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.

Franciscan Physician Network (NPI 1225327984)

Key Findings

Field	Value
Entity Type	Organization
Organization	Franciscan Physician Network
Address	8111 S Emerson Ave
City	Indianapolis
State	IN
ZIP	46237
Taxonomy	Family Medicine Physician
NPI Enumerated	April 4, 2011

Payer Source	Total Paid
Medicaid	$105.4M
Medicare	$0

FRANCISCAN PHYSICIAN NETWORK is effectively a Medicaid-focused billing entity: there is no Medicare billing on file and total Medicaid revenue is $105.4M, indicating a single-payer concentration in public insurance for the period covered. This concentrated payer mix means Medicaid policy and reimbursement changes would disproportionately affect the provider’s revenue base.

Revenue is highly concentrated in a small set of outpatient evaluation-and-management and preventive codes: the top three Medicaid codes (99214, 99213, 99391) account for 68.4% of the provider’s total Medicaid revenue. Individually these are 99214 ($39.1M, 40.4%), 99213 ($23.4M, 24.2%), and 99391 ($3.7M, 3.8%), which highlights dependence on established-patient office visits and routine preventive care.

The billing mix indicates a primary-care and family medicine operational model with very large ambulatory throughput: 99214 appears 698.6K times and 99213 509.2K times, showing extremely high volume of established-patient visits. The prominence of 99391 and additional well-patient codes (99392, 99393, 99394) reinforces a preventive-care emphasis across age groups rather than a specialist procedural focus.

State-level competitive standing for core primary-care codes is dominant: 99214 ranks #1 of 2122 providers in-state (100th percentile; extreme outlier) and 99213 ranks #3 of 2377 providers in-state (100th percentile; extreme outlier). The provider’s rank and percentile data for those high-volume E/M codes characterizes it as a major, high-volume Medicaid ambulatory provider in Indiana rather than a modest or typical practice.

The breadth of billed services spans ambulatory primary care and preventive services into obstetrics, inpatient, diagnostic imaging, and immunizations: notable codes include 59425/59426 (antepartum-related global/mini-global codes), inpatient E/M codes 99232/99233/99223, echocardiography 93306, and vaccines 90471/90472. Several of these non-E/M codes also show elevated state ranks (for example, 93306 ranks #1 of 148 providers in-state and 90471 ranks #3 of 656 providers), suggesting the organization bills across the outpatient–inpatient continuum rather than solely office visits.

High claim counts across many codes signal system-level scale: examples include 698.6K claims for 99214, 509.2K claims for 99213, 195.4K claims for 93010, and 136.2K claims for 90471. These volumes, combined with the provider’s Medicaid revenue of $105.4M, point to a large operational footprint that handles substantial patient throughput and routine procedural/immunization workflows.

Several billed codes are flagged as statistical outliers in-state, which underscores the provider’s atypical volume profile: besides the extreme outlier status for 99214 and 99213, codes such as 99391 (99th percentile; extreme outlier), 93306 (100th percentile; extreme outlier), and 90472 (99th percentile; extreme outlier) further indicate unusually high Medicaid activity across multiple service lines. These outlier labels should inform network-competitiveness and utilization-review considerations.

The NPI was enumerated on 2011-04-04 (~15 years ago), indicating an established enrollment history with more than a decade of claims activity; combined with the high-volume Medicaid billing profile, this tenure supports the interpretation of a sustained, scale-oriented Medicaid practice rather than a recent or transient billing pattern.

Medicaid: Complete Services Breakdown

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

373 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…	698,630	$60	$39.1M
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…	509,200	$50	$23.4M
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…	43,500	$80	$3.7M
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…	34,780	$90	$3.1M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	37,570	$70	$2.6M
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…	31,530	$70	$2.3M
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…	89,530	$30	$2.2M
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…	34,830	$60	$2.2M
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…	56,340	$40	$2M
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…	57,780	$40	$2M

Showing 1–10 of 373

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

Franciscan Physician Network — 22 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

373 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.	161	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.	138	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.	105	330	1,530	$100	$1.1M
J0585	Injection, onabotulinumtoxina, 1 unit	11	30	280	$820	$992.2K
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…	115	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…	24	580	710	$60	$582.9K
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	2,120	870	$60	$450.6K
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…	81	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.	12	140	430	$220	$413.2K
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…	3	2,380	920	$50	$376.8K

Showing 1–10 of 373

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Franciscan Physician Network	IN	Urgent Care Clinic/Center	$0	$16.2M
Mark Mitchell	FL	Emergency Medicine Physician	$1.9M	$38.2K
Adam Duhl	NJ	Maternal & Fetal Medicine Physician	$128.8K	$1.5M
Shah Alam	IL	Hospitalist Physician	$96.7K	$1M
Dominic Tolitano	IL	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$1.1M	$0
Shahnaz Azad	IL	Infectious Disease Physician	$366.3K	$657.8K
Costantine Albany	IN	Medical Oncology Physician	$1M	$0
Sulman Hussain	IN	Cardiovascular Disease Physician	$846.9K	$107.7K
Michael Wilczynski	IL	Diagnostic Radiology Physician	$91.1K	$657.3K
Bassel Ericsoussi	IN	Critical Care Medicine (Internal Medicine) Physician	$270K	$284.3K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Apria Healthcare LLC	IN	Durable Medical Equipment & Medical Supplies	$0	$176.1M
Franciscan Health Indianapolis & Mooresville	IN	General Acute Care Hospital	$0	$41.3M
Emergency Physicians Of Indianapolis, PC	IN	Emergency Medicine Physician	$0	$15.2M
Franciscan Health Indianapolis & Mooresville	IN	Family Medicine Physician	$0	$6.8M
Annette T. Farthing Dds, PC	IN	Pediatric Dentistry	$0	$5.5M
Apria Healthcare LLC	IN	Durable Medical Equipment & Medical Supplies	$0	$4.5M
Global Smiles Dental	IN	Dentist	$0	$4.1M
Kidz Dental Partners, LLC	IN	Pediatric Dentistry	$0	$2.6M
Franciscan Surgery Center, LLC	IN	Ambulatory Surgical Clinic/Center	$1.2M	$356K
The Endoscopy Center At St. Francis, LLC	IN	Endoscopy Clinic/Center	$755K	$247.2K

Franciscan Physician Network — Billing Profile & Reimbursement Data

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Franciscan Physician Network — 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