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.

Sound Physicians Of Indiana, LLC (NPI 1528311149)

Sound Physicians Of Indiana, LLC is a hospitalist physician provider located in Gary, Indiana. This profile covers 0 Medicare and 31 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	Sound Physicians Of Indiana, LLC
Address	600 Grant St
City	Gary
State	IN
ZIP	46402
Taxonomy	Hospitalist Physician
NPI Enumerated	October 19, 2012

Payer Source	Total Paid
Medicaid	$4.2M
Medicare	$0

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

31 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…	46,240	$40	$1.8M
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…	12,920	$80	$981.5K
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…	24,880	$30	$696.6K
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…	10,620	$40	$403.6K
99220	N/A	3,800	$30	$121.7K
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…	16,100	$10	$80.5K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	10,280	$1	$30.8K
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…	450	$50	$23.7K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	460	$20	$9.6K
99217	N/A	1,530	$10	$7.7K

Showing 1–10 of 31

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

Sound Physicians Of Indiana, LLC — 5 of 19 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

31 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	32	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…	95	140	270	$130	$195.3K
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…	7	360	430	$50	$177.4K
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…	7	330	210	$80	$126.9K
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…	8	190	190	$50	$90.2K
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…	18	270	920	$10	$88.4K
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…	109	280	210	$70	$83.4K
99349	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	42	90	250	$30	$73.3K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	185	240	400	$20	$53.5K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	91	280	160	$40	$52.2K

Showing 1–10 of 31

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Brittany Brinley	CA	Internal Medicine Physician	$902K	$17K
Ricky Bhimani	IN	Internal Medicine Physician	$152.1K	$19.5K
Steven He	GA	Internal Medicine Physician	$152.5K	$360
Joseph El-houjairy	IN	Hospitalist Physician	$138K	$0
Khaleelur Zackariya	IN	Addiction Medicine (Internal Medicine) Physician	$136.3K	$0
Frank Boateng	OH	Nephrology Physician	$117.8K	$0
Ali Ghasham	MI	Family Medicine Physician	$110.4K	$0
Muhammad Imran	MI	Internal Medicine Physician	$83.4K	$0
Sharmaine Habib	ND	Hospitalist Physician	$67.4K	$0
Peter Jensen	AL	Family Medicine Physician	$56.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Methodist Hospitals, Inc	IN	General Acute Care Hospital	$0	$75.6M
Edgewater Systems For Balanced Living, Inc	IN	Community/Behavioral Health Agency	$0	$17.8M
City Of Gary Indiana	IN	Ambulance	$442.6K	$7.2M
Cep America LLC	IN	Emergency Medicine Physician	$0	$6.9M
Community Healthnet Inc	IN	Community Health Clinic/Center	$0	$6M
Edgewater Systems For Balanced Living, Inc	IN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3.6M
Edgewater Systems For Balanced Living, Inc.	IN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$2.8M
Akeem Kareem	IN	Family Nurse Practitioner	$80.4K	$0
Amanda Neary	IN	Certified Registered Nurse Anesthetist	$13K	$10.9K
Elizabeth Baldys	IN	Physician Assistant	$17.8K	$0

Sound Physicians Of Indiana, LLC — Billing Profile & Reimbursement Data

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Sound Physicians Of Indiana, 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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