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.

University Healthcare System, L.c. (NPI 1497792527)

Key Findings

Field	Value
Entity Type	Organization
Organization	University Healthcare System, L.c.
Address	4200 Houma Blvd
City	Metairie
State	LA
ZIP	70006
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 31, 2006

Payer Source	Total Paid
Medicaid	$30.9M
Medicare	$0

This provider is effectively single-payer in scope: Medicare billing shows none on file while lifetime Medicaid revenue is $30.9M. The absence of any Medicare revenue on file makes Medicaid the dominant and sole reported public payer exposure in the dataset.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 57.4% of this provider's total Medicaid revenue. Those top contributors are 99283 ($6.6M revenue, 25.9% of total), 99284 ($6.1M revenue, 23.7% of total), and 99211 ($2M revenue, 7.8% of total), indicating a small set of codes drives the majority of Medicaid dollars.

The code mix points to a strong emergency-department and acute-care orientation. High-volume ED E/M codes such as 99283 (80.1K claims, $83 avg paid/claim, $6.6M revenue), 99284 (68.5K claims, $89 avg paid/claim, $6.1M revenue), 99285 (11.6K claims, $103 avg paid/claim, $1.2M revenue) and 99282 (8.2K claims, $54 avg paid/claim, $442.1K revenue) together suggest the provider operates a busy ED with substantial observation-and-short-stay activity supported by G0378 (3.3K claims, $148 avg paid/claim, $481.1K revenue).

Despite the ED focus, there is also an unusually large volume of very low-intensity outpatient encounters: 99211 appears as a major revenue driver (69.6K claims, $29 avg paid/claim, $2M revenue) and ranks as an extreme outlier in the state (rank #5 of 838, 100th percentile). This pattern is consistent with extensive triage, nursing visits, or high-volume clinic/ancillary encounters that generate many low-paid claims.

Laboratory and imaging services form an important secondary revenue stream, with several high-volume test codes and chest x-ray codes present. Notable entries include 80053 (86.7K claims, $8 avg paid/claim, $693.3K revenue, rank #12 of 267), 85027 (84.7K claims, $5 avg paid/claim, $423.6K revenue, rank #2 of 122, 99th percentile, labeled an extreme outlier), 93005 (31.5K claims, $14 avg paid/claim, $440.6K revenue), and multiple nucleic acid/amplified probe infectious disease codes (for example, 87635 and 87798), which together indicate substantial throughput in basic lab and infectious-disease testing.

On competitive standing within Louisiana Medicaid, the provider is a major statewide participant for several high-volume codes: 99283 ranks #12 of 266 (96th percentile) and 99284 ranks #23 of 266 (92th percentile), both described as notably above typical state volume. At the same time, higher-complexity ED care (99285) sits at a middle percentile (rank #89 of 237, 63th percentile), indicating strong mid-acuity volume but less dominance in the highest-complexity ED encounters.

The provider has an established market presence, with NPI enumeration dated 2006-05-31 (~20 years ago). This tenure supports the observed high volumes and the provider’s entrenched role in delivering Medicaid-covered ED, outpatient and ancillary services in its local market.

The combination of a Medicaid-only revenue base ($30.9M) and a heavy concentration of revenue in three codes (top three = 57.4%) suggests revenue sensitivity to changes in Medicaid policy or utilization patterns for ED and low-intensity outpatient encounters. Operationally, the provider’s mix—high ED volumes, high low-intensity visit counts, and large-scale lab/imaging throughput—points to a business model dependent on volume across a narrow set of high-frequency codes, which creates both scale advantages and concentration risk.

Medicaid: Complete Services Breakdown

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

314 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.	80,110	$80	$6.6M
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.	68,490	$90	$6.1M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	69,600	$30	$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.	11,570	$100	$1.2M
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	5,840	$130	$741.4K
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.	86,660	$10	$693.3K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	8,820	$70	$652.8K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	21,000	$30	$588.1K
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…	14,910	$40	$551.7K
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…	12,050	$50	$542.1K

Showing 1–10 of 314

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

University Healthcare System, L.c. — 6 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

314 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	36	50	3,110	$250	$5.8M
A0425	Ground mileage, per statute mile	39	60	5,300	$60	$2.9M
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.	23	270	9,980	$110	$2.6M
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.	89	240	4,030	$130	$2M
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	30	40	2,720	$140	$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.	12	270	11,250	$90	$1.8M
87150	The lab analyst performs an analysis using amplified DNA or RNA probe technique on a previously isolated and identified organism to categorize the organism more specifically, such as to the taxonomic…	4	20	490	$160	$855.8K
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…	32	100	620	$40	$560K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	23	30	2,260	$110	$460.1K
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.	91	100	760	$100	$441.2K

Showing 1–10 of 314

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lcmc Health Holdings Inc	LA	General Acute Care Hospital	$0	$11.4M
Vipul Parikh	VA	Internal Medicine Physician	$363.8K	$0
David Rosenfeld	GA	Anesthesiology Physician	$345.4K	$0
Anil Paramesh	LA	Transplant Surgery Physician	$47K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Berry's Reliable Resources LLC	LA	In Home Supportive Care Agency	$0	$8.8M
Reliable Community Alternatives, LLC.	LA	Developmentally Disabled Services Day Training Agency	$0	$8.2M
Louisiana Pain Specialists, LLC	LA	Interventional Pain Medicine Physician	$0	$7.5M
Berry's Reliable Resources L.L.C.	LA	In Home Supportive Care Agency	$0	$6M
Sunnyside Pediatrics LLC	LA	Family Medicine Physician	$0	$5.6M
East Jefferson Emergency Management LLC	LA	Emergency Medicine Physician	$0	$5.2M
Nathan A Burns Dmd Apdc	LA	Pediatric Dentistry	$0	$5.2M
Gno Snoring And Sinus, LLC	LA	Specialist	$0	$4.7M
Deepblue Wellness LLC	LA	Behavioral Neurology & Neuropsychiatry Physician	$0	$4.6M
John Frisbee	LA	Ophthalmology Physician	$2.1M	$98.5K

University Healthcare System, L.c. — Billing Profile & Reimbursement Data

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University Healthcare System, L.c. — 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