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NPI 1972500452 · Anderson, IN · General Acute Care Hospital
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Community Hospital Of Anderson & Madison County, Inc is a general acute care hospital provider located in Anderson, Indiana. This profile covers 0 Medicare and 179 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 | Community Hospital Of Anderson & Madison County, Inc |
| Address | 1515 N Madison Ave |
| City | Anderson |
| State | IN |
| ZIP | 46011 |
| Taxonomy | General Acute Care Hospital |
| NPI Enumerated | June 30, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $32.3M |
| Medicare | $0 |
This provider is effectively a Medicaid-centric hospital: total Medicaid revenue on file is $32.3M and there is no Medicare billing on file, so the facility operates with a single large public-payer footprint rather than a mixed Medicare/Medicaid payer mix. The NPI was enumerated on 2005-06-30 (≈21 years ago), indicating an established presence in the market.
Revenue is highly concentrated in a small set of outpatient emergency and diagnostic services: the precomputed top-3 Medicaid codes account for 52.6% of total Medicaid revenue, led by 99283 ($7M, 23.1%), 99284 ($6.7M, 22.2%), and 71045 ($2.2M, 7.2%). This concentration implies that a majority of Medicaid dollars flow through relatively few high-volume ED and chest-imaging services.
The code mix points to a busy emergency-department–centric operation supported by imaging and lab throughput: 99283 (46.2K claims, $152 avg paid/claim), 99284 (45.2K claims, $149 avg paid/claim), and a large chest X-ray line 71045 (16.3K claims, $134 avg paid/claim) together drive top-line Medicaid revenue. Additional ED-related services with meaningful volumes include 99285 (16K claims) and CT abdomen/pelvis 74177 (4.6K claims, $346 avg paid/claim), indicating on-site diagnostic imaging capacity to support acute care.
On statewide competitive standing the hospital is a major ED participant rather than a single dominant center: 99283 ranks #25 of 364 providers (93rd percentile) and 99284 ranks #29 of 382 providers (93rd percentile), reflecting high relative volume for those ED E/M levels in Indiana. By contrast, higher-acuity ED care (99285) is more middle-ranked (#58 of 325, 82nd percentile), suggesting strength in moderate- and lower-acuity ED throughput.
Ancillary and lab services are a disproportionate operational feature: venipuncture 36415 appears as an extreme outlier with 98.8K claims and ranks #12 of 646 providers (98th percentile), and CBC 85025 shows 73.1K claims (94th percentile, notably above typical state volume). These outlier lab and specimen-collection volumes imply substantial patient throughput and a sizeable in-house lab activity that supports both ED and outpatient encounters.
The provider shows routine use of acute-care support items—IV administration codes and imaging—that are consistent with high ED and short-stay treatment patterns: 96374 (18.6K claims, $42 avg paid/claim) and 96361 (11.3K claims, $44 avg paid/claim) appear among higher-volume codes, and CT/diagnostic imaging (74177, 70450) contribute meaningful Medicaid revenue. This mix signals operational capacity for infusions, monitoring, and rapid imaging typical of an acute-care community hospital.
Payer-concentration and downstream revenue risk are material because Medicaid accounts for the entire reported facility billing on file; absence of Medicare billing means the hospital lacks Medicare diversification which can affect revenue stability and negotiating position with other payers. Analysts should treat Medicaid reimbursement trends and state policy changes as primary drivers of the facility’s financial sensitivity given the $32.3M Medicaid base.
A number of codes are statistically notable at the state level and warrant attention for capacity and utilization monitoring: 99281 ranks #2 of 51 providers (98th percentile, notably above typical state volume) despite being the lowest-level ED E/M code, and several routine lab panels—80048 (46.5K claims, 95th percentile) and 85025 (73.1K claims, 94th percentile)—are well above typical state volume. These elevated ranks suggest heavy low-acuity ED throughput and extensive point-of-care or in-lab testing that shape both operational workflows and Medicaid revenue distribution.
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.
179 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 46,190 | $150 | $7M |
| 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. | 45,210 | $150 | $6.7M |
| 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… | 16,330 | $130 | $2.2M |
| 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. | 15,970 | $110 | $1.8M |
| 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. | 4,590 | $350 | $1.6M |
| 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… | 25,490 | $60 | $1.5M |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 5,970 | $220 | $1.3M |
| 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. | 6,730 | $140 | $928.5K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 7,710 | $110 | $879.2K |
| 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. | 2,080 | $410 | $856.5K |
Showing 1–10 of 179
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
179 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. | 29 | 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. | 25 | 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. | 58 | 330 | 1,530 | $100 | $1.1M |
| J0585 | Injection, onabotulinumtoxina, 1 unit | 18 | 30 | 280 | $820 | $992.2K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 31 | 100 | 2,210 | $70 | $926K |
| 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… | 14 | 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. | 26 | 150 | 440 | $100 | $545.6K |
| 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… | 29 | 220 | 1,850 | $30 | $449.4K |
| 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. | 29 | 140 | 430 | $220 | $413.2K |
| 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… | 2,128 | 2,380 | 920 | $50 | $376.8K |
Showing 1–10 of 179
Other providers in the same ZIP code as Community Hospital Of Anderson & Madison County, Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Epcha, PC | IN | Emergency Medicine Physician | $0 | $6.8M |
| Bridges Of Hope LLC | IN | Substance Abuse Rehabilitation Facility | $0 | $6.3M |
| Csl Keystone Woods, LLC | IN | Assisted Living Facility | $0 | $3M |
| Physicians Ambulance Service Of Indiana, LLC | IN | Land Ambulance | $530.6K | $1.4M |
| Community Endoscopy Center LLC | IN | Ambulatory Surgical Clinic/Center | $449.3K | $173.8K |
| Larry Blankenship | IN | Neurology Physician | $381.9K | $0 |
| Yi-shuang Yang | IN | Ophthalmology Physician | $258.4K | $0 |
| Tahir Naqvi | IN | Hematology & Oncology Physician | $252.2K | $0 |
| Preetham Jetty | IN | Cardiovascular Disease Physician | $172.8K | $0 |
| Jennifer Fisher | IN | Radiation Oncology Physician | $162.6K | $0 |
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