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.

Franciscan Health Indianapolis & Mooresville (NPI 1548458409)

Franciscan Health Indianapolis & Mooresville is a family medicine physician provider located in Indianapolis, Indiana. This profile covers 0 Medicare and 92 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	Franciscan Health Indianapolis & Mooresville
Address	5230a East Stop 11 Road
City	Indianapolis
State	IN
ZIP	46237
Taxonomy	Family Medicine Physician
NPI Enumerated	October 4, 2007

Payer Source	Total Paid
Medicaid	$6.8M
Medicare	$0

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

92 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…	26,580	$60	$1.6M
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…	14,410	$90	$1.3M
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…	11,570	$80	$948.3K
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…	6,750	$90	$573.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3,720	$90	$320.1K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	13,560	$20	$244K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	19,630	$10	$235.6K
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…	3,640	$50	$171.3K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	2,780	$60	$169.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,750	$90	$152K

Showing 1–10 of 92

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

Franciscan Health Indianapolis & Mooresville — 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

92 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
96152	N/A	40	40	720	$200	$1.1M
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…	519	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…	201	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…	144	2,380	920	$50	$376.8K
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…	91	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…	19	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…	90	190	1,680	$70	$264.2K
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…	33	290	770	$80	$250.8K
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…	277	530	740	$30	$210K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	44	320	310	$80	$133.9K

Showing 1–10 of 92

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Franciscan Health Indianapolis & Mooresville	IN	General Acute Care Hospital	$0	$41.3M
Franciscan Health Indianapolis & Mooresville	IN	General Acute Care Hospital	$0	$12.3M
St. Francis Medical Group, LLC	IN	Internal Medicine Physician	$0	$9.9M
Franciscan Surgery Center, LLC	IN	Ambulatory Surgical Clinic/Center	$1.2M	$356K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Apria Healthcare LLC	IN	Durable Medical Equipment & Medical Supplies	$0	$176.1M
Franciscan Physician Network	IN	Family Medicine Physician	$0	$105.4M
Emergency Physicians Of Indianapolis, PC	IN	Emergency Medicine Physician	$0	$15.2M
Annette T. Farthing Dds, PC	IN	Pediatric Dentistry	$0	$5.5M
Apria Healthcare LLC	IN	Durable Medical Equipment & Medical Supplies	$0	$4.5M
Global Smiles Dental	IN	Dentist	$0	$4.1M
Kidz Dental Partners, LLC	IN	Pediatric Dentistry	$0	$2.6M
The Endoscopy Center At St. Francis, LLC	IN	Endoscopy Clinic/Center	$755K	$247.2K
Crystal Wiles	IN	Family Nurse Practitioner	$991.7K	$0
Sachin Mehta	IN	Physical Medicine & Rehabilitation Physician	$539.4K	$0

Franciscan Health Indianapolis & Mooresville — Billing Profile & Reimbursement Data

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Franciscan Health Indianapolis & Mooresville — 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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