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.

Major Hospital (NPI 1174555692)

Major Hospital is a general acute care hospital provider located in Shelbyville, Indiana. This profile covers 0 Medicare and 158 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	Major Hospital
Address	2451 Intelliplex Dr
City	Shelbyville
State	IN
ZIP	46176
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 7, 2006

Payer Source	Total Paid
Medicaid	$14.2M
Medicare	$0

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

158 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.	15,580	$110	$1.7M
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.	19,370	$90	$1.7M
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.	5,710	$290	$1.6M
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.	11,070	$100	$1.1M
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…	17,120	$50	$873.3K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	8,360	$90	$768.8K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	6,520	$110	$723.4K
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…	5,130	$130	$676.9K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	8,710	$50	$435.7K
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…	3,270	$80	$261.9K

Showing 1–10 of 158

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

Major Hospital — 1 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

158 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	81	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.	96	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.	68	330	1,530	$100	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	28	100	2,210	$70	$926K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	31	30	450	$1,270	$886.9K
G0330	Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an…	8	10	230	$1,990	$624K
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…	27	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.	108	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…	1,296	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…	75	220	1,850	$30	$449.4K

Showing 1–10 of 158

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Major Hospital	IN	Rural Health Clinic/Center	$0	$9.5M
Ramon Halum	IN	Vascular & Interventional Radiology Physician	$174.1K	$0
Usman Qadeer	IL	Neurology Physician	$105.5K	$14.2K
Thomas Webb	IN	Vascular Surgery Physician	$117.7K	$0
Kerri Kissell	IN	Endocrinology, Diabetes & Metabolism Physician	$117.6K	$0
Sajjad Hussain	IN	Vascular Surgery Physician	$100.7K	$0
Nicole Bowman	IN	Family Nurse Practitioner	$48.7K	$0
Charles Kiell	IN	Vascular Surgery Physician	$35.3K	$0
Carlos Vieira	IN	Surgery Physician	$27.7K	$0
Christa Lewis	IN	Obstetrics & Gynecology Physician	$25.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dasco-major Home Medical Equipment, LLC	IN	Oxygen Equipment & Supplies (DME)	$0	$8.4M
Major Hospital	IN	Rural Health Clinic/Center	$0	$7.7M
Major Multispecialty Associates	IN	Internal Medicine Physician	$0	$4.8M
Emhardt Pediatric Dentistry LLC	IN	Pediatric Dentistry	$0	$2.6M
City Of Shelbyville & Sewage Works Operating	IN	Ambulance	$354.8K	$2.1M
Jaime Ayon	IN	Hematology & Oncology Physician	$342K	$0
Zachary Toppe	IN	Optometrist	$106.4K	$310
Robert Shellman	IN	Pulmonary Disease Physician	$68.7K	$0
Basil Holoyda	IN	Neurology Physician	$66.9K	$0
Jonathan Bielefeld	IN	Diagnostic Radiology Physician	$65.6K	$0

Major Hospital — Billing Profile & Reimbursement Data

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Major Hospital — 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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