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

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

Franciscan Health Lafayette (NPI 1356435341)

Key Findings

Field	Value
Entity Type	Organization
Organization	Franciscan Health Lafayette
Address	1701 S Creasy Ln
City	Lafayette
State	IN
ZIP	47905
Taxonomy	General Acute Care Hospital
NPI Enumerated	October 3, 2006

Payer Source	Total Paid
Medicaid	$38.6M
Medicare	$0

This provider is effectively single-payer in the available data: there is no Medicare billing on file while total Medicaid revenue is $38.6M, so all documented fee-for-service activity in our dataset is Medicaid-reimbursed. Analysts should treat Medicare-related benchmarking or national Medicare competitive positioning as inapplicable for this entity because no Medicare claims were reported.

Revenue is highly concentrated in a small set of outpatient emergency and diagnostic services: the top three Medicaid codes — 99284 ($7.8M, 21.6%), 99283 ($7.8M, 21.5%), and 71045 ($2.8M, 7.9%) — together account for 51.0% of the provider's total Medicaid revenue. That 51.0% concentration implies a few high-volume ED and imaging services drive more than half of all Medicaid dollars recorded here.

The code mix points to a high-volume emergency department supported by on-site imaging and diagnostic capacity. Multiple ED E/M codes appear among the top earners (99284, 99283, 99285 at $2.3M, 6.4%, and 99282 at $1.5M, 4.1%), with chest x-ray 71045 ($2.8M, 7.9%) and ECG 93005 ($1.7M, 4.6%) also prominent — a pattern consistent with an acute care hospital operating a busy ED and immediate diagnostic services.

State-level competitive standing is upper-percentile for many ED and related codes but is described in the data as 'typical' volumes for those codes. For example, 99284 ranks #24 of 382 providers in-state (94th percentile; typical, unremarkable volume for this code) and 99283 ranks #20 of 364 (95th percentile; typical, unremarkable volume). These positions indicate the provider is a strong, above-median participant in Indiana emergency care volumes, but not universally characterized as an outlier for core ED CPTs.

There are distinct high-volume outliers in ancillary services that reflect operational emphasis on testing and infusions: C9803 (SARS‑CoV‑2 clinic specimen collection) is $1.1M (3.2%) and ranks #3 of 75 in-state (97th percentile; notably above typical state volume), J7030 (normal saline 1000 cc) is $795K (2.2%) and ranks #2 of 51 (98th percentile; extreme outlier), and 87502 (multiplex influenza testing) is $767.4K (2.1%) and ranks #5 of 159 (97th percentile; notably above typical). These flags suggest above-typical throughput for infectious disease testing and high-volume infusion/fluid administration relative to peers.

Beyond the ED and testing footprint, the provider shows meaningful revenue from procedural and inpatient-support services consistent with OR/endoscopy and wound care capability. Codes such as 11042 (debridement) generate $1.9M (5.1%), 74177 (CT abdomen/pelvis with contrast) $1M (2.8%), and 43239 (EGD with biopsy) $512.8K (1.4%), indicating active surgical/wound and advanced imaging/endoscopy lines.

Because Medicaid accounts for the entire recorded revenue stream and the top codes concentrate revenue in emergency and acute diagnostics, this provider's financial exposure is sensitive to changes in Medicaid ED reimbursement and utilization patterns. The reliance on a few high-revenue ED codes (51.0% concentrated in the top three) means payer negotiations, policy shifts affecting Medicaid ED rates, or local changes in ED utilization could materially affect revenue.

The provider has a long-tenure NPI (enumerated 2006-10-03, ~20 years ago), which, combined with sustained Medicaid volumes and the broad set of ED, imaging, infusion, and procedural codes, supports the characterization of an established general acute care hospital with sustained outpatient/ED-driven Medicaid activity. For network planning or competitive analysis, treat this entity as an established, Medicaid-focused acute care provider with high ED throughput and several state-level service outliers.

Medicaid: Complete Services Breakdown

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

136 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.	51,080	$150	$7.8M
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.	53,460	$150	$7.8M
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	22,070	$130	$2.8M
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.	16,710	$140	$2.3M
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.	3,930	$470	$1.9M
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…	24,290	$70	$1.7M
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.	9,720	$150	$1.5M
C9803	Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	16,430	$70	$1.1M
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.	2,860	$350	$1M
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…	8,360	$100	$852.6K

Showing 1–10 of 136

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Indiana Distribution

Franciscan Health Lafayette — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

136 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.	24	380	2,470	$100	$1.5M
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.	20	360	3,490	$110	$1.5M
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.	53	330	1,530	$100	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	47	100	2,210	$70	$926K
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…	17	130	3,770	$60	$617.7K
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.	37	150	440	$100	$545.6K
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…	119	390	3,600	$50	$511.6K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	22	220	1,850	$30	$449.4K
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.	20	140	430	$220	$413.2K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	57	400	1,100	$40	$382.2K

Showing 1–10 of 136

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Arnett Clinic, LLC	IN	Internal Medicine Physician	$0	$35.1M
Piece By Piece Aba Therapy LLC	IN	Behavior Technician	$0	$33M
Indiana University Health Arnett Inc	IN	General Acute Care Hospital	$0	$26M
Limestone Health, LLC	IN	Methadone Clinic	$117.1K	$11.2M
Sycamore Springs, LLC	IN	Psychiatric Hospital	$0	$7M
Lafayette Pain Care, P.C.	IN	Pain Medicine Physician	$0	$6M
Awl Dentistry PC	IN	General Practice Dentistry	$0	$6M
East 53rd Street Dental-3, PC	IN	General Practice Dentistry	$0	$5.2M
Emergency Care Associates Of Indiana, LLC	IN	Emergency Medicine Physician	$0	$4.5M
Evans Eye Care Inc	IN	Optometrist	$0	$4.2M

Franciscan Health Lafayette — Billing Profile & Reimbursement Data

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Franciscan Health Lafayette — 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