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

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

The Lowell General Hospital (NPI 1407804669)

Key Findings

Field	Value
Entity Type	Organization
Organization	The Lowell General Hospital
Address	295 Varnum Ave
City	Lowell
State	MA
ZIP	01854
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 4, 2006

Payer Source	Total Paid
Medicaid	$159.6M
Medicare	$0

THE LOWELL GENERAL HOSPITAL records no Medicare billing on file and reports $159.6M in lifetime Medicaid revenue, making its public payment footprint effectively single-payer (Medicaid). The provider’s NPI was enumerated on 2006-05-04 (~20 years ago), indicating a long-established presence in the state Medicaid network.

Revenue concentration is high: the precomputed top three Medicaid codes account for 44.9% of the hospital’s total Medicaid revenue. Those top three codes are 99283 ($16.1M, 16.0%), 99284 ($14.8M, 14.7%), and 96361 ($14.2M, 14.1%), showing a small set of services driving nearly half of Medicaid receipts.

The code mix strongly indicates a heavy emergency and acute care orientation: high-revenue E/M ED codes 99283, 99284, and 99285 appear among the top payers alongside observation care G0378 and IV infusion/hydration codes 96361, 96365, and 96360. This combination points to high ED throughput with significant use of inpatient observation and short-duration infusion/rehydration services rather than elective outpatient-only care.

Competitive standing for ED services is dominant in-state: 99283 ranks #6 of 547 providers in-state at the 99th percentile and is labeled an "extreme outlier," while 99284 ranks #12 of 827 providers at the 99th percentile and is also an "extreme outlier." 99285 tallies $9.5M (9.5% of Medicaid revenue) and ranks #22 of 521 providers at the 96th percentile ("notably above typical"), together signaling unusually large ED volumes compared with peers.

Infusion and supportive-care activity is a material revenue stream and a relative outlier: 96361 produced $14.2M (14.1%) and ranks #5 of 87 providers at the 95th percentile ("notably above typical"), and related codes 96365 and 96360 also appear in the top-ranking list. These volumes are consistent with frequent IV fluid/medication administration tied to emergency and observation workflows.

Imaging and diagnostic services are sizable and include several extreme outliers for specific modalities: tomosynthesis 77063 produced $2M and ranks #2 of 261 providers at the 100th percentile ("extreme outlier"), limited and complete obstetric ultrasound codes such as 76815 ($1.5M) rank #2 of 103 at the 99th percentile ("extreme outlier"), and 76700 ranks #4 of 133 at the 98th percentile ("extreme outlier"). At the same time, abdominal/pelvic CT 74177 ($2.6M) and head CT 70450 ($2.6M) are present at volumes described as typical or unremarkable for their peer groups.

Maternity and procedural services are also represented in the revenue mix: antenatal fetal testing 59025 generated $3.4M (3.4%) and ranks #4 of 124 providers at the 98th percentile ("extreme outlier"), while endoscopy codes such as 43239 and 45385 each contribute multi-million dollar revenues but are characterized as more typical relative to peers. This pattern supports a general acute care hospital with both ED-driven urgent care and steady obstetric/procedural throughput.

High-cost oncology therapy is present but not a dominant line: J9271 (pembrolizumab) shows 212 claims and $2M in revenue, ranking #7 of 12 providers in-state at the 45th percentile (described as typical/unremarkable), indicating the hospital administers some immunotherapy but at much lower relative volumes than its ED, imaging, and infusion activities.

Medicaid: Complete Services Breakdown

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

619 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.	100,890	$160	$16.1M
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.	98,220	$150	$14.8M
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.	41,170	$350	$14.2M
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.	55,760	$170	$9.5M
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	14,420	$240	$3.4M
G0378	Hospital observation service, per hour	44,590	$60	$2.8M
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.	18,530	$140	$2.6M
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	3,540	$730	$2.6M
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.	22,190	$120	$2.6M
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	2,590	$990	$2.6M

Showing 1–10 of 619

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

The Lowell General Hospital — 13 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

619 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	Injection, pembrolizumab, 1 mg	7	10	210	$5,200	$5.5M
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.	5	90	7,560	$350	$4.2M
S9485	Crisis intervention mental health services, per diem	25	110	1,250	$540	$3.2M
81220	The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR…	13	20	310	$260	$2.1M
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	10	50	1,870	$210	$1.4M
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	8	10	1,070	$220	$1.4M
G0378	Hospital observation service, per hour	4	70	7,250	$100	$1.3M
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	11	80	4,380	$140	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	21	110	5,660	$30	$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.	22	520	120	$130	$1M

Showing 1–10 of 619

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Merrimack Valley Emergency Associates, Inc.	MA	Emergency Medicine Physician	$0	$15.1M
Christopher Kareores	MA	Undersea and Hyperbaric Medicine (Emergency Medicine) Physician	$78.4K	$193.8K
Dragan Petakov	MA	Internal Medicine Physician	$102.4K	$107.9K
Michael Muto	MA	Gynecologic Oncology Physician	$32.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Commonwealth Of Massachusetts	MA	Case Management Agency	$0	$16.9M
Lgh Medical Group, Inc.	MA	Hospitalist Physician	$0	$5.7M
Sivaram Yamajala	MA	Internal Medicine Physician	$54.1K	$636K
Seema Sahib	MA	Internal Medicine Physician	$635.4K	$7.5K
Naomi Jiang	MA	Radiation Oncology Physician	$150.1K	$0
Kevin Hewitt	MA	Diagnostic Neuroimaging (Radiology) Physician	$102.6K	$0
George Potamitis	MA	Physical Therapist	$83.2K	$0
Benson Mathew Abraham	MA	Internal Medicine Physician	$81.8K	$0
Harohalli Vijayakumar	MA	Anesthesiology Physician	$79.7K	$0
Bethany Tierno	MA	Anatomic Pathology & Clinical Pathology Physician	$60.6K	$2.7K

The Lowell General Hospital — 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