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.

Lakeshore Bone & Joint Institute, PC (NPI 1508853953)

Lakeshore Bone & Joint Institute, PC is a specialist provider located in Chesterton, Indiana. This profile covers 0 Medicare and 51 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	Lakeshore Bone & Joint Institute, PC
Address	601 Gateway Blvd N
City	Chesterton
State	IN
ZIP	46304
Taxonomy	Specialist
NPI Enumerated	September 30, 2005

Payer Source	Total Paid
Medicaid	$3.2M
Medicare	$0

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

51 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…	27,650	$40	$1.1M
99203	The provider sees a new 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 provider…	13,920	$60	$807.2K
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…	8,190	$60	$450.4K
99204	The provider sees a new 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 provider…	3,400	$90	$319.8K
L4361	Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf	980	$160	$159.2K
73630	In this diagnostic procedure, the provider takes a minimum of three views of the foot to assess injury, fracture, arthritis, tumor, or congenital abnormality.	5,030	$20	$90.5K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	3,450	$20	$82.8K
73110	The provider takes at least three X–ray images of a patient’s complete wrist to check for any fracture, swelling, or reason of pain in the wrist area.	2,070	$20	$39.3K
73610	In this procedure, the provider takes three or more X–ray images of the ankle joint to check for any fracture, swelling, or reason for pain in the ankle area.	1,900	$20	$34.2K
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.	490	$60	$29.6K

Showing 1–10 of 51

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

Lakeshore Bone & Joint Institute, PC — 2 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

51 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…	318	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.	68	140	430	$220	$413.2K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	237	400	1,100	$40	$382.2K
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…	138	2,380	920	$50	$376.8K
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…	172	490	1,080	$30	$162.7K
99204	The provider sees a new 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 provider…	54	790	150	$90	$99.4K
L4361	Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf	4	20	180	$150	$91.8K
99203	The provider sees a new 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 provider…	22	890	160	$60	$76.8K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	96	210	640	$20	$74K
72148	In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the lumbar spinal canal and contents without using contrast.	33	50	250	$60	$63.3K

Showing 1–10 of 51

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michael Kralovec	IN	Orthopaedic Surgery Physician	$306.9K	$0
Ryan Plank	IN	Orthopaedic Surgery Physician	$247.6K	$0
Anita Rao	IN	Interventional Pain Medicine Physician	$229.8K	$0
Thomas Kay	IN	Orthopaedic Surgery Physician	$213.3K	$0
Anthony Levenda	IN	Orthopaedic Surgery Physician	$212.3K	$0
Adrian Sonevytsky	IN	Pain Medicine (Anesthesiology) Physician	$209.6K	$0
Paul Gruszka	IN	Orthopaedic Surgery Physician	$202.2K	$0
David Musgrave	IN	Orthopaedic Surgery Physician	$195K	$0
Eric Szczesniak	IN	Orthopaedic Surgery Physician	$192.1K	$0
John Guzzo	IN	Specialist	$166.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Life Strategies, LLC	IN	Mental Health Counselor	$0	$6.1M
Northshore Health Centers, Inc.	IN	Federally Qualified Health Center (FQHC)	$0	$3.4M
Chesterton Surgery Center LLC	IN	Ambulatory Surgical Clinic/Center	$1.2M	$0
John Brady	IN	Nephrology Physician	$320.8K	$0
Jay Shah	IN	Cardiovascular Disease Physician	$246.9K	$0
Douglas Zale	IN	Ophthalmology Physician	$240.6K	$0
Anne Hollingsworth	IN	Internal Medicine Physician	$208.7K	$0
Emmanuel Thierry Mentor	IN	Family Medicine Physician	$187.4K	$0
Aaron Anderson	IN	Surgery of the Hand (Surgery) Physician	$165.4K	$0
Hook-superx LLC	IN	Pharmacy	$159.8K	$0

Lakeshore Bone & Joint Institute, PC — Billing Profile & Reimbursement Data

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Lakeshore Bone & Joint Institute, PC — 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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