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.

Community Physicians Of Indiana Inc (NPI 1619105244)

Key Findings

Field	Value
Entity Type	Organization
Organization	Community Physicians Of Indiana Inc
Address	7240 Shadeland Station
City	Indianapolis
State	IN
ZIP	46256
Taxonomy	Family Medicine Physician
NPI Enumerated	June 22, 2009

Payer Source	Total Paid
Medicaid	$185M
Medicare	$0

COMMUNITY PHYSICIANS OF INDIANA INC shows an effectively single‑payer footprint: there is no Medicare billing on file and the practice reports $185M in lifetime Medicaid revenue, with an NPI enumerated 2009-06-22 (~17 years ago), indicating long tenure in the market. This combination points to an established Medicaid-focused operation rather than a mixed Medicare/Medicaid practice profile.

Revenue is highly concentrated in a small set of E/M codes: the top three Medicaid codes (99213, 99214, 99232) together account for 60.7% of the provider’s total Medicaid revenue. Individually those codes are 99213 $44.4M (26.9% of Medicaid revenue), 99214 $42.6M (25.8%), and 99232 $13.2M (8.0%), which shows the business is heavily dependent on office/outpatient and subsequent inpatient evaluation-and-management services.

The code mix indicates a broad primary care and inpatient evaluation-and-management operation with significant preventive and procedural activity. Extremely high volumes of ambulatory E/M (99213: 888K claims, $50 avg paid/claim; 99214: 645.4K claims, $66 avg paid/claim) are complemented by preventive visits (99391 $7M; 99392 $5.9M; 99393 $2.3M), vaccine administration (90471/90472 combined large claim counts), COVID testing (87426/87428), and obstetric/ultrasound codes (59426, 59425, 76811, ), indicating integrated outpatient, obstetric, and some inpatient services.

On statewide competitive standing the provider is a dominant volume player: 99213 ranks #1 of 2377 providers in-state (100th percentile; extreme outlier) and 99214 ranks at the top percentiles as well. Multiple other high-revenue codes—99232, 99391, 99392, 99223, 99204, 99203, 59426, 59425—also rank #1 of hundreds of in-state providers and are labeled as extreme outliers, which collectively signals market-leading scale across several core service lines.

The sheer claim volumes suggest a multi-site or system-scale operation rather than a small group practice: 888K claims for 99213 and 645.4K claims for 99214, plus 216.1K claims for vaccine administration (90471) and 77.3K claims for COVID testing (87426). These volumes, paired with the code mix, imply high patient throughput in ambulatory primary care and immunization programs as a central operational capability.

Preventive care and pediatric well visits constitute a meaningful service line: 99391 ($7M, 85.2K claims), 99392 ($5.9M, 67.9K claims), and 99393 ($2.3M, 26.8K claims) all rank at or near the top in-state and are described as extreme outliers. Combined with substantial vaccination activity (90471/90472) this points to a strong emphasis on routine preventive services and pediatric well-care within the Medicaid population.

Obstetrics and hospital-based care are notable secondary service lines: mini-global antepartum codes 59426 ($4.9M) and 59425 ($3.5M), fetal reexamination 76816 ($1.5M), and neuraxial anesthesia 01967 ($1.1M) all rank at the top statewide, indicating a sizable maternity and perinatal service footprint. Hospital inpatient E/M codes (99223, 99222, 99233, 99239, 99238) also contribute materially to revenue, showing the provider bills for both initial and subsequent inpatient/observation care.

Statistically, the provider’s billing profile repeatedly registers as an outlier: many high-volume codes are flagged as "extreme outlier" and fall in the 99th–100th statewide percentiles (examples include 99213, 99214, 99232, 99391, 99392). This pattern indicates volumes and revenue per code that are far above typical in-state peers and should flag the provider as a leading Medicaid service-volume center in Indiana.

Medicaid: Complete Services Breakdown

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

408 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…	888,040	$50	$44.4M
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…	645,450	$70	$42.6M
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…	357,930	$40	$13.2M
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…	85,170	$80	$7M
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…	67,850	$90	$5.9M
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…	53,650	$100	$5.5M
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…	58,510	$90	$5.1M
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…	80,170	$60	$5.1M
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…	71,730	$70	$4.9M
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…	55,380	$60	$3.5M

Showing 1–10 of 408

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

Community Physicians Of Indiana Inc — 25 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

408 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	14	10	340	$320	$899.7K
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.	4	10	520	$320	$716.5K
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…	67	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…	2	2,120	870	$60	$450.6K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	262	690	1,070	$80	$422.3K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	2	140	430	$220	$413.2K
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…	1	2,380	920	$50	$376.8K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	100	220	1,380	$20	$360.2K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	3	10	250	$640	$349.8K
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	4	20	250	$100	$344.7K

Showing 1–10 of 408

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The General Hospital Corporation	MA	General Acute Care Hospital	$0	$438M
Community Health Network, Inc	IN	General Acute Care Hospital	$0	$161.7M
Massachusetts General Physicians Organization Inc	MA	Dermatology Physician	$0	$60.2M
Community Health Network, Inc	IN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$37.4M
Community Health Network, Inc	IN	General Acute Care Hospital	$0	$32.9M
Community Hospital Of Anderson & Madison County, Inc	IN	General Acute Care Hospital	$0	$32.3M
Community Hospital South, Inc.	IN	General Acute Care Hospital	$0	$27.3M
Community Howard Regional Health, Inc	IN	General Acute Care Hospital	$0	$25.5M
Boston Emergency Physician Foundation, Inc.	MA	Emergency Medicine Physician	$0	$24.3M
Colorado Permanente Medical Group, P.C.	CO	Internal Medicine Physician	$0	$23.2M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aba Programming Inc.	IN	Medical Specialty Clinic/Center	$0	$54.7M
Medical Associates	IN	Emergency Medicine Physician	$0	$50M
Radiology Of Indiana P C	IN	Diagnostic Radiology Physician	$0	$22.3M
Fairbanks Hospital, Inc.	IN	Psychiatric Hospital	$0	$18.5M
Virag	IN	Clinic/Center	$7.7M	$610
North Campus Surgery Center LLC	IN	Ambulatory Surgical Clinic/Center	$1.3M	$0
Darrel Ross	IN	Radiation Oncology Physician	$870.5K	$0
Kristi George	IN	Neurology Physician	$688.9K	$0
Lorraine Calvert	IN	Adult Health Nurse Practitioner	$484.2K	$0
Ernest Asamoah	IN	Endocrinology, Diabetes & Metabolism Physician	$401.3K	$0

Community Physicians Of Indiana Inc — Billing Profile & Reimbursement Data

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Community Physicians Of Indiana Inc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References