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.

Union Hospital Inc. (NPI 1619975331)

Key Findings

Field	Value
Entity Type	Organization
Organization	Union Hospital Inc.
Address	1606 N 7th St
City	Terre Haute
State	IN
ZIP	47804
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 7, 2005

Payer Source	Total Paid
Medicaid	$47.1M
Medicare	$0

UNION HOSPITAL INC. is effectively a single-payer Medicaid hospital in the available claims data: there is no Medicare billing on file and lifetime Medicaid revenue is $47.1M, so all observed fee-for-service revenue in our dataset is driven by Medicaid activity. This makes Medicaid the dominant commercial lever for this provider’s reported outpatient and procedural volume.

Revenue is highly concentrated in a small set of outpatient/emergency and surgical codes: the precomputed top three Medicaid codes (99285, 99284, 11042) together account for 49.3% of the provider’s total Medicaid revenue. Those three codes individually are reported as 99285 $7.8M (18.3%), 99284 $6.7M (15.6%), and 11042 $6.6M (15.5%), indicating a small number of service lines drive roughly half of Medicaid receipts.

The code mix points to a high-volume emergency department plus substantial wound debridement/surgical care: 99285/99284/99283 are the top ED E/M codes by revenue and together represent a major portion of the top codes, while 11042 (debridement to subcutaneous layer) is a top surgical revenue generator. This combination is consistent with a general acute care hospital operating an active ED that routes a steady caseload into procedural wound care and inpatient or observation management.

Competitive standing across the state is uneven but strong for select services: 11042 ranks #4 of 142 providers in-state at the 98th percentile and is labeled notably above typical state volume, indicating the hospital is a major regional provider for surgical debridement. Chemotherapy (96413) also ranks high at #4 of 65 (95th percentile, labeled notably above typical state volume), and contrast use (Q9967) ranks #3 of 105 (98th percentile, labeled notably above typical state volume), showing the facility runs comparatively high-volume oncology infusion and advanced imaging services.

Some high-volume ED activity appears routine in context: 99285 ranks #13 of 325 providers in-state (96th percentile) but is described as a typical, unremarkable volume for the code, and 99284 and 99283 also appear at high state percentiles while being characterized as typical. That suggests the hospital’s emergency care volumes are large in absolute terms but are consistent with peer community hospitals statewide rather than uniquely dominant.

The hospital is also a major hub for diagnostic and laboratory throughput: very large claim counts for routine labs and tests are present (85025 at 87.4K claims, 80048 at 66.8K claims) and both appear in the 97th percentile or higher and are labeled notably above typical state volume. High claim counts for EKGs (93005, 29.8K claims) and imaging (74177, 4.9K claims; 70450, 4.6K claims) further indicate substantial outpatient and ED diagnostic capacity supporting its clinical volume.

Beyond ED, the provider offers a broad mix of specialty and procedural services that contribute meaningful Medicaid revenue: chemotherapy infusion (96413 $1.5M), abrasion/biopsy and endoscopy codes (43239 $545.3K; 45380 $295.9K), cataract surgery (66984 $949K), and carpal tunnel release (64721 $346K) are present on the top-25 list. These entries show the facility’s service line breadth extends into oncology, ENT/GI endoscopy, ophthalmology, and orthopedics/neurosurgery-type procedures.

Institutional tenure and operational profile are consistent with an established community acute hospital: taxonomy is General Acute Care Hospital and the NPI was enumerated on 2005-07-07 (~21 years ago), indicating long-standing operations that align with the sustained, high-volume Medicaid activity observed across ED, imaging, labs, and several surgical specialties.

Medicaid: Complete Services Breakdown

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

244 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	54,850	$140	$7.8M
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.	42,960	$160	$6.7M
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.	11,230	$590	$6.6M
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.	34,850	$160	$5.5M
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…	29,760	$60	$1.8M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	12,200	$150	$1.8M
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…	14,700	$110	$1.6M
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	10,890	$140	$1.5M
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.	4,870	$240	$1.2M
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	630	$1,500	$949K

Showing 1–10 of 244

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

Union Hospital Inc. — 7 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

244 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	35	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.	38	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.	13	330	1,530	$100	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	30	100	2,210	$70	$926K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	24	30	450	$1,270	$886.9K
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…	12	130	3,770	$60	$617.7K
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.	25	150	440	$100	$545.6K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	86	390	3,600	$50	$511.6K
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…	1,605	2,120	870	$60	$450.6K
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…	34	220	1,850	$30	$449.4K

Showing 1–10 of 244

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Union Associated Physicians Clinic, LLC	IN	Family Medicine Physician	$0	$31.1M
Terre Haute Regional Hospital, L.P.	IN	General Acute Care Hospital	$0	$16.7M
Union Hospital, Inc.	IN	Family Medicine Physician	$0	$6.9M
Union Hospital, Inc.	IN	Critical Access Hospital	$0	$4.1M
Ejaz Shamim	IL	Diagnostic Radiology Physician	$34.5K	$540.6K
Vuppala Reddy	IN	Internal Medicine Physician	$516.3K	$0
Millie Kooistra	IN	Family Nurse Practitioner	$414.4K	$0
Neil Kabous	IN	Cardiovascular Disease Physician	$326.6K	$0
Nawar Mercho	IN	Cardiovascular Disease Physician	$309.5K	$0
Shantilal Patel	IN	Cardiovascular Disease Physician	$303.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hamilton Center, Inc.	IN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$84.5M
Hamilton Center, Inc.	IN	Psychiatric Hospital	$0	$28.6M
Hamilton Center, Inc.	IN	Community/Behavioral Health Agency	$0	$22.1M
Cep America LLC	IN	Emergency Medicine Physician	$0	$9M
East 53rd Street Dental-3, PC	IN	General Practice Dentistry	$0	$4.8M
Gaurav Verma	IN	Nephrology Physician	$551.8K	$0
Manish Gera	IN	Nephrology Physician	$543K	$0
Raj Jeevan	IN	Nephrology Physician	$377.3K	$0
Stephen Fern	IN	Orthopaedic Surgery Physician	$283.6K	$0
Carlos Belmar	IN	Orthopaedic Surgery Physician	$191.6K	$0

Union Hospital 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