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.

Terre Haute Pulmonary & Pediatric Clinic, LLC (NPI 1326152984)

Terre Haute Pulmonary & Pediatric Clinic, LLC is a critical care medicine (internal medicine) physician provider located in Terre Haute, Indiana. This profile covers 0 Medicare and 74 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	Terre Haute Pulmonary & Pediatric Clinic, LLC
Address	4525 S Springhill Jct
City	Terre Haute
State	IN
ZIP	47802
Taxonomy	Critical Care Medicine (Internal Medicine) Physician
NPI Enumerated	August 19, 2006

Payer Source	Total Paid
Medicaid	$4.8M
Medicare	$0

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

74 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…	44,160	$50	$2.1M
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…	16,300	$50	$750K
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…	4,780	$80	$401.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,990	$90	$254.5K
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…	2,600	$80	$218.2K
94729	In this add on procedure, the provider tests the lungs’ diffusing capacity, the ability to exchange gases, moving oxygen into the bloodstream and letting in carbon dioxide from the bloodstream.	6,970	$20	$118.4K
94060	The spirometry test is performed with a spirometer. The instrument displays a graphical representation, known as a spirogram, of the test results. The basic forced volume vital capacity (FVC) test is…	7,020	$20	$112.4K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	5,730	$20	$103.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,200	$90	$102.3K
94727	The provider performs a pulmonary function test, or PFT, to assess the patient’s lung volumes using gas dilution or washout techniques that compare a known concentration of an inhaled gas with the…	7,030	$10	$98.3K

Showing 1–10 of 74

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

Terre Haute Pulmonary & Pediatric Clinic, LLC — 4 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

74 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…	175	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…	81	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…	82	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…	55	290	770	$80	$250.8K
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…	174	530	740	$30	$210K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	48	140	270	$130	$195.3K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	25	60	120	$320	$177.6K
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…	126	360	430	$50	$177.4K
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…	93	270	470	$30	$171.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	54	320	310	$80	$133.9K

Showing 1–10 of 74

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ajay Deshpande	IN	Pulmonary Disease Physician	$340K	$0
Anand Bhuptani	IN	Pulmonary Disease Physician	$278.1K	$0
Divyesh Purohit	IN	Internal Medicine Physician	$190.4K	$0
Jessica Myers	IN	Psychiatric/Mental Health Nurse Practitioner	$103.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Summit Bhc Henryville, LLC	IN	Substance Abuse Rehabilitation Facility	$0	$90.6M
Ambulance Management Services Ltd	IN	Land Ambulance	$2.9M	$14.7M
Terre Haute Regional Hospital, L.P.	IN	General Acute Care Hospital	$0	$16.7M
Gibault, Inc.	IN	Psychiatric Residential Treatment Facility	$0	$13.5M
Mosaic	IN	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$8.2M
Providence Medical Group LLC	IN	Multi-Specialty Clinic/Center	$0	$7.3M
City Optical Co., Inc.	IN	Optometrist	$0	$5.9M
Happiness Bag Players, Incorporated	IN	Developmentally Disabled Services Day Training Agency	$0	$5.8M
Wabash Valley Children's Dentistry	IN	Dentist	$0	$5.7M
City Of Terre Haute	IN	Land Ambulance	$669K	$4.4M

Terre Haute Pulmonary & Pediatric Clinic, LLC — Billing Profile & Reimbursement Data

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Terre Haute Pulmonary & Pediatric Clinic, LLC — 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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