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

Why is the Medicaid comparison limited to Rhode Island 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. Rhode Island (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.

Lmw Healthcare Inc. (NPI 1447595368)

Field	Value
Entity Type	Organization
Organization	Lmw Healthcare Inc.
Address	25 Wells Street
City	Westerly
State	RI
ZIP	02891
Taxonomy	General Acute Care Hospital
NPI Enumerated	December 4, 2012

Payer Source	Total Paid
Medicaid	$13.1M
Medicare	$0

Key Findings

LMW HEALTHCARE INC. is effectively a Medicaid-focused provider with $13.1M in Medicaid revenue on file and no Medicare billing recorded (“no Medicare billing on file”), indicating that Medicaid is the primary payer supporting its operations. Its NPI was enumerated 2012-12-04 (~14 years ago), so the facility has an established presence in the market.

Revenue is highly concentrated in emergency department evaluation-and-management services: the top three Medicaid codes (99284, 99285, 99283) together account for 54.6% of the provider's total Medicaid revenue. Individually those codes generate $2.3M (99284; 21.4%), $1.8M (99285; 17.0%), and $1.7M (99283; 16.3%), signaling that a majority of Medicaid dollars flow through ED encounters.

The code mix and dollar-weighted volumes point to an ED-centric acute care operation supplemented by robust on-site laboratory and procedural capability. High-volume lab and specimen codes such as 85025 (20.8K claims, $435.8K, 4.1%) and 36415 (19.7K claims, $315K, 3.0%), plus panels like 80053 ($281.7K, 2.7%), support the inference of substantial same-day diagnostic throughput tied to ED visits.

LMW competes strongly in-state on several ED codes: 99284 ranks #9 of 339 providers in Rhode Island (98th percentile; notably above typical state volume) and 99283 ranks #6 of 291 providers (98th percentile; notably above typical state volume), while 99285 ranks #11 of 277 providers (96th percentile; typical, unremarkable volume). These ranks and percentiles indicate the provider is a major regional ED participant by volume, particularly for moderate- and low-complexity ED E/M visits.

Several supply/drug and lab codes are statistical outliers within the state, suggesting distinct operational patterns or service lines. J3490 (unclassified drugs) is ranked #1 of 13 providers (100th percentile; notably above typical state volume) with $432.3K in revenue (4.1%), and multiple single-analyte lab codes (for example, 84132, 82374, 82435, 84295) are ranked #1 of small provider sets (100th percentile), indicating unusually high reported volumes for those specific tests.

Infusion and IV-related services represent a meaningful ancillary revenue stream tied to acute care throughput: 96374 ($420.4K, 4.0%), 96361 ($166.9K, 1.6%), and 96375 ($116.1K, 1.1%) together reflect regular administration of IV medications and fluids. Combined with the ED E/M dominance, these codes are consistent with frequent ED treatments that require IV therapy and short-course infusions.

Operational scale is reflected in high claim counts across both ED and laboratory activity, consistent with high patient throughput: examples include 99283 (11.4K claims), 99284 (10.1K claims), 85025 (20.8K claims), and 36415 (19.7K claims). These volumes, together with the provider's percentile ranks on many codes, support positioning LMW as a busy community acute-care hospital and ED hub within Rhode Island.

The payer profile—no Medicare revenue on file and $13.1M of Medicaid revenue—means reimbursement mix and strategic negotiations will be dominated by Medicaid terms and utilization patterns. Analysts should treat LMW as effectively single-payer (Medicaid) for historical billing behavior and prioritize Medicaid-focused benchmarking and network/value analyses rather than Medicare comparisons.

Medicaid: Complete Services Breakdown

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

144 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.	10,130	$220	$2.3M
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.	5,230	$340	$1.8M
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.	11,350	$150	$1.7M
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…	20,750	$20	$435.8K
J3490	Unclassified drugs	14,910	$30	$432.3K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	3,970	$110	$420.4K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	5,280	$60	$337.9K
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…	7,780	$40	$334.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	19,690	$20	$315K
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.	10,430	$30	$281.7K

Showing 1–10 of 144

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Rhode Island Distribution

Lmw Healthcare Inc. — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

144 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	5	10	1,220	$1,410	$2.9M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	11	50	330	$50	$2.7M
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	7	20	840	$210	$789.2K
J7040	Infusion, normal saline solution, sterile (500 ml = 1 unit)	4	10	120	$290	$535.1K
J2405	Injection, ondansetron hydrochloride, per 1 mg	7	20	1,080	$180	$470.2K
J7030	Infusion, normal saline solution , 1000 cc	7	10	720	$180	$426.8K
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.	4	10	270	$210	$419.8K
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	20	310	$210	$394.7K
J0690	Injection, cefazolin sodium, 500 mg	6	10	100	$390	$339.8K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	6	20	280	$150	$330.2K

Showing 1–10 of 144

Related Providers

Other providers that share a Tax Identification Number (TIN) with Lmw Healthcare Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lawrence Proano	RI	Emergency Medicine Physician	$48.4K	$2.3M
Lmw Healthcare Inc.	RI	Psychiatric Hospital Unit	$0	$491.7K
Peter Willis	RI	Family Medicine Physician	$68.8K	$66.7K
Michael Drechsler	CT	Emergency Medicine Physician	$71.2K	$6K
Emma Cahoon	RI	Physician Assistant	$20.5K	$41.6K
Peter Bertolozzi	CT	Emergency Medicine Physician	$51.2K	$0
Jonathan Quang	CT	Emergency Medicine Physician	$28.2K	$15.9K
Tara Weathers	RI	Family Nurse Practitioner	$23.8K	$0
Kacia Yazbak Toussaint	RI	Physician Assistant	$20.2K	$0
Katie Serra	MA	Physician Assistant	$16.4K	$0

Nearby Providers

Other providers in the same ZIP code as Lmw Healthcare Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Frank Olean Center, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$6.6M
Westerly Chariho Arc, Inc.	RI	Child Intellectual and/or Developmental Disabilities Respite Care	$0	$5.5M
Westerly Public Schools	RI	Local Education Agency (LEA)	$0	$4.6M
Golden Years Assisted Living Community	RI	Assisted Living Facility	$0	$3.3M
Bhg Lvii, LLC	RI	Substance Use Disorder Rehabilitation Clinic/Center	$0	$2.7M
The Westerly Ambulance Corps Inc	RI	Land Ambulance	$525.6K	$902.2K
Christopher D'arcy	RI	Rheumatology Physician	$707.7K	$58.7K
Deanna Voisine	RI	Psychologist	$0	$605.3K
Westerly Hospital Dietary Department	RI	General Acute Care Hospital	$0	$605.3K
Anna Capalbo	RI	Pediatric Dentistry	$0	$492.6K

Lmw Healthcare Inc. — Billing Profile & Reimbursement Data

Sign up for Lmw Healthcare Inc. — Billing Profile & Reimbursement Data policy alerts

Lmw Healthcare Inc. — Billing Profile & Reimbursement Data

Sign up for Lmw Healthcare Inc. — Billing Profile & Reimbursement Data policy alerts

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