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 Inc (NPI 1114958584)

Field	Value
Entity Type	Organization
Organization	Indiana University Health Inc
Address	705 Riley Hospital Dr
City	Indianapolis
State	IN
ZIP	46202
Taxonomy	Children's Hospital
NPI Enumerated	July 5, 2006

Payer Source	Total Paid
Medicaid	$75.6M
Medicare	$0

Key Findings

INDIANA UNIVERSITY HEALTH INC reports no Medicare billing on file and $75.6M in lifetime Medicaid revenue, making its reported activity effectively single‑payer Medicaid in the available dataset; there is no Medicare revenue to compare against Medicaid scale or mix. This profile should be treated as Medicaid‑dominant for payer analyses and contract benchmarking.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes account for 60.8% of the provider’s total Medicaid revenue. Those top codes are 99283 ($27.2M, 38.8% of Medicaid revenue), 99284 ($9.4M, 13.5%), and 31622 ($5.9M, 8.5%), indicating dependence on a small set of services for the majority of payments.

The service mix implied by the top codes points to a high-volume emergency/acute care operation with specialized procedural capacity: 99283 and 99284 are emergency department E/M visits at low and moderate medical decision‑making levels (135.8K and 46.7K claims respectively), while 31622 is diagnostic bronchoscopy (1.9K claims) indicative of pediatric pulmonary diagnostic capability. This combination suggests the provider operates a busy ED with on‑site procedural and diagnostic resources.

99283 is an extreme volume outlier in-state, ranking #5 of 364 providers and noted as a 99th percentile/"extreme outlier" for that code; this underscores that INDIANA UNIVERSITY HEALTH INC is a dominant provider of lower‑complexity ED visits in Indiana. By contrast, 99284 ranks #28 of 382 (93th percentile; described as typical/unremarkable volume), indicating strong but less unusually concentrated moderate‑complexity ED activity.

Procedural/high‑acuity services show mixed standing: 31622 (bronchoscopy) ranks #2 of 4 providers in-state (67th percentile; typical), while 42820 (tonsillectomy/adenoidectomy in <12) generates $4.9M and ranks #2 of 28 (96th percentile; notably above typical). These rankings indicate INDIANA UNIVERSITY HEALTH INC is a notable regional center for certain pediatric surgical and pulmonary procedures even where statewide provider counts are small.

Operational and contracting implications follow from the code mix and claim volumes: 135.8K claims for 99283 and 46.7K claims for 99284 create scale leverage in ED services, while high average paid/claim values for procedures like 31622 ($3101) and 42820 ($2019) concentrate reimbursement into discrete procedural lines. Because 60.8% of Medicaid revenue is tied to the top three codes, payer negotiations or policy changes affecting ED evaluation/management or bronchoscopy reimbursement could materially affect revenue.

Several ancillary service codes reinforce the pediatric acute‑care profile: large volumes of imaging and diagnostic codes such as 71046 (12.2K claims, $2M revenue), 76770 (10.4K claims, $2M revenue), and 94375 (10.4K claims, $1.1M revenue) indicate substantial on‑site radiology and pulmonary function testing supporting the ED and procedural workload. These complementary services suggest integrated outpatient and inpatient diagnostic capacity aligned with a tertiary pediatric hospital.

The provider’s NPI was enumerated on 2006-07-05 (~20 years ago), indicating a long tenure in the market; combined with the high claim volumes and top‑percentile ranks for several codes, this tenure supports the interpretation of an established, high‑volume pediatric hospital operation rather than a new entrant or minor clinic.

Medicaid: Complete Services Breakdown

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

228 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	135,800	$200	$27.2M
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.	46,740	$200	$9.4M
31622	In this procedure, the provider performs diagnostic rigid or flexible bronchoscopy, a test to view airways and diagnose lung disease. He may or may not use fluoroscopic guidance to perform this test.…	1,910	$3,100	$5.9M
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	2,420	$2,020	$4.9M
99218	N/A	5,020	$580	$2.9M
76770	A retroperitoneal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e.Kidneys, urinary bladder, and aorta). This particular code is used when the ultrasound is…	10,380	$190	$2M
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	12,220	$160	$2M
64642	The provider injects a chemical, such as Botox®, into one to four muscles of one extremity to relieve a patient's pain and spasms.	1,910	$940	$1.8M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	13,490	$120	$1.6M
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	2,370	$680	$1.6M

Showing 1–10 of 228

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 Inc — 6 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

228 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
31622	In this procedure, the provider performs diagnostic rigid or flexible bronchoscopy, a test to view airways and diagnose lung disease. He may or may not use fluoroscopic guidance to perform this test.…	2	10	970	$1,160	$1.6M
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	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.	5	360	3,490	$110	$1.5M
J0475	Injection, baclofen, 10 mg	2	10	2,820	$510	$1.4M
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.	88	330	1,530	$100	$1.1M
J0585	Injection, onabotulinumtoxina, 1 unit	20	30	280	$820	$992.2K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	19	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…	78	130	3,770	$60	$617.7K
64642	The provider injects a chemical, such as Botox®, into one to four muscles of one extremity to relieve a patient's pain and spasms.	2	10	1,080	$470	$495.6K
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…	1,917	2,120	870	$60	$450.6K

Showing 1–10 of 228

Related Providers

Other providers that share a Tax Identification Number (TIN) with Indiana University Health Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Indiana University Health, Inc	IN	Home Infusion Therapy Pharmacy	$0	$178.1M
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 Southern Indiana Physicians, LLC	IN	Multi-Specialty Clinic/Center	$0	$69.5M
University Medical Diagnostic Associates, Inc.	IN	Internal Medicine Physician	$0	$28.3M
Indiana University Health Arnett Inc	IN	General Acute Care Hospital	$0	$26M
Indiana University Health West Hospital Inc	IN	General Acute Care Hospital	$0	$16M
Indiana Clinic-neurology, LLC	IN	Neurology Physician	$0	$15.8M
Indiana University Health North Hospital Inc	IN	General Acute Care Hospital	$0	$6.9M
Indiana University Health, Inc	IN	Cardiovascular Disease Physician	$0	$4.5M

Nearby Providers

Other providers in the same ZIP code as Indiana University Health Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Health And Hospital Corporation Of Marion County	IN	General Acute Care Hospital	$0	$231.6M
University Pediatric Associates, Inc.	IN	Pediatrics Physician	$0	$98.3M
University Family Physicians, Inc.	IN	Family Medicine Physician	$0	$65.3M
Indiana University Radiology Associates, Inc.	IN	Diagnostic Radiology Physician	$0	$47.8M
The Health And Hospital Corporation Of Marion County	IN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$46.9M
Icem-wishard LLC	IN	Emergency Medicine Physician	$0	$34.6M
The Health And Hospital Corporation Of Marion County	IN	Nurse Practitioner	$0	$30.1M
Eskenazi Medical Group Inc	IN	Adult Medicine Physician	$0	$18.9M
The Health And Hospital Corporation Of Marion County	IN	Federally Qualified Health Center (FQHC)	$0	$16.6M
University Obstetricians-gynecologists,inc	IN	Obstetrics & Gynecology Physician	$0	$14.3M

Indiana University Health 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