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.

Providence Medical Group LLC (NPI 1891729141)

Providence Medical Group LLC is a multi-specialty clinic/center provider located in Terre Haute, Indiana. This profile covers 0 Medicare and 88 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	Providence Medical Group LLC
Address	2723 S 7th St
City	Terre Haute
State	IN
ZIP	47802
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	July 11, 2006

Payer Source	Total Paid
Medicaid	$7.3M
Medicare	$0

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

88 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…	45,430	$50	$2.4M
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…	59,050	$40	$2.1M
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	10,970	$40	$383.9K
J1602	Injection, golimumab, 1 mg, for intravenous use	610	$490	$295.4K
J0129	Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	280	$980	$274K
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…	6,900	$30	$193.2K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	3,990	$50	$191.3K
95250	In this procedure, interstitial glucose levels are measured at regular intervals via subcutaneously implanted sensors provided by physician or other qualified health care professional's office for a…	2,730	$60	$171.7K
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…	2,180	$80	$163.3K
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…	2,040	$70	$140.8K

Showing 1–10 of 88

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

Providence Medical Group LLC — 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

88 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	4	10	450	$1,330	$816K
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…	63	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…	56	2,380	920	$50	$376.8K
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…	64	160	1,390	$70	$294.8K
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…	41	70	750	$120	$276.6K
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…	118	190	1,680	$70	$264.2K
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…	93	530	740	$30	$210K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	63	360	430	$50	$177.4K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	145	270	470	$30	$171.9K
J1602	Injection, golimumab, 1 mg, for intravenous use	1	10	320	$510	$159.4K

Showing 1–10 of 88

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Henry Davis	IN	Rheumatology Physician	$2.2M	$0
Neil Kabous	IN	Cardiovascular Disease Physician	$326.6K	$0
Nawar Mercho	IN	Cardiovascular Disease Physician	$309.5K	$0
Tony Nasser	IN	Cardiovascular Disease Physician	$217.5K	$28.2K
Elias Dalloul	IN	Cardiovascular Disease Physician	$228.7K	$0
Antwan Mardini	IN	Internal Medicine Physician	$222.7K	$0
Sang Huh	IN	Hematology & Oncology Physician	$190.8K	$800
George Bittar	IN	Cardiovascular Disease Physician	$187.8K	$0
Melhem Jabbour	IN	Hematology & Oncology Physician	$160.3K	$0
Isaiah Pittman	IN	Endocrinology, Diabetes & Metabolism Physician	$155.6K	$2.2K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Summit Bhc Henryville, LLC	IN	Substance Abuse Rehabilitation Facility	$0	$90.6M
Ambulance Management Services Ltd	IN	Land Ambulance	$2.9M	$14.7M
Terre Haute Regional Hospital, L.P.	IN	General Acute Care Hospital	$0	$16.7M
Gibault, Inc.	IN	Psychiatric Residential Treatment Facility	$0	$13.5M
Mosaic	IN	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$8.2M
City Optical Co., Inc.	IN	Optometrist	$0	$5.9M
Happiness Bag Players, Incorporated	IN	Developmentally Disabled Services Day Training Agency	$0	$5.8M
Wabash Valley Children's Dentistry	IN	Dentist	$0	$5.7M
City Of Terre Haute	IN	Land Ambulance	$669K	$4.4M
Terre Haute Pulmonary & Pediatric Clinic, LLC	IN	Critical Care Medicine (Internal Medicine) Physician	$0	$4.8M

Providence Medical Group LLC — Billing Profile & Reimbursement Data

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Providence Medical Group LLC — 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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