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.

Calcasieu Urgent Care LLC (NPI 1467715490)

Key Findings

Field	Value
Entity Type	Organization
Organization	Calcasieu Urgent Care LLC
Address	2640 Country Club Rd
City	Lake Charles
State	LA
ZIP	70605
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	June 25, 2012

Payer Source	Total Paid
Medicaid	$39.5M
Medicare	$0

This provider reports no Medicare billing on file and all documented federal revenue comes from Medicaid, with total Medicaid revenue of $39.5M. The absence of Medicare activity means the practice operates effectively as a Medicaid-focused outpatient operation rather than a mixed-payer clinic, which will shape payer-mix analysis and network contracting considerations.

Revenue is highly concentrated in office/outpatient evaluation and management (E/M) visits: the top three Medicaid codes — 99214 ($15.6M, 39.5%), 99204 ($6.7M, 17.0%), and 99213 ($4.9M, 12.3%) — together account for 68.8% of the provider's total Medicaid revenue. This concentration indicates that the business model relies predominantly on high-volume E/M encounters rather than on procedural or high-margin specialty services.

The code mix and code-level descriptions point to an urgent care–style service line: frequent uses of 99214, 99213, and 99204 indicate a steady stream of both established and new patient visits with moderate complexity and substantial face-to-face time. High counts for new-patient codes such as 99204 (89.4K claims) suggest the site handles significant walk-in or first-time evaluations in addition to repeat care.

Competitive standing within the state is unusually strong for core outpatient visit codes: 99204 ranks #1 of 1172 providers in-state (100th percentile; extreme outlier), 99214 ranks #4 of 2894 (100th percentile; extreme outlier), and 99213 ranks #27 of 3226 (99th percentile; extreme outlier). These ranks signal the provider is a dominant statewide volume leader for the key E/M services that drive its Medicaid revenue.

Besides visits, the provider runs very large volumes of point-of-care and diagnostic testing tied to respiratory illness: 87804 shows 288.3K claims ($2.3M, 5.9%), 87428 shows 74.7K claims ($2.7M, 6.8%), 87426 shows 64.7K claims ($1.8M, 4.6%), and 87811 shows 104.5K claims ($1.7M, 4.2%). This pattern indicates a high-throughput testing workflow (COVID/flu/rapid antigen and immunoassay testing) that supplements visit-based revenue and supports episodic respiratory care demand.

Multiple service and supply lines appear as statistical outliers statewide, showing breadth in high-volume, low-unit-pay items: examples include 87804 (rank #1, 100th percentile; extreme outlier), 87811 (rank #1, 100th percentile; extreme outlier), 87880 (rank #1, 100th percentile; extreme outlier), J1100 (rank #1, 100th percentile; extreme outlier), and J0696 (rank #1, 100th percentile; extreme outlier). These ranks reflect unusually large operational throughput across testing and certain injectable/administration services relative to peer providers in Louisiana.

Ancillary revenue streams exist but are small relative to E/M and testing: L4360 generated $70.7K, 71046 generated $19.9K, and 81025 generated $21.8K, each representing modest portions of overall Medicaid revenue. The presence of DME, basic imaging, and pregnancy testing revenue suggests the clinic offers a range of on-site ancillary services that complement urgent care visits but do not materially shift overall revenue concentration.

The provider's NPI was enumerated on 2012-06-25 (~14 years ago), indicating an established operating history in LAKE CHARLES. Combined with the dominant Medicaid volumes and multiple statewide #1/#2 ranks, this tenure supports the view that the practice is an entrenched Medicaid-focused urgent care hub in its market, with operational scale that likely influences local patient access for acute outpatient care.

Medicaid: Complete Services Breakdown

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

83 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	305,080	$50	$15.6M
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	89,410	$80	$6.7M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	131,400	$40	$4.9M
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	74,730	$40	$2.7M
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	288,280	$10	$2.3M
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	39,670	$50	$2M
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	64,690	$30	$1.8M
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	104,540	$20	$1.7M
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	99,640	$10	$797.1K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	3,110	$70	$220.5K

Showing 1–10 of 83

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

Calcasieu Urgent Care LLC — 15 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

83 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
10060	The provider incises the area of abscess and drains the collection of pus from a lesion, such as a carbuncle, hidradenitis, cyst, furuncle, or paronychia, with the help of surgical instruments. A…	8	10	290	$50	$442.9K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	4	2,890	980	$40	$246.8K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	201	210	630	$70	$239.6K
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…	303	370	1,080	$40	$212.3K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	27	3,230	1,120	$30	$204.3K
S9083	Global fee urgent care centers	31	40	870	$110	$145.1K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	135	360	340	$30	$120.8K
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.	193	270	3,140	$10	$111K
17110	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…	32	50	290	$50	$105.7K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	1	1,170	160	$80	$102.7K

Showing 1–10 of 83

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Marrisa Piper	LA	Family Nurse Practitioner	$38.9K	$0
James White	LA	Family Nurse Practitioner	$38.1K	$0
Katherine Hanks	LA	Family Nurse Practitioner	$36.8K	$0
Cynthia Cox	LA	Family Nurse Practitioner	$34.3K	$0
Paul Leger	LA	Physician Assistant	$27.2K	$0
Steven Martin	WY	Physician Assistant	$5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Resource Management Services, Inc. Of Southwest Louisiana	LA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$20.7M
Southwest Louisiana Independence Center, Inc	LA	In Home Supportive Care Agency	$0	$14.4M
Christus Health Southwestern Louisiana	LA	General Acute Care Hospital	$0	$11.8M
Medical Resources & Guidance, Inc.	LA	Case Management Agency	$0	$10.3M
Direct Care, Inc.	LA	Developmentally Disabled Services Day Training Agency	$0	$10.1M
Calcasieu Emergency Group LLC	LA	Emergency Medicine Physician	$0	$7.4M
Vcphcs Vi, LLC	LA	Substance Use Disorder Rehabilitation Clinic/Center	$110.8K	$6.7M
Pediatric Cardiology Of Southwest Louisiana, LLC	LA	Pediatric Cardiology Physician	$0	$6.1M
1st Abundant Home Care, LLC	LA	Developmentally Disabled Services Day Training Agency	$0	$5.1M
Regional Healthcare-lake Charles, LLC	LA	In Home Supportive Care Agency	$0	$5M

Calcasieu Urgent Care LLC — Billing Profile & Reimbursement Data

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Calcasieu Urgent Care 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