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.

St. Vincent Medical Group, Inc. (NPI 1225301740)

St. Vincent Medical Group, Inc. is a rural health clinic/center provider located in Winchester, Indiana. This profile covers 0 Medicare and 61 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	St. Vincent Medical Group, Inc.
Address	409 E Greenville Ave
City	Winchester
State	IN
ZIP	47394
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	February 14, 2012

Payer Source	Total Paid
Medicaid	$3M
Medicare	$0

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

61 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…	24,020	$60	$1.4M
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…	19,330	$40	$831.1K
T1015	Clinic visit/encounter, all-inclusive	31,480	$10	$314.8K
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…	4,770	$40	$186.2K
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…	1,600	$40	$68.8K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	3,840	$10	$26.9K
59430	For this service, the provider or nonphysician healthcare professional provides care to the patient in the outpatient setting following the delivery. Routine postpartum care can involve one or more…	180	$120	$21K
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…	280	$70	$19.7K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	6,830	$1	$13.7K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	870	$10	$11.3K

Showing 1–10 of 61

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

St. Vincent Medical Group, Inc. — 0 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

61 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	122	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…	207	2,380	920	$50	$376.8K
T1015	Clinic visit/encounter, all-inclusive	59	400	5,220	$20	$360.2K
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…	75	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…	202	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…	48	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…	231	290	770	$80	$250.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	234	320	310	$80	$133.9K
59430	For this service, the provider or nonphysician healthcare professional provides care to the patient in the outpatient setting following the delivery. Routine postpartum care can involve one or more…	47	100	170	$100	$77.7K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	201	390	990	$20	$74.5K

Showing 1–10 of 61

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Vincent Medical Group, Inc.	IN	Orthopaedic Surgery Physician	$0	$70.4M
St Mary's Medical Group, LLC	IN	Family Medicine Physician	$0	$31.1M
St. Vincent Medical Group, Inc.	IN	Rural Health Clinic/Center	$0	$10.2M
Douglas Debenham	IN	Radiation Oncology Physician	$1.8M	$0
Michael Watterson	NC	Rheumatology Physician	$669.3K	$2.6K
Sheryar Sarwar	IN	Family Medicine Physician	$631.4K	$0
Matthew Brown	TN	Diagnostic Radiology Physician	$580.8K	$0
Bruce Waller	IN	Cardiovascular Disease Physician	$540.1K	$0
Vijay Bhasin	IN	Nephrology Physician	$539.9K	$0
Vineet Venugopal	MD	Cardiovascular Disease Physician	$465.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Vincent Randolph Hospital, Inc.	IN	Critical Access Hospital	$0	$4.1M
David Davis	IN	Chiropractor	$42.2K	$0
Stephanie Eckerle	IN	Surgical Physician Assistant	$34.5K	$0
Kenneth Madler	IN	Audiologist-Hearing Aid Fitter	$2.1K	$0

St. Vincent Medical Group, 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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