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.

Ochsner Clinic LLC (NPI 1538151428)

Key Findings

Field	Value
Entity Type	Organization
Organization	Ochsner Clinic LLC
Address	1514 Jefferson Hwy
City	New Orleans
State	LA
ZIP	70121
Taxonomy	General Practice Physician
NPI Enumerated	August 17, 2005

Payer Source	Total Paid
Medicaid	$152.6M
Medicare	$0

OCHSNER CLINIC LLC is effectively a single-payer Medicaid billing entity in the available data: there is no Medicare billing on file and total Medicaid revenue is $152.6M. This concentration means analyses of utilization and network impact should treat Medicaid as the primary commercial footprint for this NPI.

Revenue is highly concentrated in a small number of office and hospital E/M codes: the top three Medicaid codes 99214, 99213, and 99233 together account for 53.1% of this provider's total Medicaid revenue. Individually those codes are reported as 99214 $32.7M (27.7%), 99213 $23.1M (19.6%), and 99233 $6.9M (5.9%), indicating ambulatory established-patient visits and inpatient subsequent care drive the majority of payments.

The code mix points to a system-level clinical operation that spans ambulatory primary care, emergency and inpatient care, and ancillary diagnostics. High-volume office E/M (99214, 99213, 99204, 99203, 99215) combined with emergency visit codes (99284, 99285), inpatient codes (99223, 99232, 99233), cardiac echo 93306, multiple CT codes (70450, 74177) and lab testing () suggest integrated outpatient-to-inpatient workflows and on-site imaging and laboratory capacity.

OCHSNER shows a dominant statewide competitive standing on its highest-impact Medicaid codes: 99214 ranks #2 of 2894 providers in-state (100th percentile; extreme outlier) and 99213 ranks #2 of 3226 (100th percentile; extreme outlier), while 99233 ranks #1 of 466 providers in-state (100th percentile; extreme outlier). These rank and percentile positions identify the provider as a major Medicaid volume leader for standard evaluation-and-management services within Louisiana.

Multiple procedure lines are statistical outliers versus in-state peers, reinforcing the scale of operations rather than niche specialization. In addition to the E/M codes labeled as "extreme outlier," high volumes for lab testing (87635 ranks #2 of 355, 100th percentile; extreme outlier), ECG interpretation 93010 (ranks #1 of 277, 100th percentile; extreme outlier), and chest X-ray 71045 (ranks #2 of 206, 100th percentile; extreme outlier) indicate broad throughput across diagnostics and routine testing.

Claim volumes show very high throughput consistent with a large health system: 99214 has 617K claims, 99213 has 577.2K claims, routine ECG 93010 has 389.6K claims, and chest X-ray 71045 has 277.7K claims. These absolute claim counts point to significant outpatient visit and testing capacity that underpins the provider's Medicaid revenue base.

Beyond core adult E/M, the provider bills substantial preventive and pediatric/neonatal services, indicating a broad service mix that includes preventive care and newborn follow-up. Preventive medicine codes 99391 ($3.2M, 2.7%) and 99392 ($2.7M, 2.3%) appear in the top 25, and neonatal follow-up/critical infant care codes 99479 ($1.3M, 1.1%) and 99472 ($1.3M, 1.1%) further signal continuity of care across age groups.

The NPI has a long tenure in public records, enumerated on 2005-08-17 (~21 years ago), which supports interpretation of these patterns as durable operational behavior rather than a short-term spike. Long-standing enumeration plus persistent high ranks on multiple codes suggests stable, system-level Medicaid participation rather than a transient billing pattern.

Medicaid: Complete Services Breakdown

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

477 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…	617,040	$50	$32.7M
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…	577,200	$40	$23.1M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	150,550	$50	$6.9M
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.	87,100	$80	$6.5M
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…	60,680	$90	$5.2M
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…	92,870	$50	$5M
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…	56,400	$60	$3.5M
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…	83,450	$40	$3.2M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	52,660	$60	$3.2M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	83,970	$30	$2.9M

Showing 1–10 of 477

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

Ochsner Clinic LLC — 22 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

477 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.	13	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.	51	240	4,030	$130	$2M
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.	127	270	11,250	$90	$1.8M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	4	20	1,890	$280	$1M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	2	10	630	$270	$927K
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	4	20	5,680	$100	$863.1K
95800	A patient undergoes a sleep study with no provider physically present. Parameters recorded include heart rate, blood oxygen concentration, respiratory analysis, and the amount of time sleeping.	16	30	150	$520	$631.5K
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…	2	30	2,260	$110	$460.1K
01967	The provider performs neuraxial anesthesia services for a patient undergoing a planned vaginal delivery.	6	40	330	$240	$447.6K
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.	4	100	760	$100	$441.2K

Showing 1–10 of 477

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lsu Health Sciences Center Shreveport Faculty Group Practice	LA	Family Medicine Physician	$0	$235.7M
Ochsner Clinic Foundation	LA	General Acute Care Hospital	$0	$166.7M
University Health Shreveport LLC	LA	General Acute Care Hospital	$0	$98.1M
Ochsner Clinic LLC	LA	Internal Medicine Physician	$0	$32.2M
Summitstone Health Partners	CO	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$7.4M
Summitstone Health Partners	CO	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.8M
Brfhh Shreveport LLC	LA	General Acute Care Hospital	$0	$6.3M
Acme Medical Supplies, Inc.	MD	Oxygen Equipment & Supplies (DME)	$0	$5.3M
Medical Foundation, Inc.	MS	Geriatric Medicine (Family Medicine) Physician	$0	$1.8M
Artin Aharonian	MD	Diagnostic Radiology Physician	$1M	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ochsner Home Medical Equipment, LLC	LA	Oxygen Equipment & Supplies (DME)	$0	$16.9M
Rizwan Shaikh	LA	Ophthalmology Physician	$2.2M	$0
James Lamar	LA	Optometrist	$62.2K	$1.1M
Genevieve Maronge	LA	Internal Medicine Physician	$590.6K	$0
Adam Harless	LA	Interventional Cardiology Physician	$553.3K	$0
Zachary Dowdy	LA	Cardiovascular Disease Physician	$232K	$0
Dean Yamaguchi	LA	Vascular Surgery Physician	$197.9K	$0
Suneeta Walia	LA	MOHS-Micrographic Surgery Physician	$176.5K	$0
Pulin Shah	LA	Cornea and External Diseases Specialist Physician	$174.2K	$0
Brian Dupont	LA	Diagnostic Radiology Physician	$162.7K	$0

Ochsner Clinic 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