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.

Midwest Child And Adolescent Specialty Group, P.C. (NPI 1588605349)

Midwest Child And Adolescent Specialty Group, P.C. is a pediatrics physician provider located in Terre Haute, Indiana. This profile covers 0 Medicare and 44 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	Midwest Child And Adolescent Specialty Group, P.C.
Address	1310 E Davis Dr
City	Terre Haute
State	IN
ZIP	47802
Taxonomy	Pediatrics Physician
NPI Enumerated	June 10, 2006

Payer Source	Total Paid
Medicaid	$4.8M
Medicare	$0

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

44 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…	37,710	$60	$2.1M
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…	7,190	$90	$610.8K
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…	7,090	$80	$531.7K
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…	6,910	$70	$511.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4,870	$80	$384.4K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	10,640	$20	$180.8K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	19,260	$10	$154.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,640	$80	$124.6K
92551	The provider delivers a limited series of tones or sounds to a patient to determine if the patient’s hearing is in an acceptable range to detect hearing problems.	7,020	$10	$49.1K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	1,320	$40	$48.8K

Showing 1–10 of 44

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

Midwest Child And Adolescent Specialty Group, P.C. — 3 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

44 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	343	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…	97	2,380	920	$50	$376.8K
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…	39	280	880	$80	$267.2K
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…	29	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…	508	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.	27	320	310	$80	$133.9K
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
99203	The provider sees a new 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 provider…	871	890	160	$60	$76.8K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	41	390	990	$20	$74.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	43	290	160	$80	$67.3K

Showing 1–10 of 44

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Summit Bhc Henryville, LLC	IN	Substance Abuse Rehabilitation Facility	$0	$90.6M
Ambulance Management Services Ltd	IN	Land Ambulance	$2.9M	$14.7M
Terre Haute Regional Hospital, L.P.	IN	General Acute Care Hospital	$0	$16.7M
Gibault, Inc.	IN	Psychiatric Residential Treatment Facility	$0	$13.5M
Mosaic	IN	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$8.2M
Providence Medical Group LLC	IN	Multi-Specialty Clinic/Center	$0	$7.3M
City Optical Co., Inc.	IN	Optometrist	$0	$5.9M
Happiness Bag Players, Incorporated	IN	Developmentally Disabled Services Day Training Agency	$0	$5.8M
Wabash Valley Children's Dentistry	IN	Dentist	$0	$5.7M
City Of Terre Haute	IN	Land Ambulance	$669K	$4.4M

Midwest Child And Adolescent Specialty Group, P.C. — Billing Profile & Reimbursement Data

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Midwest Child And Adolescent Specialty Group, P.C. — 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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Frequently Asked Questions

References