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.

Medical Associates (NPI 1710932736)

Key Findings

Field	Value
Entity Type	Organization
Organization	Medical Associates
Address	7150 Clearvista Dr
City	Indianapolis
State	IN
ZIP	46256
Taxonomy	Emergency Medicine Physician
NPI Enumerated	May 24, 2006

Payer Source	Total Paid
Medicaid	$50M
Medicare	$0

MEDICAL ASSOCIATES appears to operate primarily as an emergency medicine practice based on the Medicaid code mix: 99285, 99284, and 99283 (high-, moderate-, and low-complexity ED E/M visits) together account for 97.9% of the provider’s total Medicaid revenue, indicating the organization’s revenue is concentrated in emergency department evaluations and management services. The presence of ancillary ED codes such as 93010 (ECG interpretation) and 99291 (critical care) further supports an ED-centered service line with occasional higher-acuity critical care encounters.

Revenue concentration is extremely high: the top three Medicaid codes (99285, 99284, 99283) generate 97.9% of the provider’s Medicaid revenue, signaling reliance on a narrow set of emergency visit codes for the $50M in reported Medicaid revenue. This narrow concentration suggests financial sensitivity to changes in ED visit volume or reimbursement for those specific E/M levels.

This provider is effectively single-payer in the observed dataset: there is no Medicare billing on file while Medicaid accounts for $50M in lifetime revenue. The lack of Medicare activity means payer mix is dominated by Medicaid, and any competitive or utilization conclusions should be interpreted in the context of a Medicaid-focused billing profile rather than a balanced Medicare/Medicaid practice.

Competitive standing within the state is dominant for high-acuity ED visits: 99284 ranks #1 of 382 providers in-state (100th percentile) and 99285 ranks #2 of 325 providers in-state (100th percentile), both characterized as extreme outliers and far above typical state volume for those codes. These ranks indicate MEDICAL ASSOCIATES is a leading statewide provider of moderate- and high-complexity emergency care by claim volume and revenue.

Despite dominance on top ED codes, volumes for other services are more typical or unremarkable: codes such as 99291 (critical care) rank #29 of 140 providers (80th percentile) and several procedure codes (e.g., 10061, 31500) fall in mid-to-lower statewide percentiles. This pattern suggests the organization’s scale is focused on ED E/M throughput rather than a broad mix of critical care procedures or subspecialty interventions.

Several individual codes are flagged as extreme or notable outliers in state comparisons beyond the top E/M codes: 93010 (ECG interpretation) ranks #2 of 285 providers (100th percentile) and 99053 (overnight facility services) ranks #1 of 44 providers (100th percentile), both described as extreme outliers. These placements reinforce that the practice operates at unusually high volume for certain ED-associated services relative to peers.

The provider has been enumerated for approximately 20 years (NPI enumerated: 2006-05-24), indicating long-standing presence in the market. This tenure combined with outsized ranks on core ED codes suggests an established emergency services operation with sustained Medicaid billing activity over time.

Operationally, the predominance of ED visit codes at different complexity levels (99285, 99284, 99283) implies a high-throughput emergency department handling a broad acuity mix from low to high complexity visits. The very large counts reported for these codes (295.4K claims for 99285, 311.4K for 99284, 155.5K for 99283) point to a volume-driven model where visit counts, rather than high per-claim reimbursement, are the primary revenue drivers under Medicaid for this provider.

Medicaid: Complete Services Breakdown

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

18 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.	295,430	$80	$24.8M
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.	311,430	$60	$18.7M
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.	155,520	$40	$5.4M
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	200,830	$1	$803.3K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	1,980	$90	$176.1K
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.	3,890	$20	$66K
12011	This CPT code is used for the simple repair of superficial wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes, that are 2.5 cm or less in size.	250	$10	$1.8K
12001	This CPT code is used for the simple repair of superficial wounds to the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including the hands and feet) that are 2.5 cm or less in…	490	$1	$1.5K
10060	The provider incises the area of abscess and drains the collection of pus from a lesion, such as a carbuncle, hidradenitis, cyst, furuncle, or paronychia, with the help of surgical instruments. A…	500	$1	$990
12002	This CPT code is used for the simple repair of superficial wounds to the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including the hands and feet) that are 2.6 to 7.5 cm in…	280	$1	$840

Showing 1–10 of 18

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

Medical Associates — 8 of 11 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

18 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.	1	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.	3	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.	2	330	1,530	$100	$1.1M
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.	31	200	280	$130	$321.2K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	29	140	270	$130	$195.3K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	2	290	630	$1	$45.5K
10061	The provider incises the area of abscess and drains the collection of pus, such as those related to a carbuncle, hidradenitis, cyst, furuncle, or paronychia, with the help of surgical instruments. A…	4	10	80	$60	$15K
12011	This CPT code is used for the simple repair of superficial wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes, that are 2.5 cm or less in size.	1	10	200	$20	$2.3K
12001	This CPT code is used for the simple repair of superficial wounds to the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including the hands and feet) that are 2.5 cm or less in…	1	10	110	$10	$1.3K
29125	The provider applies a static, or rigid, splint to the lower arm extending from the elbow to the palm to immobilize an injury to the forearm or wrist during healing or for stabilization of a fracture…	7	10	50	$10	$460

Showing 1–10 of 18

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vincent Keating	IN	Clinical Cardiac Electrophysiology Physician	$185.5K	$0
Nicole Engle	IN	Medical Physician Assistant	$21.5K	$0
Tina Saini	IN	Physician Assistant	$8.7K	$0
Che Phillmann	IN	Family Nurse Practitioner	$5.3K	$0
Kelsey Cairns	IN	Physician Assistant	$3.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Physicians Of Indiana Inc	IN	Family Medicine Physician	$0	$185M
Aba Programming Inc.	IN	Medical Specialty Clinic/Center	$0	$54.7M
Community Health Network, Inc	IN	General Acute Care Hospital	$0	$32.9M
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

Medical Associates — Billing Profile & Reimbursement Data

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Medical Associates — 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