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.

Indiana University Health Southern Indiana Physicians, LLC (NPI 1013953983)

Key Findings

Field	Value
Entity Type	Organization
Organization	Indiana University Health Southern Indiana Physicians, LLC
Address	2651 E Discovery Pkwy
City	Bloomington
State	IN
ZIP	47408
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	June 21, 2006

Payer Source	Total Paid
Medicaid	$69.5M
Medicare	$0

This provider reports no Medicare billing on file and is effectively a single-payer Medicaid operation by scale, with lifetime Medicaid revenue of $69.5M driving nearly all recorded public-payer activity. Analysts should treat Medicare activity as absent when modeling payer mix or network exposure for this entity.

Revenue concentration is high in a narrow set of outpatient E/M and emergency services: the precomputed top three Medicaid codes (99213, 99214, 99285) account for 60.9% of the provider's total Medicaid revenue. Individually those top codes are $16.6M (99213, 25.2%), $14.9M (99214, 22.6%), and $8.7M (99285, 13.1%), indicating the business is heavily dependent on routine office visits and higher-acuity ED encounters.

The CPT mix signals a hybrid ambulatory/acute practice footprint: very large volumes of office E/M codes (99213, 99214) alongside substantial emergency department codes (99285, 99284, 99283) and inpatient subsequent/initial care codes (99232, 99233, 99223). This pattern suggests integrated outpatient clinics with emergency and inpatient throughput rather than a narrow specialty clinic; the presence of preventive pediatrics codes (99391, 99392, 99393) and obstetric antepartum codes (59426, ) points to broad primary care and women's/children’s services.

Competitive standing within Indiana is strong and often extreme for core outpatient E/M: 99213 ranks #8 of 2377 providers (100th percentile; extreme outlier) and 99214 ranks #9 of 2122 providers (100th percentile; extreme outlier), indicating dominant statewide volume for routine established-patient visits. Emergency-service codes are also well above typical state volume—99285 ranks #9 of 325 (98th percentile; notably above typical) and 99284 ranks #18 of 382 (96th percentile; notably above typical)—showing the provider is a major ED participant in-state.

Several ancillary service lines show high relative volume, reinforcing a broad-service operation: vaccination administration (90471, 90472) and routine ECG interpretation (93010) are in the high percentiles (90471: rank #10 of 656, 99th percentile; 90472: rank #7 of 385, 98th percentile; 93010: rank #7 of 285, 98th percentile), suggesting substantial preventive care and cardiac screening throughput within their Medicaid population. These high-volume ancillary codes are consistent with a large primary-care and outpatient procedural platform.

There are also notable inpatient and procedure-level contributions: inpatient initial and subsequent care codes (99223, 99233, 99232) and procedures like echo (93306) and EGD with biopsy (43239) appear in the top code list at notable percentiles (most in the mid-90s), indicating the provider performs both hospital-based E/M and some diagnostic procedures rather than solely clinic-based visits. These entries support a mixed ambulatory–hospital service footprint.

Tenure and market persistence are long enough to matter for network planning: the NPI was enumerated on 2006-06-21 (~20 years ago), consistent with sustained Medicaid engagement reflected in large cumulative volumes (for example, 264.3K claims for 99213 and 188.5K claims for 99214). This longevity plus the extreme-volume signals suggests established referral patterns and patient panels in the region.

While many high-volume codes are extreme or notably above typical state volume, a minority of codes in the top 25 show more typical participation (for example, 99232 rank #28 of 527 at the 95th percentile and 43239 rank #17 of 132 at the 88th percentile), indicating pockets of routine-state-level activity alongside dominant outpatient and ED presence. For payers, the mix implies negotiating leverage and network impact driven primarily by outpatient E/M and emergency services where the provider is a statewide outlier.

Medicaid: Complete Services Breakdown

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

299 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…	264,270	$60	$16.6M
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…	188,450	$80	$14.9M
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.	78,720	$110	$8.7M
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.	70,040	$90	$6M
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.	60,630	$50	$3.2M
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…	21,300	$90	$1.9M
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…	29,980	$50	$1.5M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	17,600	$80	$1.4M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	16,420	$90	$1.4M
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…	31,460	$30	$1.1M

Showing 1–10 of 299

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

Indiana University Health Southern Indiana Physicians, LLC — 19 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

299 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	18	380	2,470	$100	$1.5M
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.	16	360	3,490	$110	$1.5M
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.	9	330	1,530	$100	$1.1M
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	10	340	$320	$899.7K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	82	580	710	$60	$582.9K
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…	9	2,120	870	$60	$450.6K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	458	690	1,070	$80	$422.3K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	39	140	430	$220	$413.2K
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…	8	2,380	920	$50	$376.8K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	163	220	1,380	$20	$360.2K

Showing 1–10 of 299

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Indiana University Health Care Associates, Inc	IN	General Practice Physician	$0	$125.4M
Indiana University Health Inc	IN	General Acute Care Hospital	$0	$111.5M
Indiana University Health Inc	IN	Children's Hospital	$0	$75.6M
University Medical Diagnostic Associates, Inc.	IN	Internal Medicine Physician	$0	$28.3M
Indiana University Health Ball Memorial Physicians, Inc.	IN	Family Medicine Physician	$0	$26M
Indiana Clinic-neurology, LLC	IN	Neurology Physician	$0	$15.8M
Indiana University Health, Inc	IN	Cardiovascular Disease Physician	$0	$4.5M
Gordon Hughes	IN	Rheumatology Physician	$2M	$0
Randall Reed	IN	Rheumatology Physician	$1.2M	$0
Heather Hosfield	IN	Adult Health Nurse Practitioner	$283.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Stone Belt Arc, Inc.	IN	Community/Behavioral Health Agency	$0	$38.6M
Indiana University Health Bloomington Inc	IN	General Acute Care Hospital	$0	$28.7M
The Growing Place, Inc	IN	Community/Behavioral Health Agency	$0	$8.4M
Julie Morton	IN	Intellectual & Developmental Disabilities Psychologist	$0	$3.6M
Joan Crawford	IN	Cardiovascular Disease Physician	$222.6K	$0
Todd Winkler	IN	Diagnostic Radiology Physician	$125.5K	$0
George Wolfer	IN	Diagnostic Radiology Physician	$31.1K	$0
Alan Sawchuk	IN	Vascular Surgery Physician	$29.9K	$0
Katherine Roza	IN	Hospice and Palliative Medicine (Internal Medicine) Physician	$22K	$1K
Raghunandan Motaganahalli	IN	Vascular Surgery Physician	$22K	$0

Indiana University Health Southern Indiana Physicians, LLC — Billing Profile & Reimbursement Data

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Indiana University Health Southern Indiana Physicians, LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References