Providers
THOMAS JAMES SMALL, MD
NPI 1720083082, individual, Franklin, IN, Emergency Medicine
5
Evidence tier
informational
score 31 of 100, rank 11153, $657K at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | THOMAS JAMES SMALL, MD |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | June 14, 2005, last updated September 27, 2022 |
| Practice location | 1101 W JEFFERSON ST, STE H, Franklin, IN 46131-2184, 317-736-9655 |
| Specialties | Family Medicine, Addiction Medicine (207QA0401X, license 0102451A IN) Emergency Medicine (207P00000X, primary, license 01025451A IN) Specialist (174400000X, license 25451 IN) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| H0047 | Medicaid service code | $982K | 37% | $457 | $300 (top 5% from $6K) | 65th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $583K | 22% | $91 | $44 (top 5% from $110) | 92nd percentile | |
| 90853 | Group psychotherapyhistory of abuse | $420K | 16% | $59 | $60 (top 5% from $332) | 49th percentile | |
| 99283 | Emergency department visit with low level of medical decision making | $271K | 10% | $85 | $60 (top 5% from $193) | 66th percentile | |
| 99284 | Emergency department visit with moderate level of medical decision making | $143K | 5% | $79 | $86 (top 5% from $224) | 43rd percentile | |
| 99285 | Emergency department visit with high level of medical decision making | $69K | 3% | $88 | $100 (top 5% from $264) | 34th percentile | |
| 80305 | Testing for presence of drug, read by direct observation | $68K | 3% | $12 | $9.23 (top 5% from $22) | 67th percentile | |
| 99282 | Emergency department visit with straightforward medical decision making | $49K | 2% | $109 | $71 (top 5% from $204) | 73rd percentile |
Medicare Part B 2024, largest codes
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| G2087 | Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month | 95 | 32 | $30K | $394 | $409 | 1.0x | 1.5x (90th percentile 2.8x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 100 | 34 | $6K | $84 | $87 | 1.0x | 2.2x (90th percentile 3.8x) |
| G2088 | Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; each additional 30 minutes beyond the first 120 minutes (list separately in addition to code for primary procedure) | 199 | 24 | $6K | $34 | $36 | 1.0x | 1.6x (90th percentile 2.8x) |
| 80305 | Testing for presence of drug, read by direct observation | 167 | 31 | $2K | $13 | $12 | 1.0x | 3.2x (90th percentile 8.2x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
5 providers in Johnson County, IN carry an indicator in the public record, with $8.6M at stake between them. The most common is more hours than a day holds, on 3 of them, followed by part of a provider network on 2.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | INDIANA MASONIC HOME, INC. Franklin, IN, ranked 3015 | $0 |
|
| 3 | JOHNSON MEMORIAL HOSPITAL Franklin, IN, ranked 5513 | $0 |
|
| 4 | EMILY ZARSE Greenwood, IN, ranked 8491 | $3.6M |
|
| 4 | BENJAMIN COPLAN Greenwood, IN, ranked 8595 | $2.8M |
|
| 5 | JENNIFER COMER Greenwood, IN, ranked 9955 | $2.2M |
|
Recent enforcement in IN
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJSentencedJun 18, 2026
Florida Man Sentenced to 36 Months in Prison
As vice president of a dental practice, he submitted claims to Indiana Medicaid falsely billing for hundreds of dental surgeries that were never performed, used patients' personal identifiers without authorization to support the claims, and committed tax evasion to conceal the income.
DOJSentencedFeb 18, 2026
Highland Physician Sentenced to 97 Months in Prison
Cataldi, sole owner of an otolaryngology practice, billed Medicare and private insurance for thousands of balloon sinuplasty procedures that she did not perform, seeking approximately $50 million and being paid almost $20 million.
DOJCivil settlementJan 28, 2026
Settlement for $1.7 Million With Former Physician Don J. Wagoner and His Business Entity for Fraudulently Billing the Indiana Medicaid Program
Defendants required patients seeking opioid or pain medicine prescriptions to give a single urine sample, tested it with one inexpensive multiplexed screening kit, and billed Indiana Medicaid $171.27 or more per patient by falsely certifying that nine or more separate samples had been collected and analyzed.
DOJSentencedJan 8, 2026
Indiana Woman Sentenced to 84 Months in Prison
Reese falsely claimed to be a licensed clinical psychologist, used forged documents to obtain employment and stole the identities and license numbers of three medical professionals to enroll in Indiana Medicaid and bill for therapy services.
DOJSentencedOct 3, 2024
Merrillville Doctor Sentenced to Prison and Ordered to Pay Restitution
Farley submitted claims to Medicaid and Medicare falsely representing that he had complex, extended visits with patients at his addiction treatment practice, billing for more than 7,000 services he did not provide.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.