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.

South Bend Emergency Physicians, Inc (NPI 1487132114)

Field	Value
Entity Type	Organization
Organization	South Bend Emergency Physicians, Inc
Address	615 N Michigan St
City	South Bend
State	IN
ZIP	46601
Taxonomy	Emergency Medicine Physician
NPI Enumerated	August 3, 2018

Payer Source	Total Paid
Medicaid	$11.8M
Medicare	$0

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
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.	88,350	$70	$5.9M
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.	53,900	$90	$4.9M
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.	24,530	$40	$882.9K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	19,390	$1	$77.6K
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…	580	$130	$72.9K
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…	110	$150	$17.2K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	210	$20	$4.1K
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.	10	$30	$370
99053	The provider renders overnight services at a 24 hour facility.	930	$0	$0

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

South Bend Emergency Physicians, Inc — 2 of 8 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
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.	13	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.	61	360	3,490	$110	$1.5M
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.	14	330	1,530	$100	$1.1M
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.	195	200	280	$130	$321.2K
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…	53	140	270	$130	$195.3K
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…	201	330	210	$80	$126.9K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	34	290	630	$1	$45.5K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	60	160	100	$10	$3.3K
99053	The provider renders overnight services at a 24 hour facility.	11	40	250	$1	$10

Nearby Providers

Other providers in the same ZIP code as South Bend Emergency Physicians, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Memorial Hospital Of South Bend	IN	General Acute Care Hospital	$0	$33.3M
City Of South Bend	IN	Land Ambulance	$874.9K	$8.5M
Healthlinc, Inc	IN	Federally Qualified Health Center (FQHC)	$0	$5.5M
Beacon Medical Group, Inc.	IN	Pediatrics Physician	$0	$4.7M
Beacon Medical Group, Inc.	IN	Family Medicine Physician	$0	$4.7M
Beacon Medical Group, Inc.	IN	Psychiatry Physician	$0	$4.4M
Labcorp Indiana Inc	IN	Clinical Medical Laboratory	$0	$4M
South Bend Community School Corporation	IN	Local Education Agency (LEA)	$0	$3.9M
Lincoln Counseling, PC	IN	Social Worker	$0	$3.4M
Pediatrix Medical Group Of Indiana, PC	IN	Neonatal-Perinatal Medicine Physician	$0	$2.6M

South Bend Emergency Physicians, Inc — Billing Profile & Reimbursement Data

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South Bend Emergency Physicians, 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

Nearby Providers

Frequently Asked Questions

References