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.

Goshen Health System Inc (NPI 1194772293)

Goshen Health System Inc is a family medicine physician provider located in Goshen, Indiana. This profile covers 0 Medicare and 153 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	Goshen Health System Inc
Address	1701 S Main St
City	Goshen
State	IN
ZIP	46526
Taxonomy	Family Medicine Physician
NPI Enumerated	May 27, 2006

Payer Source	Total Paid
Medicaid	$12M
Medicare	$0

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

153 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…	84,040	$60	$5.2M
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…	75,880	$50	$3.6M
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…	7,280	$70	$531.7K
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…	4,650	$80	$357.7K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	6,130	$40	$232.8K
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…	4,240	$50	$220.5K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	9,880	$20	$197.7K
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…	2,330	$80	$193.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	15,790	$10	$173.7K
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…	2,750	$50	$140K

Showing 1–10 of 153

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

Goshen Health System Inc — 2 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

153 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0585	Injection, onabotulinumtoxina, 1 unit	23	30	280	$820	$992.2K
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…	28	2,120	870	$60	$450.6K
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…	38	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…	79	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…	35	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…	51	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…	56	290	770	$80	$250.8K
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.	63	130	360	$280	$234.4K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	53	60	150	$480	$221.3K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	313	530	740	$30	$210K

Showing 1–10 of 153

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bronson Methodist Hospital	MI	General Acute Care Hospital	$0	$109.1M
Bronson Methodist Hospital	MI	Hospitalist Physician	$0	$64.8M
Lakeland Medical Practices	MI	Internal Medicine Physician	$0	$20.9M
Bronson Battle Creek Hospital	MI	Internal Medicine Physician	$0	$9.8M
Beacon Medical Group, Inc.	IN	Critical Care Medicine (Internal Medicine) Physician	$0	$4.6M
Jody Neer	IN	Neurology Physician	$741.1K	$0
Mujahed Abbas	MI	Critical Care Medicine (Internal Medicine) Physician	$649.8K	$0
Wassim Bazzi	MI	Urology Physician	$370.6K	$0
John Peck	OH	Urology Physician	$355.7K	$0
Younho Chung	MI	Internal Medicine Physician	$228.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Goshen Hospital Association Inc	IN	General Acute Care Hospital	$0	$10.9M
Mosaic	IN	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$7.4M
Parkmor Drug Inc.	IN	Durable Medical Equipment & Medical Supplies	$0	$7.2M
Dental Center Of Goshen PLLC	IN	Dentist	$0	$3.2M
Hewitt Dental Group Of Goshen, Ltd.	IN	General Practice Dentistry	$0	$2.7M
City Of Goshen	IN	Ambulance	$293.1K	$1.1M
Megan Heil	IN	Ophthalmology Physician	$794.6K	$0
Dicky Bhagat	IN	Internal Medicine Physician	$310K	$0
Goshen Health Surgery Center, LLC	IN	Ambulatory Surgical Clinic/Center	$294.2K	$8.3K
Paul Buller	IN	Family Medicine Physician	$196.5K	$41.3K

Goshen Health System 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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