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.

St. Francis Medical Group, LLC (NPI 1467693135)

St. Francis Medical Group, LLC is a internal medicine physician provider located in Greenwood, Indiana. This profile covers 0 Medicare and 56 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	St. Francis Medical Group, LLC
Address	701 E County Line Rd Ste 101
City	Greenwood
State	IN
ZIP	46143
Taxonomy	Internal Medicine Physician
NPI Enumerated	March 10, 2009

Payer Source	Total Paid
Medicaid	$9.9M
Medicare	$0

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

56 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	69,920	$40	$3.1M
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…	37,040	$60	$2.1M
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…	10,930	$110	$1.2M
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…	37,150	$30	$1.1M
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	21,080	$20	$463.7K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	9,840	$50	$452.5K
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…	9,470	$40	$407.4K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	5,130	$70	$374.3K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	2,000	$50	$101.8K
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…	1,050	$80	$79.9K

Showing 1–10 of 56

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

St. Francis Medical Group, LLC — 6 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

56 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…	72	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…	373	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…	126	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…	149	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…	25	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…	3	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,…	51	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…	2	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.	170	320	310	$80	$133.9K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	22	330	210	$80	$126.9K

Showing 1–10 of 56

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Franciscan Health Indianapolis & Mooresville	IN	General Acute Care Hospital	$0	$41.3M
Franciscan Health Indianapolis & Mooresville	IN	General Acute Care Hospital	$0	$12.3M
Franciscan Health Indianapolis & Mooresville	IN	Family Medicine Physician	$0	$6.8M
Steven Samuels	IN	Internal Medicine Physician	$401K	$0
Sachin Dave	MN	Internal Medicine Physician	$301.6K	$0
Robert Daly	IN	Pulmonary Disease Physician	$232.9K	$0
Ahmad Saltagi	IN	Pulmonary Disease Physician	$156.9K	$0
Sanjay Vyas	IN	Family Medicine Physician	$128K	$0
Faron Skelton	IN	Critical Care Medicine (Internal Medicine) Physician	$126.3K	$0
Abhinav Singh	IN	Internal Medicine Physician	$125.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cornerstone Autism Center	IN	Early Intervention Provider Agency	$0	$30.4M
Lincare Inc.	IN	Durable Medical Equipment & Medical Supplies	$0	$16.1M
Valle Vista LLC	IN	Methadone Clinic	$75.6K	$14.6M
Mid America Professional Group, PC	IN	Dentist	$0	$10.5M
Indiana University Health Urgent Care Centers, LLC.	IN	Urgent Care Clinic/Center	$0	$5.9M
Valle Vista LLC	IN	Mental Health Counselor	$0	$4.5M
Fiorenza Dental Group, LLC	IN	Dentist	$0	$3.8M
Mark Ellis	IN	Pediatric Dentistry	$0	$3.7M
Valle Vista, LLC	IN	Psychiatric Hospital	$0	$3M
Ddeutsch Homecare , Inc.	IN	In Home Supportive Care Agency	$0	$2.7M

St. Francis Medical Group, 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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