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.

Childrens & Family Medicine Clinic PC (NPI 1265978043)

Childrens & Family Medicine Clinic PC is a primary care clinic/center provider located in Munster, Indiana. This profile covers 0 Medicare and 50 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	Childrens & Family Medicine Clinic PC
Address	9128 Columbia Ave Ste A
City	Munster
State	IN
ZIP	46321
Taxonomy	Primary Care Clinic/Center
NPI Enumerated	January 17, 2017

Payer Source	Total Paid
Medicaid	$4.2M
Medicare	$0

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

50 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	36,750	$50	$1.8M
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…	23,070	$60	$1.5M
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…	2,460	$80	$189.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,190	$70	$150.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,640	$70	$121.1K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	2,440	$30	$78.1K
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…	970	$70	$72K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	5,040	$10	$50.4K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	500	$80	$40.7K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	1,000	$30	$30.8K

Showing 1–10 of 50

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

Childrens & Family Medicine Clinic PC — 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

50 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…	125	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…	102	2,380	920	$50	$376.8K
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…	198	280	880	$80	$267.2K
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…	129	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.	78	320	310	$80	$133.9K
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…	47	510	180	$90	$93.6K
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…	374	890	160	$60	$76.8K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	134	390	990	$20	$74.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	26	290	160	$80	$67.3K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	124	880	250	$40	$59.2K

Showing 1–10 of 50

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Munster Medical Research Foundation Inc	IN	General Acute Care Hospital	$0	$23.6M
Munster Radiology Group PC	IN	Diagnostic Radiology Physician	$0	$6.4M
Preference Health Services Inc.	IN	Home Health Agency	$0	$6.1M
Nwi Urgent Care, LLC	IN	Urgent Care Clinic/Center	$0	$4.4M
Urgentdent	IN	Dental Clinic/Center	$0	$4M
Chest Physician Consultants, Ltd	IN	Multi-Specialty Clinic/Center	$0	$3.9M
Cep America LLC	IN	Emergency Medicine Physician	$0	$3.5M
Midwest Emergency Associates-munster, LLC	IN	Emergency Medicine Physician	$0	$3.2M
Jeffrey T. Meister, Dds, LLC	IN	General Practice Dentistry	$0	$3M
Franciscan Health Munster	IN	General Acute Care Hospital	$0	$2.7M

Childrens & Family Medicine Clinic PC — Billing Profile & Reimbursement Data

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Childrens & Family Medicine Clinic PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References