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 Louisiana for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Louisiana 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. Louisiana (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.

East Baton Rouge Medical Center LLC (NPI 1053360651)

Key Findings

Field	Value
Entity Type	Organization
Organization	East Baton Rouge Medical Center LLC
Address	17000 Medical Center Dr
City	Baton Rouge
State	LA
ZIP	70816
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 9, 2006

Payer Source	Total Paid
Medicaid	$48.3M
Medicare	$0

This provider has no Medicare billing on file and is effectively a Medicaid-focused operation at the scale reported: Total Medicaid revenue is $48.3M and there is no Medicare revenue recorded. The absence of Medicare billing makes Medicaid the sole publicly reported payer driving the facility’s revenue profile and competitive positioning in-state.

Revenue is highly concentrated in a small set of E/M codes: the precomputed top 3 Medicaid codes account for 57.5% of this provider’s total Medicaid revenue, led by 99284 ($11.5M, 27.7%), 99285 ($6.4M, 15.4%), and 99213 ($6M, 14.5%). This concentration indicates that a majority of Medicaid dollars flow through emergency and high-volume outpatient evaluation-and-management services.

The mix of high-revenue codes points to a hospital-centered operation with heavy emergency department throughput and substantial outpatient clinic activity: 99284, 99285, and 99283 are among the top revenue drivers for ED visits, while 99213 and related office E/M codes show very large outpatient claim volumes (99213: 177.4K claims). Together these code patterns are consistent with a General Acute Care Hospital that manages a broad spectrum of acute ED cases alongside high-volume ambulatory care.

Competitive standing is uneven across service lines: 99213 ranks #15 of 3226 in-state and is labeled an "extreme outlier, far above typical state volume," signaling market dominance in office/outpatient E/M visits. Several diagnostic and lab codes (for example, 87389 ranks #2 of 130 at the 99th percentile and 85025 ranks #9 of 379 at the 98th percentile) are also extreme or notable outliers, indicating outsized state-level lab/testing throughput relative to peers.

Emergency-department acuity is broad: the presence of large revenues from 99285 (high MDM; $6.4M) and 99284 (moderate MDM; $11.5M) alongside substantial volume for 99283 (low MDM; $5.7M) shows the ED is treating a full range of complexity. While the rank/percentile notes for 99284 and 99285 (92th and 86th percentiles, respectively) are described as "typical, unremarkable volume," their absolute dollar contributions make them central to the provider’s Medicaid revenue mix.

Diagnostic, laboratory, and ancillary services are meaningful secondary revenue streams: high claim volumes and above-typical state percentiles for 87635 (28.6K claims, $1.1M; 97th percentile, notably above typical), 85025 (105.9K claims, $529.7K; 98th percentile, notably above typical), and 93005 (39.4K claims, $473.3K; 96th percentile, notably above typical) suggest substantial onsite lab and ECG capacity that supports both ED and outpatient workflows. These ancillary services amplify revenue even beyond core E/M billing.

Because Medicaid accounts for all reported public payer revenue ($48.3M) and Medicare is absent, the provider is particularly sensitive to Medicaid reimbursement policy and enrollment shifts: any material change in Medicaid rates, scope, or utilization management could have outsized impact on overall revenue. The single-payer concentration increases financial and strategic exposure compared with more diversified payer mixes.

The provider’s NPI has been enumerated since 2006-05-09 (~20 years ago), indicating an established presence in the Baton Rouge market. Combined with the high-volume and extreme-outlier code ranks in several outpatient and lab services, the tenure and utilization profile point to a mature facility with entrenched ED and ambulatory operations rather than a newly scaled entrant.

Medicaid: Complete Services Breakdown

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

288 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	68,970	$170	$11.5M
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.	36,120	$180	$6.4M
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…	177,440	$30	$6M
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.	53,910	$110	$5.7M
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,…	68,900	$30	$2.1M
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	28,580	$40	$1.1M
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…	19,010	$50	$988.4K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	14,470	$60	$882.5K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	97,770	$10	$684.4K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	18,330	$30	$549.9K

Showing 1–10 of 288

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Louisiana providers billing the same CPT/HCPCS codes.

Claims Volume vs. Louisiana Distribution

East Baton Rouge Medical Center LLC — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Louisiana

Full comparison — all codes billed, vs. Louisiana median

288 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.	22	270	9,980	$110	$2.6M
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.	33	240	4,030	$130	$2M
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.	19	270	11,250	$90	$1.8M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	48	100	620	$40	$560K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	16	30	2,260	$110	$460.1K
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.	65	100	760	$100	$441.2K
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…	42	90	1,270	$50	$375.3K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	44	150	1,070	$60	$346.2K
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.	40	170	1,260	$70	$322.4K
87653	The lab analyst performs a test for Streptococcus, group B, using amplified nucleic acid probe technique. The amplified probe provides a rapid means to assess colonization by Streptococcus, group B,…	20	30	390	$20	$285.9K

Showing 1–10 of 288

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Moreau Physical Therapy Inc.	LA	Physical Therapist	$0	$23.1M
Holistic Health Care Services, Inc.	LA	Intellectual Disabilities Intermediate Care Facility	$0	$13.7M
F C P A, LLC	LA	In Home Supportive Care Agency	$0	$12.8M
Greater Fellowship Outreach Center	LA	Attendant Care Provider	$0	$11.7M
Beginners Mind, Inc	LA	Case Management Agency	$0	$11.4M
Mayfair Emergency Group, LLC	LA	Emergency Medicine Physician	$0	$11.3M
Our Grace LLC	LA	In Home Supportive Care Agency	$0	$11.2M
Graves LLC	LA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.4M
South Regional Personal Care Service, LLC	LA	Community Based Hospice Care Agency	$0	$7.2M
Acadian Diagnostic Laboratories LLC	LA	Clinical Medical Laboratory	$0	$6.8M

East Baton Rouge Medical Center LLC — Billing Profile & Reimbursement Data

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East Baton Rouge Medical Center LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References