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NPI 1730488818 · Indianapolis, IN · Federally Qualified Health Center (FQHC)
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Jane Pauley Community Health Center Inc is a federally qualified health center (fqhc) provider located in Indianapolis, Indiana. This profile covers 0 Medicare and 164 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Jane Pauley Community Health Center Inc |
| Address | 1503 N Mitthoeffer Rd Ste 150 |
| City | Indianapolis |
| State | IN |
| ZIP | 46229 |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| NPI Enumerated | March 15, 2011 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $30.1M |
| Medicare | $0 |
This provider is effectively a Medicaid-centric FQHC: it reports no Medicare billing on file and $30.1M in lifetime Medicaid revenue, with an NPI enumerated on 2011-03-15 (~15 years ago), indicating roughly a decade-and-a-half of active enrollment. The absence of Medicare revenue means analysis of its scale and risk should be framed primarily around Medicaid business lines and state-level competition.
Revenue is highly concentrated in a small set of clinic and E&M codes: the precomputed top-3 Medicaid codes account for 64.2% of this provider's total Medicaid revenue, led by T1015 ($7.6M, 26.7%), 99213 ($6.7M, 23.6%), and 99214 ($4M, 13.9%). This concentration indicates the bulk of dollars flow through routine clinic encounters and established-patient office visits rather than procedure- or specialty-driven billing.
The code mix and volumes point to a high-capacity primary care and wraparound clinic model typical of FQHCs: T1015 (Clinic visit/encounter, all-inclusive) and high-volume E&M visits (99213 and 99214) together suggest many bundled primary-care encounters and a focus on longitudinal management of patients. High counts for lower-level E&M (e.g., 99212 and 99213) alongside moderate-complexity visits (99214) imply a mix of routine access visits and ongoing chronic-care follow-up.
On competitive standing within Indiana, this provider is a dominant outlier for key clinic and E&M codes: T1015 ranks #2 of 404 providers in-state (100th percentile; extreme outlier), 99213 ranks #14 of 2377 (99th percentile; extreme outlier), and 99214 ranks #48 of 2122 (98th percentile; notably above typical state volume). Those ranks indicate the organization is a major statewide player for bundled clinic encounters and established-patient office visits, with volumes far above typical peers.
Behavioral health services appear to be a meaningful component of the care mix: psychotherapy codes 90834 ($2.2M, 7.7%), 90837 ($1.3M, 4.4%), and 90832 ($1.2M, 4.4%) together represent a material share of Medicaid revenue and show mid-to-high percentile state rankings (90834 at 95th, 90837 at 93th, 90832 at 96th). While some psychotherapy ranks are described as typical or unremarkable for the state, the absolute revenues indicate integrated behavioral health capacity at scale within the clinic footprint.
Maternal, pediatric, and preventive care are visible in the top-billed codes: preventive medicine codes 99392 ($640.7K, 2.2%) and 99391 ($559.1K, 2.0%) and antepartum codes 59426 ($406.1K, 1.4%) and 59425 ($381.7K, 1.3%) together show the provider delivers both routine preventive visits and maternity-related services. These code-level revenues support a broad primary-care scope that includes well-child visits and obstetric care typical of community health centers.
High-volume vaccine administration and pediatric access are evident from large claim counts for immunization codes: 90471 shows 43K claims for $258.1K (0.9%) and 90472 shows 21.1K claims for $253.1K (0.9%), both ranked notably above typical state volume (90471 at 98th percentile, 90472 at 96th percentile). The combination of many low-dollar vaccine claims with substantial overall clinic visit volume aligns with a practice that runs high-throughput immunization and preventive pediatric services.
The practice also bills a nontrivial amount for dental and oral health procedures, indicating on-site oral health capacity: D7140 ($180K, 0.6%), D0150 ($165.2K, 0.6%), D0210 ($164.1K, 0.6%), and D1110 ($157.7K, 0.6%) appear in the top-25 Medicaid codes and rank at or above typical in-state volumes for dental codes. This mix reinforces the FQHC model of integrated primary, behavioral, maternal, pediatric, and dental services rather than a narrowly specialized clinic.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
164 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 253,620 | $30 | $7.6M |
| 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… | 153,330 | $40 | $6.7M |
| 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… | 59,180 | $70 | $4M |
| 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… | 42,920 | $50 | $2.2M |
| 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… | 18,030 | $70 | $1.3M |
| 90832 | 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… | 31,970 | $40 | $1.2M |
| 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… | 8,660 | $70 | $640.7K |
| 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… | 7,990 | $70 | $559.1K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 18,970 | $30 | $550.2K |
| 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… | 6,350 | $60 | $406.1K |
Showing 1–10 of 164
How this provider's Medicaid billing volume and revenue compare to other Indiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Indiana median
164 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 96152 | N/A | 28 | 40 | 720 | $200 | $1.1M |
| 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… | 31 | 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… | 48 | 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… | 52 | 690 | 1,070 | $80 | $422.3K |
| 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… | 14 | 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… | 93 | 220 | 1,380 | $20 | $360.2K |
| T1015 | Clinic visit/encounter, all-inclusive | 2 | 400 | 5,220 | $20 | $360.2K |
| 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… | 32 | 160 | 1,390 | $70 | $294.8K |
| 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… | 30 | 280 | 880 | $80 | $267.2K |
| 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… | 38 | 190 | 1,680 | $70 | $264.2K |
Showing 1–10 of 164
Other providers in the same ZIP code as Jane Pauley Community Health Center Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| City Optical Co., Inc. | IN | Optometrist | $0 | $5.5M |
| Beltway Surgery Centers, LLC | IN | Ambulatory Surgical Clinic/Center | $867.2K | $0 |
| Peter Koerner | IN | Optometrist | $132.9K | $0 |
| Haihong Mao | IN | Family Medicine Physician | $100.7K | $0 |
| Issa Shammas | IN | Internal Medicine Physician | $79K | $0 |
| Brett Fink | IN | Orthopaedic Surgery Physician | $57.6K | $0 |
| Kristin Kindred | IN | Foot & Ankle Surgery Podiatrist | $28.2K | $0 |
| Mary Ann Wietbrock | IN | Clinical Nurse Specialist | $15.1K | $0 |
| Krista Brandle | IN | Clinical Social Worker | $1.6K | $0 |
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