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.

The Methodist Hospitals, Inc (NPI 1467504555)

Field	Value
Entity Type	Organization
Organization	The Methodist Hospitals, Inc
Address	600 Richard Gordon Hatcher Blvd
City	Gary
State	IN
ZIP	46402
Taxonomy	General Acute Care Hospital
NPI Enumerated	January 17, 2007

Payer Source	Total Paid
Medicaid	$75.6M
Medicare	$0

Key Findings

THE METHODIST HOSPITALS, INC reports no Medicare billing on file and $75.6M in lifetime Medicaid revenue, making its observed activity effectively single‑payer (Medicaid) in the available claims dataset. This concentration means analyses of utilization and competitive position should be interpreted as Medicaid‑driven rather than split across Medicare and Medicaid populations.

Revenue is highly concentrated in emergency department evaluation-and-management services: the precomputed top three Medicaid codes (99283, 99284, 99285) together account for 37.2% of the provider’s total Medicaid revenue. Individually those codes generate $10.9M (16.6%) for 99283, $7M (10.8%) for 99284, and $6.4M (9.8%) for 99285, indicating ED care is the dominant revenue driver for this hospital.

The code mix and volumes indicate a high-throughput emergency department operation across acuity levels: 99282 (44.2K claims, $5.7M, 8.7%) is a noted extreme outlier (rank #2 of 197, 99th percentile) while 99283 (71.2K claims, $10.9M, 16.6%), 99284 (44.3K claims, $7M, 10.8%), and 99285 (36.9K claims, $6.4M, 9.8%) all rank in high state percentiles. High claim counts for ED E/M codes paired with substantial imaging and EKG volumes (71045: 33.6K claims, $4.8M; 93005: 39.2K claims, $2.7M) point to an ED-centric service model with integrated diagnostics on site.

State-level competitive standing is above typical for many of its top codes: 99283 ranks #12 of 364 (97th percentile), 99284 ranks #30 of 382 (92th percentile), and 99285 ranks #23 of 325 (93th percentile), signaling the hospital is a major Medicaid ED provider in Indiana rather than a modest participant. Several other procedure codes also place the hospital in top percentiles (for example 93005 at the 97th percentile and 71045 at the 92th percentile), reinforcing its elevated outpatient and ED footprint statewide.

Beyond emergency care, the facility reports meaningful revenue in procedural and specialty areas that support inpatient and ambulatory services. Notable examples include 11042 (debridement) with $4M (6.1%) revenue, 99218 (initial observation/inpatient code) at $4.2M (6.5%) where the provider is an extreme outlier (rank #1 of 45, 100th percentile), and 96413 (chemotherapy) with $773.1K (1.2%), indicating capacity for surgical, wound care, and oncology infusion services.

Oncology and infusion capability is further suggested by J9271 (pembrolizumab) producing $3M (4.5%) in Medicaid revenue and ranking #2 of 4 providers in-state, and chemotherapy administration codes such as 96413 and 96374 appearing on the top list. While J9271’s rank sits at the 67th percentile among a small cohort, the dollar amount ($3M) signals a material oncology revenue line for the hospital’s outpatient or infusion operations.

The hospital shows historically high COVID and lab testing throughput during the pandemic period: U0003 ($1.6M, 2.4%) ranks #8 of 89 (92th percentile), C9803 ($1.5M, 2.3%) ranks #2 of 75 (99th percentile, extreme outlier), and 87636 ($1.4M, 2.2%) ranks #1 of 50 (100th percentile, extreme outlier). These high ranks and combined testing revenue indicate the provider handled substantial SARS‑CoV‑2 testing volume relative to in‑state peers.

The NPI was enumerated on 2007-01-17 (~19 years ago), reflecting a long tenure in the market. Paired with consistent, high Medicaid revenue and repeated extreme outlier placements across several codes (for example 99218 at the 100th percentile and 96372 at the 100th percentile), the hospital appears to be an established, high-volume Medicaid safety‑net and emergency care provider in Gary, IN.

Medicaid: Complete Services Breakdown

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

260 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	71,170	$150	$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.	44,280	$160	$7M
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.	36,930	$170	$6.4M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	44,170	$130	$5.7M
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…	33,600	$140	$4.8M
99218	N/A	12,280	$350	$4.2M
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.	5,750	$690	$4M
J9271	Injection, pembrolizumab, 1 mg	660	$4,500	$3M
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…	39,160	$70	$2.7M
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	20,730	$100	$2M

Showing 1–10 of 260

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

The Methodist Hospitals, Inc — 10 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

260 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	Injection, pembrolizumab, 1 mg	2	10	540	$4,910	$2.2M
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.	30	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.	12	360	3,490	$110	$1.5M
J2323	Injection, natalizumab, 1 mg	3	10	360	$4,130	$1.1M
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.	23	330	1,530	$100	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	25	100	2,210	$70	$926K
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…	5	130	3,770	$60	$617.7K
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.	38	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…	412	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…	19	220	1,850	$30	$449.4K

Showing 1–10 of 260

Related Providers

Other providers that share a Tax Identification Number (TIN) with The Methodist Hospitals, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Methodist Hospitals, Inc	IN	Internal Medicine Physician	$0	$10.9M
Raja Devanathan	IN	Pulmonary Disease Physician	$3M	$0
Ghassan Jano	IN	Hematology & Oncology Physician	$2.1M	$0
Daksha Vyas	IN	Neurology with Special Qualifications in Child Neurology Physician	$88.8K	$1.1M
Abdullgabbar Hamid	IL	Neuroradiology Physician	$139K	$368K
Larry Salberg	IN	Neurology with Special Qualifications in Child Neurology Physician	$410.5K	$0
Richard Cristea	IN	Neurology Physician	$375.4K	$0
Louis Elkins	AR	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$368.5K	$0
Helen Xiao-li	WA	Radiation Oncology Physician	$368.1K	$0
Arif Dalvi	FL	Neurology Physician	$307.4K	$0

Nearby Providers

Other providers in the same ZIP code as The Methodist Hospitals, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Edgewater Systems For Balanced Living, Inc	IN	Community/Behavioral Health Agency	$0	$17.8M
City Of Gary Indiana	IN	Ambulance	$442.6K	$7.2M
Cep America LLC	IN	Emergency Medicine Physician	$0	$6.9M
Community Healthnet Inc	IN	Community Health Clinic/Center	$0	$6M
Sound Physicians Of Indiana, LLC	IN	Hospitalist Physician	$0	$4.2M
Edgewater Systems For Balanced Living, Inc	IN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3.6M
Edgewater Systems For Balanced Living, Inc.	IN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$2.8M
Akeem Kareem	IN	Family Nurse Practitioner	$80.4K	$0
Amanda Neary	IN	Certified Registered Nurse Anesthetist	$13K	$10.9K
Elizabeth Baldys	IN	Physician Assistant	$17.8K	$0

The Methodist Hospitals, Inc — Billing Profile & Reimbursement Data

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The Methodist Hospitals, Inc — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References