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.

Reid Hospital & Health Care Services, Inc (NPI 1063457380)

Key Findings

Field	Value
Entity Type	Organization
Organization	Reid Hospital & Health Care Services, Inc
Address	1100 Reid Pkwy
City	Richmond
State	IN
ZIP	47374
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 19, 2006

Payer Source	Total Paid
Medicaid	$66.8M
Medicare	$0

This provider is effectively single‑payer at the claims level: there is no Medicare billing on file while total Medicaid revenue is $66.8M. The absence of any Medicare activity suggests Medicaid reimbursement and utilization patterns will dominate financial and operational analysis for this entity.

Revenue is moderately concentrated in a few high‑earning Medicaid codes: the top three Medicaid codes (T2048, 45380, 99283) together account for 29.6% of the provider’s total Medicaid revenue. Those top codes individually are T2048 ($7.2M, 12.1%), 45380 ($5.4M, 9.0%), and 99283 ($5M, 8.4%), indicating a small group of services drive a large share of Medicaid dollars.

Emergency department care is a major service line based on claim counts and revenue: 99285 has 40.5K claims and $4.1M revenue, 99283 has 35.2K claims and $5M revenue, and 99284 has 28.7K claims and $4.1M revenue. High volumes across low, moderate, and high ED E/M codes show broad ED utilization for the Medicaid population and that emergency services are a central operational focus.

The provider is a strong in‑state performer in gastrointestinal endoscopy and upper endoscopy procedures. 45380 (colonoscopy with biopsy) is $5.4M and ranks #1 of 67 providers in-state (100th percentile, extreme outlier), while 43239 (EGD with biopsy) is $4.1M and ranks #2 of 132 (99th percentile, extreme outlier), signaling market leadership in GI procedural volume.

There is a meaningful behavioral health/residential component: T2048 (behavioral health long‑term care residential, per diem) accounts for $7.2M and 1.7K claims and ranks #6 of 13 providers in-state (58th percentile). This suggests the provider operates or bills for extended residential behavioral health services alongside its acute care activity, contributing a sizable single-code share (12.1%) of Medicaid revenue.

Service breadth extends beyond ED and GI into wound care and procedural specialties: 11042 (debridement) produces $4.7M and ranks #6 of 142 providers (96th percentile, notably above typical), while procedural pain/interventional and imaging codes (e.g., 64635, 74177, 93005) and lab testing (85025 with 105.9K claims) show high ancillary volumes. The mix indicates a full-service acute hospital footprint with substantial ancillary throughput for Medicaid patients.

Several codes show statistically extreme or notably above‑typical statewide standing, highlighting competitive concentration: 45380 and 43239 are labeled extreme outliers in state rankings, and 99281 is #1 of 51 providers (100th percentile, extreme outlier) for lowest‑level ED visits. These outlier positions imply the provider dominates certain service niches locally, which is important for network contracting or referral analysis.

NPI tenure is long‑standing: the provider has been enumerated since 2006-06-19 (~20 years ago), indicating an established market presence. That longevity, combined with concentrated Medicaid volume and leadership in select procedural codes, supports a profile of an established regional acute care hospital heavily oriented to Medicaid patients.

Medicaid: Complete Services Breakdown

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

242 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2048	Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem	1,740	$4,150	$7.2M
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	3,570	$1,500	$5.4M
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.	35,180	$140	$5M
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.	9,900	$480	$4.7M
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.	40,540	$100	$4.1M
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.	6,260	$660	$4.1M
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.	28,700	$140	$4.1M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	23,930	$140	$3.3M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	42,830	$60	$2.7M
43249	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum and dilates (widens) the esophagus with a balloon less than 30 mm in diameter.	1,340	$1,990	$2.7M

Showing 1–10 of 242

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

Reid Hospital & Health Care Services, Inc — 7 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

242 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2048	Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem	6	10	1,520	$730	$8.5M
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.	57	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.	36	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.	20	330	1,530	$100	$1.1M
96152	N/A	38	40	720	$200	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	8	100	2,210	$70	$926K
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…	8	130	3,770	$60	$617.7K
43249	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum and dilates (widens) the esophagus with a balloon less than 30 mm in diameter.	1	10	210	$1,060	$576.8K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	42	150	440	$100	$545.6K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	71	390	3,600	$50	$511.6K

Showing 1–10 of 242

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Henry Chong	OH	Cardiovascular Disease Physician	$398K	$0
Xinqiang Han	IN	Clinical Cardiac Electrophysiology Physician	$280.5K	$0
John Mcginty	IN	Cardiovascular Disease Physician	$206.9K	$0
Vuy Li	OH	Clinical Cardiac Electrophysiology Physician	$204.8K	$0
Jithendra Choudary	IN	Interventional Cardiology Physician	$167.2K	$0
Ahmed Amro	IN	Interventional Cardiology Physician	$166.7K	$0
Rubinder Dab	IN	Cardiovascular Disease Physician	$163.2K	$0
Sunil Gujrathi	NV	Diagnostic Radiology Physician	$86.1K	$63.8K
Stephen Hornak	IN	Cardiovascular Disease Physician	$143.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Reid Physician Associates, Inc.	IN	Internal Medicine Physician	$11.9K	$66.4M
Richmond Treatment Center, LLC	IN	Methadone Clinic	$377.2K	$16.8M
Mcsherr Inc.	IN	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$12.5M
Meridian Health Services Corp	IN	Substance Abuse Rehabilitation Facility	$0	$10.8M
Indiana Signal Health Group Skilled	IN	Home Health Agency	$0	$6.3M
City Of Richmond	IN	Ambulance	$932.7K	$4.3M
Richmond Oral & Maxillofacial Surgery,llc	IN	Oral and Maxillofacial Surgery (Dentist)	$0	$4.2M
Indiana Signal Health Group Skilled	IN	Home Health Agency	$0	$3.9M
Bryan Hainline	IN	Ophthalmology Physician	$3.7M	$0
Reid Health Ambulance, Inc.	IN	Ambulance	$964.1K	$2.7M

Reid Hospital & Health Care Services, Inc — 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