgery Center	IN	Ambulatory Surgical Clinic/Center	$525.2K	$7K
Elkhart Day Surgery, LLC	IN	Ambulatory Surgical Clinic/Center	$516K	$3.6K

Privia Medical Group Indiana, LLC — Billing Profile & Reimbursement Data

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Privia Medical Group Indiana, LLC — 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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