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.

Beacon Medical Group, Inc. (NPI 1548415474)

Beacon Medical Group, Inc. is a pediatrics physician provider located in South Bend, Indiana. This profile covers 0 Medicare and 47 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	Beacon Medical Group, Inc.
Address	100 Navarre Pl Ste 5550
City	South Bend
State	IN
ZIP	46601
Taxonomy	Pediatrics Physician
NPI Enumerated	November 19, 2008

Payer Source	Total Paid
Medicaid	$4.7M
Medicare	$0

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

47 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…	30,100	$70	$2.2M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	9,220	$100	$939.9K
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…	4,570	$110	$502.4K
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…	6,760	$50	$331.4K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	1,760	$130	$233.9K
94375	The provider performs a respiratory flow volume loop study to differentiate a patient's obstructive pulmonary disorder from restrictive pulmonary disorders. He may also use the procedure to…	4,590	$30	$119.4K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	1,190	$90	$102.6K
97803	The provider reassesses the dietary needs of a patient and uses specific diet therapy to treat medical conditions and related symptoms by interacting individually with the patient. This code…	1,010	$70	$68.6K
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	520	$90	$47.4K
94060	The spirometry test is performed with a spirometer. The instrument displays a graphical representation, known as a spirogram, of the test results. The basic forced volume vital capacity (FVC) test is…	630	$40	$24.1K

Showing 1–10 of 47

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

Beacon Medical Group, Inc. — 4 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

47 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	3	10	520	$320	$716.5K
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…	89	2,120	870	$60	$450.6K
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…	464	2,380	920	$50	$376.8K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	112	130	360	$280	$234.4K
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…	322	530	740	$30	$210K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	9	60	120	$320	$177.6K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	379	520	240	$80	$165K
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…	261	330	210	$80	$126.9K
94375	The provider performs a respiratory flow volume loop study to differentiate a patient's obstructive pulmonary disorder from restrictive pulmonary disorders. He may also use the procedure to…	4	20	200	$40	$113.5K
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…	42	790	150	$90	$99.4K

Showing 1–10 of 47

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
La Porte Clinic Company LLC	IN	Internal Medicine Physician	$0	$18.8M
Beacon Medical Group, Inc.	IN	Urgent Care Clinic/Center	$0	$7.2M
Beacon Medical Group, Inc.	IN	Family Medicine Physician	$0	$4.7M
Beacon Medical Group, Inc.	IN	Critical Care Medicine (Internal Medicine) Physician	$0	$4.6M
Beacon Medical Group, Inc.	IN	Psychiatry Physician	$0	$4.4M
Beacon Medical Group, Inc.	IN	Family Medicine Physician	$0	$3.4M
Natali Balog	IN	Rheumatology Physician	$2.4M	$0
Adam Duhl	NJ	Maternal & Fetal Medicine Physician	$128.8K	$1.5M
Mary Ann Domingo	IN	Rheumatology Physician	$1.4M	$0
James Jin	IN	Medical Oncology Physician	$1.2M	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Memorial Hospital Of South Bend	IN	General Acute Care Hospital	$0	$33.3M
South Bend Emergency Physicians, Inc	IN	Emergency Medicine Physician	$0	$11.8M
City Of South Bend	IN	Land Ambulance	$874.9K	$8.5M
Healthlinc, Inc	IN	Federally Qualified Health Center (FQHC)	$0	$5.5M
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
Brian Schirf	IN	Vascular & Interventional Radiology Physician	$574.9K	$200
Nicholas Rizzo	IN	Internal Medicine Physician	$269.6K	$0

Beacon Medical Group, 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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