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.

Saint Joseph Regional Medical Center, Inc. (NPI 1467406074)

Field	Value
Entity Type	Organization
Organization	Saint Joseph Regional Medical Center, Inc.
Address	60101 Bodnar Blvd Ste 100b
City	Mishawaka
State	IN
ZIP	46544
Taxonomy	Family Medicine Physician
NPI Enumerated	May 19, 2006

Payer Source	Total Paid
Medicaid	$10.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

92 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…	91,690	$50	$4.4M
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…	65,450	$60	$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…	8,360	$80	$644K
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…	6,700	$80	$549.6K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	21,900	$10	$240.9K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	11,320	$20	$215.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,240	$80	$179K
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…	1,060	$90	$96.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	630	$80	$50.6K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	1,360	$30	$40.8K

Showing 1–10 of 92

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

Saint Joseph Regional Medical Center, Inc. — 3 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

92 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…	44	2,120	870	$60	$450.6K
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.	98	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…	30	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…	28	280	880	$80	$267.2K
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…	151	190	1,680	$70	$264.2K
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…	34	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…	362	530	740	$30	$210K
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…	251	360	430	$50	$177.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	63	320	310	$80	$133.9K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	131	160	740	$60	$119.1K

Showing 1–10 of 92

Related Providers

Other providers that share a Tax Identification Number (TIN) with Saint Joseph Regional Medical Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Joseph Regional Medical Center, Inc.	IN	Pulmonary Disease Physician	$0	$5.5M
Hunter Nolen	MO	Urology Physician	$359.5K	$0
Blair Macphail	IN	Cardiovascular Disease Physician	$160.9K	$0
Sachin Patel	IN	Cardiovascular Disease Physician	$160.4K	$0
Adam Perlmutter	IN	Urology Physician	$156.4K	$0
Austin Gerber	IN	Ophthalmic Plastic and Reconstructive Surgery Physician	$154.3K	$0
David Deboer	IL	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$147.5K	$0
Mark Ross	CO	Neurology Physician	$144.4K	$0
Charbel Maskiny	IN	Critical Care Medicine (Internal Medicine) Physician	$140.7K	$0
Mairaj Uddin	IN	Diagnostic Radiology Physician	$119.1K	$16.3K

Nearby Providers

Other providers in the same ZIP code as Saint Joseph Regional Medical Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Landmark Recovery Of Carmel LLC	IN	Substance Abuse Rehabilitation Facility	$0	$16.3M
Franciscan Physician Network	IN	Urgent Care Clinic/Center	$0	$16.2M
Journeys Behavior Learning Center LLC	IN	Developmental Disabilities Clinic/Center	$0	$12.4M
Healthlinc, Inc.	IN	Federally Qualified Health Center (FQHC)	$0	$8.2M
The Dental Center Of Mishawaka PC	IN	General Practice Dentistry	$0	$4.7M
City Of Mishawaka	IN	Ambulance	$543.3K	$2.6M
Vinicius Teixeira	IN	Psychiatry Physician	$452.9K	$0
Abhishek Das	IN	Pain Medicine Physician	$164.9K	$0
Michael Mitcheff	IN	Clinical Neuropsychologist	$114.5K	$0
Philip Kurochkin	IN	Ophthalmology Physician	$59.9K	$20.1K

Saint Joseph Regional Medical Center, Inc. — Billing Profile & Reimbursement Data

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Saint Joseph Regional Medical Center, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References