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.

Dungarvin Indiana, LLC (NPI 1275743205)

Field	Value
Entity Type	Organization
Organization	Dungarvin Indiana, LLC
Address	3575 Moreau Ct Ste 200
City	South Bend
State	IN
ZIP	46628
Taxonomy	Intellectual and/or Developmental Disabilities Residential Treatment Facility
NPI Enumerated	May 22, 2007

Payer Source	Total Paid
Medicaid	$66.4M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-focused operator: there is no Medicare billing on file and total Medicaid revenue is $66.4M, indicating near-exclusive reliance on Medicaid for billed services. The absence of Medicare activity simplifies payer administration but concentrates financial exposure in a single program.

Dungarvin Indiana, LLC has a long tenure in the registry, with its NPI enumerated on 2007-05-22 (~19 years ago), signaling it is an established provider in the state market and not a recent entrant. This longevity is consistent with the large Medicaid revenue base reported.

Revenue is highly concentrated in a very small set of waiver-related codes: the precomputed top 3 Medicaid codes account for 96.7% of the provider’s total Medicaid revenue. In particular, T2016 alone represents $60.1M (90.5% of Medicaid revenue), with T2020 at $2.9M (4.4%) and T2002 at $1.2M (1.8%), underscoring that most income flows from a single residential habilitation service.

The code mix indicates the provider operates primarily as a residential and habilitation services organization: T2016 (Habilitation, residential, waiver; per diem) is the dominant service line, supported by day habilitation (T2020) and high-volume non-emergency transportation (T2002). These codes together suggest care delivery focused on long-term residential habilitation with accompanying day programs and transportation supports rather than acute medical or Medicare-type services.

Competitive standing on the flagship service is strong in absolute rank: for T2016 the provider ranks #4 of 65 in-state and is in the 95th percentile, yet the dataset labels the volume as "typical, unremarkable volume for this code," implying that while the provider is among the larger billed volumes in-state, this level of T2016 activity is not anomalous within the market. Analysts should read this as high placement within a market where sizable residential habilitation billing is common.

The provider is a clear outlier on transportation: for T2002 it ranks #2 of 65 and sits in the 98th percentile, which the data characterizes as "notably above typical state volume for this code." This suggests either a strategic emphasis on providing non-emergency transportation at scale or a large client base requiring frequent transport, and it is a distinct competitive advantage relative to peers.

Other billed codes are minor by comparison and show limited diversification: H0004 accounts for $1M (1.6% of revenue) and ranks #23 of 72 (69th percentile), while codes like T2033 ($482.4K, 0.7%) and S5151 ($464.4K, 0.7%) are each under 1% of total Medicaid revenue and occupy middle-to-lower ranks in-state. This pattern confirms services beyond core residential habilitation are present but not material to overall revenue.

The combination of near-total Medicaid dependence and extreme concentration in T2016 (90.5% of Medicaid revenue) creates a single-payer and single-service concentration risk: reimbursement or policy shifts affecting waiver residential habilitation or related per-diem rates could materially impact the provider’s finances. Conversely, the lack of Medicare billing reduces exposure to Medicare-specific payment changes and administrative complexity.

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	135,610	$440	$60.1M
T2020	Day habilitation, waiver; per diem	13,640	$210	$2.9M
T2002	Non-emergency transportation; per diem	41,820	$30	$1.2M
H0004	Behavioral health counseling and therapy, per 15 minutes	10,500	$100	$1M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	1,360	$360	$482.4K
S5151	Unskilled respite care, not hospice; per diem	710	$660	$464.4K
T2025	Waiver services; not otherwise specified (nos)	420	$300	$125.2K
T2022	Case management, per month	820	$100	$79.4K
H2032	Activity therapy, per 15 minutes	60	$470	$27.7K

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

Dungarvin Indiana, LLC — 2 of 9 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

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	4	70	3,190	$630	$14.7M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	24	50	1,090	$180	$2.3M
H0004	Behavioral health counseling and therapy, per 15 minutes	23	70	3,960	$130	$1.9M
T2020	Day habilitation, waiver; per diem	16	60	5,550	$110	$1.4M
S5151	Unskilled respite care, not hospice; per diem	24	40	970	$220	$1.3M
T2022	Case management, per month	47	100	710	$180	$1.1M
H2032	Activity therapy, per 15 minutes	24	30	1,780	$70	$942.2K
T2002	Non-emergency transportation; per diem	2	70	2,190	$50	$319.8K
T2025	Waiver services; not otherwise specified (nos)	19	20	850	$140	$173.4K

Nearby Providers

Other providers in the same ZIP code as Dungarvin Indiana, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Partners In Opportunities, Inc.	IN	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$26M
Michiana Family Dental LLC	IN	Dentist	$0	$3M
Laboratory Corporation Of America	IN	Clinical Medical Laboratory	$233.5K	$2.5M
Syed Rizvi	IN	Nephrology Physician	$202K	$0
Arif Goreja	IN	Nephrology Physician	$180.2K	$0
Shamiram Badal	IN	Family Medicine Physician	$86.9K	$0
Vpa PC	IN	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$22K	$19K
Alice Shaw	IN	Family Nurse Practitioner	$33.5K	$0

Dungarvin Indiana, LLC — Billing Profile & Reimbursement Data

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Dungarvin Indiana, LLC — 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

Nearby Providers

Frequently Asked Questions

References