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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

Lovelace Health System LLC (NPI 1306914213)

Key Findings

Field	Value
Entity Type	Organization
Organization	Lovelace Health System LLC
Address	601 Dr Martin Luther King Jr Ave Ne
City	Albuquerque
State	NM
ZIP	87102
Taxonomy	General Acute Care Hospital
NPI Enumerated	November 30, 2006

Payer Source	Total Paid
Medicaid	$45.2M
Medicare	$0

LOVELACE HEALTH SYSTEM LLC is effectively a single‑payer Medicaid provider: Medicare billing is listed as “none (no Medicare billing on file)” while total Medicaid revenue is $45.2M, indicating Medicaid is the dominant — and for available data the only — public payer-revenue stream reported. This concentration means any analysis of revenue, service mix, or competitive position for this entity should be interpreted in a Medicaid-only context.

Nearly half of LOVELACE’s Medicaid revenue is concentrated in three emergency department evaluation-and-management codes: the precomputed top 3 Medicaid codes account for 48.2% of total Medicaid revenue, led by 99284 ($6.6M, 18.5%), 99285 ($6.4M, 18.0%), and 99283 ($4.2M, 11.7%). That concentration signals a heavy reliance on ED visits for topline Medicaid receipts and suggests ED throughput is a primary driver of financial performance.

The claim volumes for core ED codes corroborate an ED- and acute-care operational profile: 99284 has 33.1K claims, 99285 has 25.7K claims, and 99283 has 28.7K claims, and the outpatient clinic code G0463 has 23.3K claims. In combination with an observation-hours code (G0378, $968.4K revenue) this mix indicates the facility operates a high-volume emergency department with downstream observation and hospital outpatient activity rather than being primarily an elective or ambulatory-only center.

LOVELACE shows specialized imaging and cardiac-service capacity that is above typical statewide peers on several high-revenue, high-reimbursement codes. The provider ranks #1 in-state (100th percentile; notably above typical state volume for this code) for 78452 ($992.3K) and 93458 ($839.9K), and also ranks #1 (100th percentile; notably above typical state volume for this code) for 93017 ($496.6K); these codes — myocardial perfusion SPECT, imaging supervision for left-heart catheterization, and non-interpretive stress ECG recordings — point to a substantive cardiology and advanced imaging capability with above-typical statewide volumes and relatively high avg paid/claim (e.g., 93458 avg paid/claim $1714).

For core ED evaluation-and-management codes the provider’s statewide percentile positions are modestly above median but not dominant: 99284 ranks #15 of 76 providers (81th percentile; typical, unremarkable volume for this code), 99285 ranks #12 of 71 (84th percentile; typical, unremarkable volume for this code), and 99283 ranks #18 of 84 (80th percentile; typical, unremarkable volume for this code). These placements indicate a steady, higher-than-average ED caseload statewide but not market dominance in emergency visits.

Ancillary and laboratory throughput is also substantial and supports the acute-care profile: 80053 has 45.5K claims ($954.7K), 85025 has 52.3K claims ($575.4K), and 93005 has 36.5K claims ($1.6M), with 93005 specifically ranked #3 of 46 providers (96th percentile; typical, unremarkable volume for this code). High claim counts in basic panels, CBCs, and ECG recordings are consistent with high-volume ED and observation activity and suggest sizeable downstream utilization of routine diagnostics.

The provider’s tenure — NPI enumerated 2006-11-30 (~20 years ago) — indicates an established presence in the Albuquerque market. That longevity, combined with high-volume ED claims and state-leading cardiac/imaging codes, implies a stable acute-care operation that has built specialized procedural capacity over time.

Operationally, the revenue concentration in ED E/M codes (48.2% from the top three) implies sensitivity of Medicaid revenue to changes in emergency-department utilization, observation-hour policies, or Medicaid reimbursement adjustments for ED and observation services. Meanwhile, the state-leading positions on select cardiac and imaging codes create a complementary revenue stream that partially diversifies income away from pure ED visits, but overall the provider remains Medicaid-centric in the available data.

Medicaid: Complete Services Breakdown

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

289 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.	33,080	$200	$6.6M
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.	25,730	$250	$6.4M
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.	28,700	$150	$4.2M
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.	6,740	$320	$2.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	23,280	$80	$1.9M
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	5,710	$300	$1.7M
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…	36,490	$40	$1.6M
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.	6,460	$170	$1.1M
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	2,020	$490	$992.3K
G0378	Hospital observation service, per hour	2,650	$370	$968.4K

Showing 1–10 of 289

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Mexico Distribution

Lovelace Health System LLC — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. New Mexico median

289 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.	15	80	12,050	$160	$3.9M
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.	12	70	6,920	$210	$3.5M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	7	40	3,670	$80	$3.2M
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.	18	80	10,650	$130	$2.4M
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.	13	60	3,070	$210	$1.4M
G0378	Hospital observation service, per hour	10	40	1,000	$400	$1M
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…	7	30	3,760	$120	$900.7K
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.	14	60	2,820	$110	$799.5K
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…	3	50	7,300	$60	$737.6K
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	25	30	280	$400	$607.8K

Showing 1–10 of 289

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tricore Reference Laboratories	NM	Clinical Medical Laboratory	$0	$64.8M
Bright Horizons, Inc.	NM	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$46.9M
Tricore Inc.	NM	Clinical Medical Laboratory	$7M	$35.8M
App Of New Mexico Ed PLLC	NM	Emergency Medicine Physician	$0	$42M
Duke City Recovery Toolbox LLC	NM	Community/Behavioral Health Agency	$108.4K	$28M
Metro Treatment Of New Mexico LP	NM	Methadone Clinic	$220.4K	$27.9M
Enchanted Care Solutions, LLC	NM	Home Health Agency	$0	$25.8M
Open Skies Healthcare	NM	Community/Behavioral Health Agency	$0	$23.8M
Krossroads Integrative Health And Recovery Solutions Inc	NM	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$16.7M
Behavioral Healthcare Services, Inc.	NM	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$14.8M

Lovelace Health System LLC — Billing Profile & Reimbursement Data

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Lovelace Health System 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

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lovelace Health System, LLC	NM	General Acute Care Hospital	$0	$57.7M
Lovelace Health System, LLC	NM	General Acute Care Hospital	$0	$31.2M
Lovelace Health System LLC	NM	General Acute Care Hospital	$0	$20.1M
Lovelace Health System LLC	NM	Obstetrics Physician	$0	$3M
Lovelace Health System, Inc.	NM	Geriatric Psychiatry Physician	$0	$2.6M
Lovelace Health System LLC	NM	Rural Health Clinic/Center	$0	$1.5M
Yubao Wang	CA	Hematology & Oncology Physician	$612K	$0
Michael Hoskins	NM	Clinical Cardiac Electrophysiology Physician	$254.2K	$0
Michael Bestawros	NM	Clinical Cardiac Electrophysiology Physician	$251.8K	$0
Sean Mazer	NM	Clinical Cardiac Electrophysiology Physician	$251.7K	$0