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.

Radiology, Inc (NPI 1578557815)

Radiology, Inc is a diagnostic radiology physician provider located in Mishawaka, Indiana. This profile covers 0 Medicare and 94 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	Radiology, Inc
Address	620 W Edison Rd
City	Mishawaka
State	IN
ZIP	46545
Taxonomy	Diagnostic Radiology Physician
NPI Enumerated	September 1, 2005

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.

94 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	45,140	$50	$2.4M
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	50,780	$20	$1.2M
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	178,380	$10	$891.9K
71275	In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a…	10,480	$50	$534.3K
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…	60,530	$10	$363.2K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	12,620	$20	$290.2K
77063	The provider captures three dimensional images of the breast using X–rays at various angles for routine checkup. He checks for the presence of any abnormality within the breasts. Tomosynthesis…	10,900	$20	$196.1K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	3,360	$40	$131.1K
76705	An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code…	5,100	$20	$81.5K
72125	In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the cervical spine without contrast material.	2,840	$30	$70.9K

Showing 1–10 of 94

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

Radiology, 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

94 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	7	150	440	$100	$545.6K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	5	220	1,850	$30	$449.4K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	6	170	430	$30	$192.2K
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…	8	270	470	$30	$171.9K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	11	40	290	$90	$163.8K
71275	In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a…	6	60	180	$60	$159.6K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	39	130	410	$70	$133.5K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	8	90	650	$30	$125.8K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	14	100	280	$50	$113.8K
76770	A retroperitoneal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e.Kidneys, urinary bladder, and aorta). This particular code is used when the ultrasound is…	14	40	170	$50	$104.9K

Showing 1–10 of 94

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Nazar Golewale	IN	Vascular & Interventional Radiology Physician	$2.6M	$268.9K
Joel Baber	IL	Diagnostic Radiology Physician	$68.8K	$241.7K
Karl Schultz	MI	Orthopaedic Surgery Physician	$233.6K	$0
Tiffany Sae Kho	MN	Diagnostic Radiology Physician	$192.1K	$0
Albert Cho	IN	Diagnostic Radiology Physician	$168.9K	$0
Timothy Tsai	IN	Diagnostic Radiology Physician	$163.3K	$580
Nicholas Abel	IN	Diagnostic Radiology Physician	$159.6K	$0
Mark Crain	IN	Diagnostic Radiology Physician	$154.3K	$0
Samir Patel	IN	Diagnostic Radiology Physician	$127.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Joseph Regional Medical Center-south Bend Campus, Inc.	IN	General Acute Care Hospital	$0	$18.7M
Toxusa Labs LLC	IN	Clinical Medical Laboratory	$1.3M	$9.6M
Pic Indiana PC	IN	Urgent Care Clinic/Center	$0	$10.7M
Miracle Lane Family Dentistry P.C.	IN	Dental Clinic/Center	$0	$5.1M
Michiana Eye Center LLC	IN	Ophthalmology Physician	$0	$5M
Saint Joseph Regional Medical Center-south Bend Campus, Inc.	IN	Family Medicine Physician	$0	$4.8M
Northern Indiana Interim Healthcare Company LLC	IN	Home Health Agency	$0	$4.5M
Del Pilar Medical & Urgent Care PC	IN	Geriatric Medicine (Family Medicine) Physician	$0	$3.6M
Michiana Hematology-oncology P C	IN	Medical Oncology Physician	$0	$3M
Linda Monroe	IN	Clinical Psychologist	$15.4K	$2.9M

Radiology, 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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