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.

Lafayette General Medical Center Inc (NPI 1275536799)

Key Findings

Field	Value
Entity Type	Organization
Organization	Lafayette General Medical Center Inc
Address	1214 Coolidge Blvd
City	Lafayette
State	LA
ZIP	70503
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 30, 2005

Payer Source	Total Paid
Medicaid	$31.1M
Medicare	$0

This provider reports no Medicare billing on file and $31.1M in lifetime Medicaid revenue, so Medicaid is effectively the sole payer represented in the available claims data. Absence of Medicare activity means national Medicare benchmarks are not available for comparative analysis and the provider’s observed financial footprint is concentrated entirely in the Medicaid population.

Revenue concentration is extreme: the precomputed top 3 Medicaid codes by revenue account for 74.3% of this provider's total Medicaid revenue. Those three codes are 99284, 99283, and 99285, each representing emergency department evaluation and management visits at moderate, low, and high levels of medical decision making respectively, signaling that a small set of ED services drives the majority of Medicaid receipts.

The code mix points to a high-volume emergency department as the core service line. High-volume ED codes include 99284 (73.5K claims, $9.4M revenue) and 99283 (78.7K claims, $7.3M revenue), and the presence of robust volumes in lab and imaging codes (for example 80053, 85025, 70450, 74177) plus procedure codes such as 96372 and 11042 indicate on-site capacity for diagnostics, injections/infusions, and wound care that support ED throughput and inpatient transition.

State-level competitive standing is strong on ED volumes: 99283 ranks #13 of 266 providers in-state (95th percentile; notably above typical state volume) and 99284 ranks #19 of 266 providers in-state (93th percentile; notably above typical state volume). 99285 ranks #40 of 237 providers in-state (83th percentile; typical, unremarkable volume) — together these ranks indicate the provider is a major in-state ED participant for low-to-moderate acuity visits, with more typical volume at the highest-acuity ED code.

There are notable statistical outliers in specific ancillary codes that signal unusual volume patterns relative to peers. Code 0240U is an extreme outlier, ranking #1 of 23 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code), while 96372 ranks #16 of 787 providers in-state (98th percentile; extreme outlier, far above typical state volume for this code). High ranking for 36415 (89.8K claims) also appears well above peers (ranks #17 of 690 providers in-state, 98th percentile; notably above typical state volume).

Ancillary services contribute steady but smaller shares of Medicaid revenue, reflecting high-volume, low-paid testing and imaging that support ED operations rather than driving revenue independently. Examples include 80053 ($542.1K revenue, 1.9% of total Medicaid revenue), 85025 ($400.3K, 1.4%), and 70450 ($388K, 1.4%), which are high-claim, lower-paid services that diversify activity but do not offset the concentration in ED E/M codes.

The provider has a long tenure in the NPI registry (enumerated 2005-05-30, ~21 years ago), indicating an established market presence and likely entrenched operational relationships with state Medicaid payers. For payers and contracting analysts, that longevity combined with a heavy reliance on ED-driven Medicaid receipts (74.3% from the top three codes) frames both the provider as a stable counterparty and its revenue profile as concentrated and potentially sensitive to changes in ED utilization or reimbursement policy.

Medicaid: Complete Services Breakdown

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

234 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.	73,550	$130	$9.4M
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.	78,710	$90	$7.3M
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.	29,900	$130	$4M
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.	77,440	$10	$542.1K
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.	6,790	$80	$509.1K
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.	3,480	$150	$504.5K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	4,140	$120	$484.1K
0240U	N/A	5,340	$90	$464.9K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	27,170	$20	$434.8K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	80,070	$10	$400.3K

Showing 1–10 of 234

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

Lafayette General Medical Center Inc — 5 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

234 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.	19	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.	40	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.	13	270	11,250	$90	$1.8M
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	4	10	1,250	$180	$699.2K
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.	33	100	760	$100	$441.2K
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	57	90	650	$40	$404.2K
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…	90	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.	34	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.	32	170	1,260	$70	$322.4K
G0378	Hospital observation service, per hour	23	80	580	$210	$270.6K

Showing 1–10 of 234

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wade May	LA	Cardiovascular Disease Physician	$1.8M	$0
Ankur Lodha	LA	Interventional Cardiology Physician	$1.2M	$0
Agostino Ingraldi	LA	Interventional Cardiology Physician	$981.3K	$0
Fernando Ruiz	LA	Interventional Cardiology Physician	$871.4K	$0
Siby Ayalloore	LA	Advanced Heart Failure and Transplant Cardiology Physician	$790.5K	$0
Bose Cheeran	LA	Interventional Cardiology Physician	$788.1K	$0
Louis Salvaggio	LA	Interventional Cardiology Physician	$752.9K	$0
Marc Saad	LA	Clinical Cardiac Electrophysiology Physician	$724.1K	$0
Craig Walker	LA	Interventional Cardiology Physician	$508.6K	$0
Amit Amin	LA	Interventional Cardiology Physician	$480.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Merakey Pennsylvania	LA	Community/Behavioral Health Agency	$0	$37.7M
New Day Personal Care Services	LA	In Home Supportive Care Agency	$0	$28.5M
Gulf Coast Teaching Family Services, Inc.	LA	Community/Behavioral Health Agency	$0	$13.1M
Coolidge Emergency Group LLC	LA	Emergency Medicine Physician	$0	$11.1M
Pediatrust Acadiana, LLC	LA	Medically Fragile Infants and Children Day Care	$0	$8.6M
Critical Care Newborn Services	LA	Neonatal-Perinatal Medicine Physician	$0	$7.6M
New Day Personal Care Services	LA	In Home Supportive Care Agency	$0	$6.9M
A Blessing Personal Home Care	LA	In Home Supportive Care Agency	$0	$6.4M
Priority Medical Care Inc.	LA	Home Health Agency	$0	$6.2M
Bryan G Sibley Md Apmc	LA	Pediatrics Physician	$0	$6M

Lafayette General 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