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.

Raphael Health Center, Inc (NPI 1487764759)

Raphael Health Center, Inc is a federally qualified health center (fqhc) provider located in Indianapolis, Indiana. This profile covers 0 Medicare and 91 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	Raphael Health Center, Inc
Address	401 E 34th St
City	Indianapolis
State	IN
ZIP	46205
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	August 30, 2006

Payer Source	Total Paid
Medicaid	$6.2M
Medicare	$0

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

91 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…	34,770	$50	$1.7M
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…	12,980	$70	$895.4K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	13,150	$60	$749.3K
T1015	Clinic visit/encounter, all-inclusive	57,500	$10	$460K
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	3,640	$60	$221.7K
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…	4,050	$50	$214.7K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1,350	$100	$134.8K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	1,380	$90	$128K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	3,410	$40	$126.2K
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…	1,640	$80	$122.8K

Showing 1–10 of 91

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

Raphael Health Center, Inc — 1 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

91 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99408	The provider spends 15 to 30 minutes screening a patient for abuse of alcohol or another non–tobacco substance. The provider then performs a brief intervention at the same session.	8	10	100	$180	$584.1K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	63	580	710	$60	$582.9K
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…	221	2,120	870	$60	$450.6K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	307	690	1,070	$80	$422.3K
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…	109	2,380	920	$50	$376.8K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	147	220	1,380	$20	$360.2K
T1015	Clinic visit/encounter, all-inclusive	29	400	5,220	$20	$360.2K
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	49	160	1,390	$70	$294.8K
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…	110	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…	53	190	1,680	$70	$264.2K

Showing 1–10 of 91

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Indianapolis Treatment Center, LLC	IN	Methadone Clinic	$386.2K	$41.4M
Quinton Residential Living	IN	Developmentally Disabled Services Day Training Agency	$0	$39.9M
Meridian Health Services Corp.	IN	Federally Qualified Health Center (FQHC)	$0	$8.5M
A Passionate Helping Hand Home Health Care, LLC	IN	Home Health Agency	$0	$4.2M
Anointed Touch Home Health Care LLC	IN	Home Health Agency	$0	$4M
Meridian Health Services Corp	IN	Federally Qualified Health Center (FQHC)	$0	$4M
Zachary Eppert	IN	Nurse Practitioner	$93.6K	$0
Stephanie Dexter	IN	Clinical Social Worker	$60.6K	$0
Nicole O'rourke	IN	Family Nurse Practitioner	$41.8K	$0

Raphael Health Center, Inc — Billing Profile & Reimbursement Data

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Raphael Health 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

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