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    OpenPayerNPI Medicare & MedicaidCleanslate Medical Group Of Indiana LLC
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    Cleanslate Medical Group Of Indiana LLC — Billing Profile & Reimbursement Data

    NPI 1023464294 · Alexandria, IN · Addiction Medicine (Internal Medicine) Physician

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    Cleanslate Medical Group Of Indiana LLC is a addiction medicine (internal medicine) physician provider located in Alexandria, Indiana. This profile covers 0 Medicare and 29 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationCleanslate Medical Group Of Indiana LLC
    Address101 N Harrison St
    CityAlexandria
    StateIN
    ZIP46001
    TaxonomyAddiction Medicine (Internal Medicine) Physician
    NPI EnumeratedMay 6, 2016

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$79.2M
    Medicare$0

    Key Findings

    This provider is effectively single‑payer: there is no Medicare billing on file and total Medicaid revenue is $79.2M, so Medicaid accounts for the entire recorded payer volume for this NPI. Analysts should treat this profile as a Medicaid-centric operation when assessing network exposure and reimbursement risk.

    Revenue is extremely concentrated in a small set of codes: the top three Medicaid codes (99214, 80307, 99213) account for 91.3% of the provider’s total Medicaid revenue. Individually those codes generated $36.3M (45.9%), $21.8M (27.6%), and $14.2M (17.9%) of Medicaid revenue respectively, indicating revenue dependency on high-volume office visits and drug testing.

    The code mix strongly indicates an addiction‑medicine outpatient model with integrated toxicology: high volumes of established patient evaluation/management visits (99214 and 99213) combined with large-scale presumptive and definitive drug testing (80307 and G0480). This pattern is consistent with frequent follow‑up visit workflows tied to routine drug screening and confirmation testing rather than episodic specialty procedures.

    Competitive standing in-state is dominant for several key services: 80307 ranks #1 of 190 providers in-state (100th percentile; extreme outlier) and G0480 ranks #1 of 88 providers in-state (100th percentile; extreme outlier), while 99214 ranks #3 of 2122 providers (100th percentile; extreme outlier) and 99213 ranks #7 of 2377 providers (100th percentile; extreme outlier). Those ranks signal the provider is an outlier in scale for both visit-level E/M services and drug testing versus typical state peers.

    Beyond the three revenue drivers, the practice also bills for ancillary behavioral‑health and visit bundle services at measurable but much smaller scale: T1015 generated $1.1M (1.4% of Medicaid revenue) and psychotherapy code 90832 generated $601K (0.8% of Medicaid revenue), while telehealth originating site fees (Q3014) contributed $189.1K (0.2%). These secondary lines suggest the organization offers clinic encounters and behavioral‑health services alongside its core testing and follow‑up visits.

    The laboratory/testing footprint is substantial and operationally material: 80307 shows 428.3K claims and G0480 shows 87.6K claims, and the pregnancy test 81025 appears in high volume (33K claims, $132K revenue) with ranks that are above typical state volume for those codes. High claim volumes for both presumptive and definitive testing imply centralized specimen processing, supply and reporting workflows that are a major part of the business model.

    This entity has an established enrollment history (NPI enumerated 2016-05-06, ~10 years ago) and demonstrates very large claim volumes (for example 497.5K claims for 99214 and 428.3K claims for 80307), indicating sustained operational scale in Medicaid over multiple years. Tenure plus the outlier ranks supports the interpretation of a mature, high‑volume outpatient addiction‑medicine practice focused on repeat visits and routine toxicology screening.

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    29 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99214The 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…497,520$70$36.3M
    80307The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.428,310$50$21.8M
    99213The 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…272,530$50$14.2M
    G0480Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…87,560$50$4.2M
    T1015Clinic visit/encounter, all-inclusive9,210$120$1.1M
    90832In 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…12,790$50$601K
    Q3014Telehealth originating site facility fee12,610$20$189.1K
    90791In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.1,480$100$146.7K
    99212The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…6,370$20$146.5K
    81025The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.33,010$1$132K

    Showing 1–10 of 29

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Indiana median

    29 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    T1016Case management, each 15 minutes29508,980$30$3.8M
    90834In 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…277580710$60$582.9K
    99214The 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…32,120870$60$450.6K
    90837In 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…6746901,070$80$422.3K
    99213The 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…72,380920$50$376.8K
    90853Group 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…2102201,380$20$360.2K
    T1015Clinic visit/encounter, all-inclusive1554005,220$20$360.2K
    80307The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.1190800$40$344.7K
    90832In 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…39430630$40$243.8K
    G0480Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…190390$40$171.1K

    Showing 1–10 of 29

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Cleanslate Medical Group Of Indiana LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Cleanslate Medical Group Of Pennsylvania LLCPAMulti-Specialty Clinic/Center$0$18.6M
    Malee BlueINFamily Nurse Practitioner$108.5K$0
    John BuonocoreINPain Medicine (Anesthesiology) Physician$74K$2.5K
    Song BaekINFamily Nurse Practitioner$47.1K$0
    Ashley WolfgangINPhysician Assistant$25.8K$0
    Krista BrandleINClinical Social Worker$1.6K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Indiana Providers
    6 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Indiana Distribution
    Cleanslate Medical Group Of Indiana LLC — 9 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Indiana