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NPI 1568407310 · Indianapolis, IN · General Acute Care Hospital
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The Health And Hospital Corporation Of Marion County is a general acute care hospital provider located in Indianapolis, Indiana. This profile covers 0 Medicare and 353 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | The Health And Hospital Corporation Of Marion County |
| Address | 720 Eskenazi Ave |
| City | Indianapolis |
| State | IN |
| ZIP | 46202 |
| Taxonomy | General Acute Care Hospital |
| NPI Enumerated | June 17, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $231.6M |
| Medicare | $0 |
THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY is registered as a General Acute Care Hospital and its NPI was enumerated on 2006-06-17 (~20 years ago). This profile shows no Medicare billing on file and $231.6M in lifetime Medicaid revenue, indicating the organization’s billed volume in our data is effectively single-payer Medicaid.
The service mix indicates a heavy focus on emergency medical services and emergency department care. High-revenue transport codes A0429 ($44.5M), A0427 ($28.1M), and ground mileage A0425 ($8M) combined with ED E/M codes 99283 ($23.1M), 99282 ($13.1M), and 99284 ($12.3M) point to integrated pre-hospital ambulance operations feeding a high-volume ED.
This provider is a dominant statewide supplier of ambulance services: A0429 ranks #1 of 195 providers in-state (100th percentile; extreme outlier), A0427 ranks #1 of 181 providers (100th percentile; extreme outlier), and A0425 ranks #1 of 327 providers (100th percentile; extreme outlier). Those rank/percentile positions characterize the organization as the clear leader in Medicaid-funded emergency transport in Indiana.
The hospital also ranks at or near the top of the state for multiple ED and outpatient visit codes, signaling major competitive standing across acute outpatient access points. Examples include 99283 at $23.1M (rank #4 of 364, 99th percentile; extreme outlier), 99282 at $13.1M (rank #1 of 197, 100th percentile; extreme outlier), and G0463 at $8.9M (rank #2 of 99, 99th percentile; extreme outlier).
Behavioral health services contribute meaningful Medicaid revenue and volume, suggesting sizable psychiatric clinic or consult capacity. Psychotherapy and evaluation codes 90837 ($5.6M, rank #7 of 687, 99th percentile; extreme outlier), 90834 ($4.1M, rank #29 of 584, 95th percentile; typical), and 90791 ($1.5M, rank #17 of 521, 97th percentile; notably above typical) together indicate substantial ongoing mental health visits billed to Medicaid.
The provider also shows considerable procedural and diagnostic throughput across imaging and endoscopy. Notable items include chest x-ray 71046 ($6.4M, rank #9 of 266, 97th percentile; notably above typical), colonoscopic polypectomy 45385 ($6.2M, rank #2 of 61, 98th percentile; extreme outlier), and CT abdomen/pelvis 74177 ($2.1M, rank #23 of 147, 85th percentile; typical), reflecting robust hospital-based diagnostic and procedural capacity.
Operational and payer-mix implications follow from the concentration in ambulance and ED codes alongside the lack of Medicare billing on file. With $231.6M in Medicaid revenue and no Medicare claims, the organization is highly exposed to Medicaid reimbursement dynamics and utilization patterns; the fact that the top 3 codes account for 46.9% of Medicaid revenue underscores material revenue dependence on emergency transport and ED services.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
353 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 235,550 | $190 | $44.5M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 128,820 | $220 | $28.1M |
| 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. | 141,460 | $160 | $23.1M |
| 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. | 85,050 | $150 | $13.1M |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 143,300 | $90 | $12.9M |
| 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. | 78,700 | $160 | $12.3M |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 130,640 | $70 | $8.9M |
| A0425 | Ground mileage, per statute mile | 379,840 | $20 | $8M |
| 71046 | In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and… | 51,640 | $120 | $6.4M |
| 93005 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 93,550 | $70 | $6.4M |
Showing 1–10 of 353
How this provider's Medicaid billing volume and revenue compare to other Indiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Indiana median
353 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 3 | 10 | 540 | $4,910 | $2.2M |
| 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. | 15 | 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. | 4 | 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. | 36 | 330 | 1,530 | $100 | $1.1M |
| 96152 | N/A | 37 | 40 | 720 | $200 | $1.1M |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 2 | 100 | 2,210 | $70 | $926K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1 | 180 | 1,730 | $180 | $744.6K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1 | 200 | 1,130 | $160 | $730.5K |
| 93005 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 2 | 130 | 3,770 | $60 | $617.7K |
| J0178 | Injection, aflibercept, 1 mg | 18 | 20 | 470 | $610 | $598.3K |
Showing 1–10 of 353
Other providers in the same ZIP code as The Health And Hospital Corporation Of Marion County, ranked by combined Medicare and Medicaid revenue.
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