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NPI 1073680419 · South Bend, IN · Clinic/Center
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The South Bend Clinic LLC is a clinic/center provider located in South Bend, Indiana. This profile covers 19 Medicare and 242 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | The South Bend Clinic LLC |
| Address | 211 N Eddy St |
| City | South Bend |
| State | IN |
| ZIP | 46617 |
| Taxonomy | Clinic/Center |
| NPI Enumerated | November 29, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $19.3M |
| Medicare | $566.3K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
19 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 27130 | In this procedure, the provider surgically replaces the hip joint by prosthesis, or artificial hip joint. He replaces both the femoral and acetabular components with or without using an autograft or… | 20 | $7,050 | $162.1K |
| 66984 | The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to… | 150 | $840 | $124.7K |
| 47562 | The provider removes the gallbladder through a laparoscope, a tubular instrument with a light source and camera inserted through the abdominal wall, to treat gallbladder disease. | 20 | $1,940 | $38.7K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 90 | $420 | $37.3K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 90 | $410 | $36.4K |
| 49505 | The provider repairs an initial inguinal hernia on a child, five years of age or older. She pushes the hernia back to reduce it. | 30 | $1,210 | $36.1K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 50 | $420 | $22.6K |
| 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… | 50 | $380 | $17.6K |
| 64483 | This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral). | 50 | $330 | $17.5K |
| 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. | 70 | $230 | $17K |
Showing 1–10 of 19
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
19 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 66984 | 123 | 450 | 50 | $480 | $87.5K |
| 27130 | 123 | 220 | 30 | $1,280 | $40.9K |
| 45385 | 146 | 370 | 60 | $260 | $26.5K |
| 64483 | 108 | 190 | 60 | $180 | $17.8K |
| 58558 | 8 | 10 | 10 | $850 | $15.2K |
| 49505 | 2 | 20 | 20 | $650 | $11.1K |
| 62323 | 187 | 190 | 50 | $150 | $10.8K |
| G0105 | 19 | 220 | 30 | $250 | $10.2K |
| 43239 | 145 | 330 | 70 | $100 | $8.8K |
| 45380 | 145 | 340 | 40 | $140 | $8.6K |
Showing 1–10 of 19
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
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 |
|---|---|---|---|---|
| 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… | 110,300 | $60 | $6.9M |
| 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… | 95,170 | $50 | $5M |
| 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… | 9,420 | $100 | $913.6K |
| 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… | 7,920 | $90 | $696.9K |
| 99204 | The provider sees a new 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 provider… | 5,580 | $90 | $474.4K |
| 90471 | In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route. | 33,240 | $10 | $432.1K |
| 99393 | The provider performs an established well–patient visit for a child who is between the ages of 5 and 11. | 4,350 | $100 | $421.8K |
| 90472 | This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection. | 17,310 | $20 | $398K |
| 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… | 5,990 | $50 | $299.7K |
| 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… | 6,500 | $40 | $259.9K |
Showing 1–10 of 242
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
242 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 19 | 20 | 1,610 | $70 | $841.6K |
| 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… | 580 | 580 | 710 | $60 | $582.9K |
| 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. | 133 | 150 | 440 | $100 | $545.6K |
| 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… | 23 | 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… | 663 | 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. | 43 | 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… | 29 | 2,380 | 920 | $50 | $376.8K |
| 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… | 54 | 160 | 1,390 | $70 | $294.8K |
| 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… | 31 | 280 | 880 | $80 | $267.2K |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 108 | 140 | 830 | $50 | $265K |
Showing 1–10 of 242
Other providers in the same ZIP code as The South Bend Clinic LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| The Dental Center Of South Bend LLC | IN | Pediatric Dentistry | $0 | $15.9M |
| William Paul | IN | Oral and Maxillofacial Surgery (Dentist) | $0 | $5.4M |
| Divine Interventions Inc. | IN | In Home Supportive Care Agency | $0 | $2.6M |
| Ahmed Abdel-latief | IN | Cardiovascular Disease Physician | $248K | $0 |
| Brett Stephens | IN | Diagnostic Radiology Physician | $230.9K | $0 |
| Rita Schmid | IN | Internal Medicine Physician | $229.8K | $0 |
| Jonathan Mccrea | IN | Diagnostic Radiology Physician | $172K | $0 |
| Ron Clark | IN | Orthopaedic Surgery Physician | $117.7K | $52.2K |
| Rachelina Kvietkus | IN | Internal Medicine Physician | $155.2K | $0 |
| Vu Nguyen | IN | Diagnostic Radiology Physician | $140.6K | $0 |
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