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.

Major Hospital (NPI 1811406531)

Major Hospital is a rural health clinic/center provider located in Shelbyville, Indiana. This profile covers 0 Medicare and 51 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	Major Hospital
Address	2451 Intelliplex Dr Ste 260
City	Shelbyville
State	IN
ZIP	46176
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	September 26, 2017

Payer Source	Total Paid
Medicaid	$9.5M
Medicare	$0

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

51 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	75,950	$70	$5.5M
T1015	Clinic visit/encounter, all-inclusive	83,590	$20	$1.7M
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…	17,680	$50	$919.2K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	3,450	$90	$314K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	6,630	$30	$205.5K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	8,640	$20	$198.7K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	1,680	$80	$130.7K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	1,290	$90	$115.1K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	840	$110	$92.7K
99310	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…	2,870	$30	$83.2K

Showing 1–10 of 51

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

Major Hospital — 2 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

51 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	286	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…	35	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…	230	2,380	920	$50	$376.8K
T1015	Clinic visit/encounter, all-inclusive	14	400	5,220	$20	$360.2K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	59	220	190	$90	$112.1K
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…	156	790	150	$90	$99.4K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	34	510	180	$90	$93.6K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	38	270	920	$10	$88.4K
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…	503	890	160	$60	$76.8K
99349	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	47	90	250	$30	$73.3K

Showing 1–10 of 51

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Major Hospital	IN	General Acute Care Hospital	$0	$14.2M
Ramon Halum	IN	Vascular & Interventional Radiology Physician	$174.1K	$0
Usman Qadeer	IL	Neurology Physician	$105.5K	$14.2K
Thomas Webb	IN	Vascular Surgery Physician	$117.7K	$0
Kerri Kissell	IN	Endocrinology, Diabetes & Metabolism Physician	$117.6K	$0
Sajjad Hussain	IN	Vascular Surgery Physician	$100.7K	$0
Nicole Bowman	IN	Family Nurse Practitioner	$48.7K	$0
Charles Kiell	IN	Vascular Surgery Physician	$35.3K	$0
Carlos Vieira	IN	Surgery Physician	$27.7K	$0
Christa Lewis	IN	Obstetrics & Gynecology Physician	$25.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dasco-major Home Medical Equipment, LLC	IN	Oxygen Equipment & Supplies (DME)	$0	$8.4M
Major Hospital	IN	Rural Health Clinic/Center	$0	$7.7M
Major Multispecialty Associates	IN	Internal Medicine Physician	$0	$4.8M
Emhardt Pediatric Dentistry LLC	IN	Pediatric Dentistry	$0	$2.6M
City Of Shelbyville & Sewage Works Operating	IN	Ambulance	$354.8K	$2.1M
Jaime Ayon	IN	Hematology & Oncology Physician	$342K	$0
Zachary Toppe	IN	Optometrist	$106.4K	$310
Robert Shellman	IN	Pulmonary Disease Physician	$68.7K	$0
Basil Holoyda	IN	Neurology Physician	$66.9K	$0
Jonathan Bielefeld	IN	Diagnostic Radiology Physician	$65.6K	$0

Major Hospital — Billing Profile & Reimbursement Data

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Major Hospital — 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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