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NPI 1265689111 · Richmond, IN · Internal Medicine Physician
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Reid Physician Associates, Inc. is a internal medicine physician provider located in Richmond, Indiana. This profile covers 15 Medicare and 313 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Reid Physician Associates, Inc. |
| Address | 1100 Reid Pkwy |
| City | Richmond |
| State | IN |
| ZIP | 47374 |
| Taxonomy | Internal Medicine Physician |
| NPI Enumerated | August 22, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $66.4M |
| Medicare | $11.9K |
This profile is overwhelmingly Medicaid-driven: lifetime Medicaid revenue is $66.4M versus total Medicare revenue of $11.9K, so the provider operates with an effective single-payer scale concentrated in Medicaid. The NPI was enumerated on 2008-08-22 (~18 years ago), indicating an established operation that has grown primarily within the Medicaid market over an extended period.
Medicaid billing is structurally dominated by office/ambulatory evaluation-and-management codes: 99214 generated $22.6M (39.1% of Medicaid revenue) and 99213 generated $10.9M (18.9% of Medicaid revenue), and the precomputed top-3 Medicaid codes account for 64.6% of the provider's Medicaid revenue. This concentration points to a business model focused on high-volume primary care and follow-up visits delivered in an outpatient setting.
Despite the heavy outpatient focus, the Medicaid code mix shows meaningful hospital and acute-care activity: 99284 ($3.8M, 6.6% of Medicaid revenue) and 99285 ($3.4M, 5.8%) appear among top revenue drivers, indicating the practice also bills for moderate- and high-acuity emergency department services. The presence of inpatient/hospital codes (for example, 99233 and 99232 among top-ranked services) suggests the organization bills both ambulatory and facility-based care.
The provider is a dominant in-state Medicaid biller for core primary care codes: 99214 ranks #6 of 2122 in-state (100th percentile; extreme outlier) and 99213 ranks #10 of 2377 in-state (100th percentile; extreme outlier). Additional high ranks for preventive and high-complexity E/M codes (for example, 99215 ranks #4 of 511; 99223 ranks #9 of 325) reinforce that this entity is a major statewide volume leader for outpatient and inpatient evaluation-and-management services.
Medicaid service breadth extends beyond adult primary care: high-volume preventive and pediatric codes (99391, 99392, 99393), obstetric mini-global codes (59426, 59425), substantial lab and infectious-disease testing (87428 $540.1K, 87880 $500.5K), vaccine administration (90472 $390.4K), and allergen immunotherapy preparation (95165 $416K, rank #1 in-state) appear in the top lines. This mix indicates diversified clinical capabilities — ambulatory primary care, pediatrics, obstetrics, allergy/immunotherapy, diagnostics, and vaccination programs — all funded largely by Medicaid.
Revenue concentration is pronounced on both payers' top codes: the precomputed top-3 Medicare codes account for 50.2% of Medicare revenue while the precomputed top-3 Medicaid codes account for 64.6% of Medicaid revenue. For Medicaid this means financial performance is highly dependent on a few high-volume E/M and ED codes, creating exposure to changes in outpatient/ED utilization or reimbursement for those specific services.
Medicare activity is minimal in scale ($11.9K lifetime) and concentrated in imaging: 71046 generated $3.5K (29.6% of Medicare revenue) and the top-3 Medicare codes together explain 50.2% of the Medicare revenue. Nationally, the Medicare code ranks (for example, 71046 at the 86th percentile, described as "typical, unremarkable volume") indicate this provider is a modest, typical participant in Medicare imaging rather than a national leader.
Taken together, the tenure (NPI enumerated 2008-08-22 (~18 years ago)), extreme in-state Medicaid volumes for core E/M codes, and diversified Medicaid service mix position REID PHYSICIAN ASSOCIATES, INC. as an established, Medicaid-focused provider with major state-level scale in primary care and ancillary services. From a payer or competitive perspective, the entity should be treated as a dominant Medicaid outpatient/ED billing organization with only a limited Medicare footprint.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
15 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 270 | $10 | $3.5K |
| 73502 | In this diagnostic procedure, the provider takes X–ray images of one hip, either left or right, from two or three projections (directions or angles) to check for any fracture, swelling, or other… | 50 | $20 | $1.2K |
| 73630 | In this diagnostic procedure, the provider takes a minimum of three views of the foot to assess injury, fracture, arthritis, tumor, or congenital abnormality. | 70 | $20 | $1.2K |
| 73030 | This particular procedure is for a minimum of 2 X–ray views of the complete shoulder. | 60 | $20 | $990 |
| 73564 | In this procedure, the provider takes four or more X–ray views of the knee joint to check for any fracture, swelling, or reason for pain in the knee area. | 30 | $30 | $810 |
| 72100 | The technician takes 2 or 3 views of the vertebrae in the lumbar region which is the lower part of the spine and the sacrum, the area that connects the spine to the pelvis. Lumbosacral spine X–rays… | 50 | $20 | $720 |
| 73130 | In this procedure, the provider takes a minimum of three X–ray images of a patient’s hand to check for any fracture, swelling, or reason of pain in the hand. | 30 | $20 | $610 |
| 73560 | In this procedure, the provider takes one or two X–ray images of a patient’s knee joint to check for any fracture, swelling, or reason for pain in the knee area. | 50 | $10 | $560 |
| 73562 | In this procedure, the provider takes three X–ray images of a patient’s knee joint to check for any fracture, swelling, or reason for pain in the knee area. | 20 | $20 | $460 |
| 73110 | The provider takes at least three X–ray images of a patient’s complete wrist to check for any fracture, swelling, or reason of pain in the wrist area. | 20 | $20 | $460 |
Showing 1–10 of 15
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
313 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… | 383,060 | $60 | $22.6M |
| 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… | 227,550 | $50 | $10.9M |
| 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. | 53,260 | $70 | $3.8M |
| 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. | 39,070 | $90 | $3.4M |
| 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. | 36,110 | $40 | $1.6M |
| 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… | 15,170 | $90 | $1.3M |
| 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… | 15,390 | $80 | $1.2M |
| 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… | 16,740 | $70 | $1.1M |
| 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… | 13,000 | $80 | $1.1M |
| 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… | 24,370 | $40 | $1M |
Showing 1–10 of 313
How this provider's Medicaid billing volume and revenue compare to other Indiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Indiana median
313 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. | 22 | 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. | 35 | 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. | 21 | 330 | 1,530 | $100 | $1.1M |
| J0585 | Injection, onabotulinumtoxina, 1 unit | 5 | 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… | 68 | 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… | 246 | 580 | 710 | $60 | $582.9K |
| 43249 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum and dilates (widens) the esophagus with a balloon less than 30 mm in diameter. | 2 | 10 | 210 | $1,060 | $576.8K |
| 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. | 19 | 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… | 6 | 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… | 24 | 220 | 1,850 | $30 | $449.4K |
Showing 1–10 of 313
Other providers in the same ZIP code as Reid Physician Associates, Inc., ranked by combined Medicare and Medicaid revenue.
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