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.

Norton - Kings Daughters Health Inc (NPI 1114955093)

Norton - Kings Daughters Health Inc is a family medicine physician provider located in Madison, Indiana. This profile covers 0 Medicare and 144 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	Norton - Kings Daughters Health Inc
Address	1373 E State Road 62
City	Madison
State	IN
ZIP	47250
Taxonomy	Family Medicine Physician
NPI Enumerated	June 29, 2006

Payer Source	Total Paid
Medicaid	$11.8M
Medicare	$0

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

144 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…	84,210	$40	$3.7M
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…	69,780	$50	$3.7M
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…	8,980	$70	$664.4K
59425	This service is considered a mini global code for the provider who provides only four to six of the patient’s antepartum visits. This can happen when the patient transfers out of the practice prior…	6,690	$70	$441.4K
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…	5,580	$80	$435.6K
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…	6,010	$70	$396.9K
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.	4,930	$50	$256.3K
99212	The 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,…	7,230	$30	$195.2K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	8,370	$20	$184.2K
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…	3,210	$50	$163.8K

Showing 1–10 of 144

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

Norton - Kings Daughters Health Inc — 4 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

144 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	126	130	3,770	$60	$617.7K
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.	24	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…	39	2,120	870	$60	$450.6K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	33	220	1,850	$30	$449.4K
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.	85	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…	33	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…	35	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…	24	280	880	$80	$267.2K
59425	This service is considered a mini global code for the provider who provides only four to six of the patient’s antepartum visits. This can happen when the patient transfers out of the practice prior…	39	190	1,680	$70	$264.2K
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…	44	290	770	$80	$250.8K

Showing 1–10 of 144

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Norton - Kings Daughters Health, Inc	IN	General Acute Care Hospital	$0	$8.9M
Ryan Malone	IN	Urology Physician	$784.5K	$0
Charles Goodwin	IN	Urology Physician	$596.2K	$0
John Eifler	IN	Urology Physician	$427.6K	$0
Dennis Smith	IN	Urology Physician	$408.6K	$0
David Rosenbaum	IN	Urology Physician	$401.3K	$0
Richard Medley	IN	Urology Physician	$400.9K	$0
Trevor Soergel	IN	Urology Physician	$380.8K	$0
Daniel Kmetz	IN	Urology Physician	$375.9K	$0
Emmanuel Nidhiry	KY	Medical Oncology Physician	$347.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lincare Inc.	IN	Durable Medical Equipment & Medical Supplies	$0	$3.6M
Eduardo Rivera	IN	MOHS-Micrographic Surgery Physician	$896.9K	$0
George Alcorn	IN	Internal Medicine Physician	$254.8K	$0
William Porter	IN	Radiation Oncology Physician	$227.5K	$0
Nathan Polley	IN	Orthopaedic Surgery Physician	$215K	$0
Steven Vorhies	IN	Family Medicine Physician	$148.4K	$0
Abdelmessiah Guirguis	IN	Internal Medicine Physician	$148.1K	$0
Mark Totten	IN	Family Medicine Physician	$133.7K	$0
Jefferson County Auditor	IN	Public Health or Welfare Agency	$63.7K	$65.5K
Thomas Eckert	IN	Gastroenterology Physician	$128.4K	$0

Norton - Kings Daughters Health Inc — 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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