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.

Marion General Hospital (NPI 1528099041)

Marion General Hospital is a family medicine physician provider located in Marion, Indiana. This profile covers 0 Medicare and 132 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	Marion General Hospital
Address	330 N Wabash Avenue
City	Marion
State	IN
ZIP	46952
Taxonomy	Family Medicine Physician
NPI Enumerated	July 5, 2006

Payer Source	Total Paid
Medicaid	$18.8M
Medicare	$0

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

132 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	114,530	$50	$6.1M
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…	70,860	$50	$3.4M
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.	18,790	$70	$1.3M
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.	26,930	$40	$1.2M
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.	8,000	$90	$736.4K
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…	9,090	$80	$681.7K
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…	9,930	$70	$645.1K
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…	5,020	$80	$416.9K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	4,410	$90	$396.4K
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…	4,460	$80	$361.3K

Showing 1–10 of 132

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

Marion General Hospital — 3 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

132 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.	86	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.	53	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.	80	330	1,530	$100	$1.1M
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…	21	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.	51	140	430	$220	$413.2K
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…	42	2,380	920	$50	$376.8K
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.	13	200	280	$130	$321.2K
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…	17	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…	57	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…	17	190	1,680	$70	$264.2K

Showing 1–10 of 132

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Marion General Hospital	IN	General Acute Care Hospital	$0	$29.3M
Marion General Hospital	IN	Emergency Medicine Physician	$0	$2.7M
Kavita Raj	IN	Family Medicine Physician	$224.3K	$0
James Orrell	IN	General Practice Physician	$200.5K	$0
Kiran Mandya Chikkalingaiah	IN	Nephrology Physician	$165.4K	$0
Benjamin Martin	IN	Urology Physician	$151.1K	$0
George Geier	IN	Urology Physician	$138.5K	$0
Jeremy Spaulding	IN	Podiatrist	$117.4K	$0
Jeffrey Bragg	IN	Family Medicine Physician	$117.2K	$0
Peter Knapp	IN	Urology Physician	$115.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Normal Life Of Indiana	IN	Community/Behavioral Health Agency	$0	$56.8M
Premier Care Of Indiana, Inc.	IN	Methadone Clinic	$309.7K	$33.8M
Grant-blackford Mental Health, Inc.	IN	Psychiatric Hospital Unit	$0	$8.8M
Hoosier Pediatric Dental Group	IN	Pediatric Dentistry	$0	$7.2M
Grant-blackford Mental Health, Inc.	IN	Community/Behavioral Health Agency	$0	$5.3M
Premier Home Health LLC	IN	Home Health Agency	$0	$3.5M
Alphabet Soup Aba, LLC.	IN	Behavior Analyst	$0	$2.9M
Progressive Cancer Care LLC	IN	Radiation Oncology Clinic/Center	$432.6K	$5.8K
Christopher Powers	IN	Cardiovascular Disease Physician	$124.8K	$157.5K
Bradford Bichey	IN	Specialist	$212.5K	$0

Marion General Hospital — Billing Profile & Reimbursement Data

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Marion General Hospital — 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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