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.

Arnett Clinic, LLC (NPI 1164490843)

Key Findings

Field	Value
Entity Type	Organization
Organization	Arnett Clinic, LLC
Address	5165 Mccarty Ln
City	Lafayette
State	IN
ZIP	47905
Taxonomy	Internal Medicine Physician
NPI Enumerated	March 9, 2006

Payer Source	Total Paid
Medicaid	$35.1M
Medicare	$0

ARNETT CLINIC, LLC is effectively a single-payer Medicaid billing entity: no Medicare billing is on file while total Medicaid revenue is reported as $35.1M, so Medicaid dominates the provider’s publicly observed payer mix and financial footprint. This concentration means analyses of utilization and contracting should focus on Medicaid reimbursement and program rules rather than Medicare dynamics.

Revenue is highly concentrated in a small set of outpatient evaluation-and-management and imaging codes: the top 3 Medicaid codes by revenue account for 62.4% of total Medicaid revenue, driven by 99214 ($11.3M, 37.1%), 99213 ($6M, 19.8%) and 74177 ($1.7M, 5.4%). This concentration indicates the practice’s Medicaid finances depend disproportionately on a few high-volume services.

Operationally, the code mix points to a large, high-throughput ambulatory primary care operation: 99214 shows 154.8K claims and 99213 shows 100.6K claims, reflecting very large volume of established-patient office visits and chronic-care management typical of an internal medicine–led clinic. The high counts for new-patient codes 99203 (16.2K) and 99204 (9.8K) further suggest ongoing patient intake and significant outpatient visit throughput.

ARNETT also shows substantial diagnostic imaging and hospital-based activity alongside ambulatory care. Imaging codes such as 74177 (20.7K claims) and chest radiography codes 71045 (41.5K claims) and 71046 (31.4K claims) indicate high imaging throughput, while inpatient/observation E/M codes 99233 (25.2K claims), 99223 (10K claims) and 99232 (9.2K claims) signal involvement in inpatient or observation services or close affiliation with hospital-based care.

Competitive standing within Indiana is strong for core E/M codes: 99214 ranks #11 of 2122 providers in-state (100th percentile; "extreme outlier, far above typical state volume for this code") and 99213 ranks #26 of 2377 (99th percentile; "notably above typical state volume"). Those ranks characterize ARNETT as a major statewide volume leader for established-patient E/M services, which has implications for market share and contracting leverage in Medicaid networks.

Specialty and procedure lines beyond primary care are also material: the practice reports $917.2K from J0585 (onabotulinumtoxina), where it ranks #3 of 26 providers in-state (92th percentile), and notable antepartum/delivery-related revenue including 59426 (10.4K claims, $966.5K) and 01967 (2.2K claims, $264.9K, rank #3 of 43, 95th percentile). These entries indicate ARNETT provides or bills for procedural and maternity-related services in addition to primary care, broadening its service-line footprint.

ARNETT’s long tenure—NPI enumerated 2006-03-09 (~20 years ago)—combined with $35.1M in Medicaid revenue and very high claim volumes for select codes implies an established regional operation with sizable patient panels and operational capacity. That longevity and scale increase the likelihood that changes in Medicaid policy or code-level reimbursement for the dominant codes would materially affect the provider’s revenues.

Because a small set of codes (top 3 = 62.4% of Medicaid revenue) and extremely high claim volumes (e.g., 154.8K claims for 99214 and 100.6K claims for 99213) drive most revenue, the provider has concentrated operational and reimbursement risk. Analysts should monitor utilization trends and state Medicaid policy changes for 99214/99213 and 74177, as shifts in coverage or payment for those codes would have outsized financial impact; similarly, the provider’s high in-state ranks for these codes make it a focal target for utilization-management and network-negotiation strategies.

Medicaid: Complete Services Breakdown

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

266 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…	154,830	$70	$11.3M
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…	100,600	$60	$6M
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.	20,740	$80	$1.7M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	25,220	$50	$1.2M
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…	16,230	$70	$1.1M
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…	9,780	$110	$1.1M
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…	10,390	$90	$966.5K
J0585	Injection, onabotulinumtoxina, 1 unit	2,750	$330	$917.2K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	9,950	$90	$905.5K
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…	8,020	$80	$649.9K

Showing 1–10 of 266

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

Arnett Clinic, LLC — 9 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

266 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0585	Injection, onabotulinumtoxina, 1 unit	3	30	280	$820	$992.2K
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	6	10	340	$320	$899.7K
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…	117	130	3,770	$60	$617.7K
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…	357	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.	10	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…	370	390	3,600	$50	$511.6K
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…	11	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…	15	220	1,850	$30	$449.4K
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…	538	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.	101	140	430	$220	$413.2K

Showing 1–10 of 266

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Arnett Clinic, LLC	IN	Clinical Medical Laboratory	$330.3K	$1.1M
Ghada Kassab	CA	Dermatology Physician	$1.1M	$0
Matthew Orton	IN	Radiation Oncology Physician	$782.4K	$0
Neil Estabrook	IN	Radiation Oncology Physician	$769.3K	$0
Saif Choudhury	IN	Internal Medicine Physician	$492.3K	$0
Jason Passafiume	IN	Diagnostic Radiology Physician	$374.2K	$0
Luke Gerges	IN	Diagnostic Radiology Physician	$268.9K	$0
Dona Gray	IN	Endocrinology, Diabetes & Metabolism Physician	$259.3K	$0
Cheng Du	IN	Neurology Physician	$243.6K	$0
Mark Arvin	IN	Diagnostic Radiology Physician	$237.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Franciscan Health Lafayette	IN	General Acute Care Hospital	$0	$38.6M
Piece By Piece Aba Therapy LLC	IN	Behavior Technician	$0	$33M
Indiana University Health Arnett Inc	IN	General Acute Care Hospital	$0	$26M
Limestone Health, LLC	IN	Methadone Clinic	$117.1K	$11.2M
Sycamore Springs, LLC	IN	Psychiatric Hospital	$0	$7M
Lafayette Pain Care, P.C.	IN	Pain Medicine Physician	$0	$6M
Awl Dentistry PC	IN	General Practice Dentistry	$0	$6M
East 53rd Street Dental-3, PC	IN	General Practice Dentistry	$0	$5.2M
Emergency Care Associates Of Indiana, LLC	IN	Emergency Medicine Physician	$0	$4.5M
Evans Eye Care Inc	IN	Optometrist	$0	$4.2M

Arnett Clinic, LLC — Billing Profile & Reimbursement Data

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Arnett Clinic, LLC — 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