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

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

Lakeland Regional Medical Center, Inc. (NPI 1144228446)

Key Findings

Field	Value
Entity Type	Organization
Organization	Lakeland Regional Medical Center, Inc.
Address	1324 Lakeland Hills Blvd
City	Lakeland
State	FL
ZIP	33805
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 11, 2005

Payer Source	Total Paid
Medicaid	$62.1M
Medicare	$0

This provider is effectively single-payer in publicly reported claims: there is no Medicare billing on file and total Medicaid revenue is $62.1M, so Medicaid represents the entire public payer footprint shown in these data. That concentration means analyses of this facility’s public-payer performance should focus on Medicaid trends and reimbursement policies rather than Medicare comparators.

Revenue is heavily concentrated in a small set of emergency department E/M codes: the precomputed top three Medicaid codes account for 54.8% of total Medicaid revenue, led by 99283 ($15.6M, 31.4% of Medicaid revenue), then 99284 ($7.6M, 15.3%), and 99282 ($4M, 8.0%). This degree of concentration indicates that a majority of Medicaid dollars flow through ED evaluation-and-management visits rather than a broad mix of outpatient or elective procedural lines.

The code mix points to a high-throughput acute care and emergency-service operation: dominant ED E/M codes (99282–99285) are complemented by high-volume diagnostic imaging and lab services such as 70450 (CT head, $1.7M), 74177 (CT abdomen/pelvis with contrast, $1.7M), and 80051 (electrolyte panel, $1.2M). Significant volumes of infusion-related codes (J7030, $2M) and COVID NAAT testing (87635, $1.8M) further support a profile of an acute hospital with substantial ED, observation, infusion, and inpatient/outpatient diagnostic throughput.

State-level competitive standing for core ED services is well above typical: 99283 is ranked #9 of 701 providers in-state (99th percentile; extreme outlier) with 162.9K claims and $96 avg paid/claim, 99282 ranks #5 of 315 providers in-state (99th percentile; extreme outlier) with 43K claims and $93 avg paid/claim, and 99284 ranks #18 of 739 (98th percentile; notably above typical) with 107.3K claims and $71 avg paid/claim. These rankings indicate the provider is among the highest-volume ED service providers in Florida for the specific codes driving its Medicaid revenue.

Multiple ancillary and support services also show outlier-level volumes, reinforcing the high-throughput picture: 80051 is #1 of 170 providers in-state (100th percentile; extreme outlier) with 107.5K claims, J7030 is #2 of 167 (99th percentile; extreme outlier) with 53K claims, 87635 is #2 of 648 (100th percentile; extreme outlier) with 57.3K claims, and 96374 is #2 of 239 (100th percentile; extreme outlier) with 61.1K claims. These concentrations suggest that lab, infusion, and rapid diagnostic services are significant operational and revenue drivers alongside the ED.

Operational and utilization implications are clear from the raw volumes: 99283 alone has 162.9K claims and high relative revenue, and observation services (G0378) appear at scale with 43.5K claims ($696K, ranked #5 of 196, 98th percentile; notably above typical). High claim counts for ED E/M plus observation and frequent imaging/lab use imply sustained demand for ED staff, observation beds, imaging capacity, and infusion/IV supply chains.

The provider’s enrollment history shows a long tenure: NPI enumerated on 2005-07-11 (~21 years ago), indicating an established facility with multi-year presence in the market. That longevity, combined with the high state-level ranks on multiple codes, supports interpretation of these patterns as structural features of the hospital rather than short-term anomalies.

From a payer or network management perspective, the combination of no Medicare billing on file, $62.1M in Medicaid revenue, and a concentrated revenue base (54.8% from top three codes) signals both negotiation focus areas and concentration risk. Contracting, utilization management, and capacity planning should prioritize ED E/M, infusion, and high-volume lab/imaging services because changes in Medicaid reimbursement or utilization patterns for those categories would disproportionately affect the provider’s revenue and service capacity.

Medicaid: Complete Services Breakdown

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

374 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.	162,930	$100	$15.6M
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.	107,260	$70	$7.6M
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.	43,000	$90	$4M
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.	41,120	$70	$2.8M
J7030	Infusion, normal saline solution , 1000 cc	52,960	$40	$2M
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…	57,310	$30	$1.8M
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.	15,760	$110	$1.7M
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.	11,490	$150	$1.7M
80051	The lab analyst performs an electrolyte panel; this panel must include measurement of carbon dioxide, chloride, potassium, and sodium.	107,500	$10	$1.2M
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	17,580	$70	$1.2M

Showing 1–10 of 374

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Florida Distribution

Lakeland Regional Medical Center, Inc. — 15 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. Florida median

374 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	9	700	2,400	$80	$1.2M
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.	18	740	2,180	$70	$1.1M
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.	26	660	1,900	$70	$743.6K
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.	5	320	1,970	$90	$463.1K
G0257	Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility	6	30	500	$250	$377.6K
44970	Laparoscopy, surgical, appendectomy	5	10	60	$1,820	$372.9K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	58	80	230	$400	$331.4K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	275	2,250	1,250	$50	$324.4K
G0381	Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is…	8	10	2,100	$70	$324.2K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	29	210	2,890	$70	$321.6K

Showing 1–10 of 374

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lakeland Regional Health Systems, Inc.	FL	Multi-Specialty Clinic/Center	$0	$12.1M
Ethan Carey	FL	Physician Assistant	$567.7K	$0
Frances Martin	KY	Urology Physician	$532.8K	$0
Ghulam Thaver	AL	Diagnostic Radiology Physician	$444.7K	$0
Paul Rochon	CO	Vascular & Interventional Radiology Physician	$420.6K	$0
Edward Denstman	CT	Diagnostic Radiology Physician	$420K	$0
Zia Rab	FL	Interventional Cardiology Physician	$365.6K	$0
William Upshaw	FL	Psychiatry Physician	$310.3K	$0
Anthony Infante	FL	Orthopaedic Surgery Physician	$294.9K	$0
Mark Mines	FL	Interventional Cardiology Physician	$251K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Osprey Emergency Physicians LLC	FL	Emergency Medicine Physician	$0	$14.6M
Good Shepherd Hospice, Inc.	FL	Community Based Hospice Care Agency	$0	$10.3M
Bio-medical Applications Of Florida, Inc.	FL	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$9.6M
Total Renal Care Inc	FL	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$9.1M
Watson Clinic LLP	FL	Clinical Medical Laboratory	$3.4M	$2.7K
Leonard Gitter	FL	Medical Oncology Physician	$2.5M	$0
Shalini Mulaparthi	FL	Medical Oncology Physician	$2.2M	$0
David Graham	FL	Radiation Oncology Physician	$1.7M	$0
Richard Hamilton	FL	Retina Specialist (Ophthalmology) Physician	$1.6M	$0
Sandra Sha	FL	Radiation Oncology Physician	$1.5M	$0

Lakeland Regional Medical Center, Inc. — Billing Profile & Reimbursement Data

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Lakeland Regional Medical Center, Inc. — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References