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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

Lovelace Health System, LLC (NPI 1649373887)

Field	Value
Entity Type	Organization
Organization	Lovelace Health System, LLC
Address	10501 Golf Course Rd Nw
City	Albuquerque
State	NM
ZIP	87114
Taxonomy	General Acute Care Hospital
NPI Enumerated	September 6, 2006

Payer Source	Total Paid
Medicaid	$31.2M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and is effectively single‑payer with Medicaid driving its entire recorded public revenue base; total Medicaid revenue on file is $31.2M. The absence of Medicare activity means analyses of Medicare payment patterns or cross‑payer mix are not possible for this entity from these records.

Revenue is highly concentrated in a small set of emergency department evaluation and management codes: the precomputed top‑3 Medicaid codes account for 44.1% of the provider’s Medicaid revenue, and those top three are 99284, 99283, and 99285. This concentration implies emergency department visits are the primary revenue driver in Medicaid and that changes to ED utilization or reimbursement would materially affect overall Medicaid revenue.

The ED codes show very large claim volumes—22.5K claims for 99284, 21.4K claims for 99283, and 10.2K claims for 99285—indicating substantial ED throughput. Despite high absolute volumes, the provider’s competitive standing on these ED codes is middle‑of‑the‑pack statewide (99284: #25/76, 68th percentile; 99283: #25/84, 71st percentile; 99285: #27/71, 63rd percentile), so the hospital operates a busy ED but is not an outlier leader in the state for these services.

A distinct and notable service line is dental procedures: D2930 is an extreme outlier with 22.3K claims and $2.2M revenue (9.0% of Medicaid revenue) and ranks #3 of 81 providers in the state (98th percentile). Additional dental codes are also well above typical state volume—D2934 ($1M, 4.1%; rank #2 of 13, 92th percentile) and D3220 ($904.1K, 3.7%; rank #2 of 60, 98th percentile)—together signaling an unusually large dental services footprint for a general acute care hospital.

Ancillary and diagnostic services are a meaningful component of the Medicaid mix but generally at typical statewide volumes: CT abdomen/pelvis 74177 accounts for $1.1M (4.7%) with a mid ranking (#27/56, 53rd percentile), comprehensive metabolic panels 80053 account for $492.8K (2.0%; #26/97, 74th percentile), and multiplex respiratory testing 87636 contributes $458.4K (1.9%; #10/26, 64th percentile). Sleep medicine capacity is also present (95810 $500.4K, 2.0%; 95811 $389.4K, 1.6%) with both codes ranking in the upper half of in‑state providers but not dominant, which supports a broad acute/diagnostic service mix rather than a narrowly specialized profile.

Several high‑volume medication administration and IV therapy codes (96374, 96375, 96361) and therapy/exercise code 97110 appear in the top Medicaid code list with typical state rankings, indicating routine inpatient/ED supportive care and rehabilitation services that complement the ED and surgical/dental activity. These codes (for example, 96374: $413.5K, 1.7%; 96375: $412.1K, 1.7%; 97110: $568.4K, 2.3%) suggest standard acute care throughput rather than a specialty concentration.

The provider has been enumerated since 2006-09-06 (~20 years ago), which indicates an established presence in the Albuquerque market and supports interpretation of its current billing mix as the result of long‑standing service offerings and referral patterns. The combination of long tenure, large ED claim volumes, and an outsized dental footprint points to a stable institution that has developed specific high‑volume service lines within the state Medicaid population.

Overall competitive positioning is mixed: the hospital is a major outlier and clear statewide leader on specific dental procedure codes (e.g., D2930, D3220, D2934) while for core revenue drivers in the ED and most imaging/lab codes it is a typical mid‑ranking participant. That pattern—dominant in a narrow set of dental procedures but otherwise a conventional acute care provider—should guide payer negotiations and network decisions toward recognizing both routine acute capacity and exceptional dental throughput when assessing value and utilization risk.

Medicaid: Complete Services Breakdown

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

224 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.	22,530	$210	$4.8M
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.	21,370	$160	$3.4M
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.	10,240	$260	$2.6M
D2930	N/A	22,290	$100	$2.2M
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.	3,220	$360	$1.1M
D2934	N/A	8,770	$120	$1M
D3220	N/A	7,350	$120	$904K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	4,840	$130	$633.4K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	2,740	$210	$585.9K
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…	9,020	$60	$568.4K

Showing 1–10 of 224

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Mexico Distribution

Lovelace Health System, LLC — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. New Mexico median

224 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.	25	80	12,050	$160	$3.9M
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.	27	70	6,920	$210	$3.5M
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.	25	80	10,650	$130	$2.4M
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.	27	60	3,070	$210	$1.4M
G0378	Hospital observation service, per hour	24	40	1,000	$400	$1M
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	10	30	3,760	$120	$900.7K
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.	33	60	2,820	$110	$799.5K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	21	50	7,300	$60	$737.6K
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.	47	80	3,340	$60	$595K
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…	12	40	880	$80	$527.4K

Showing 1–10 of 224

Related Providers

Other providers that share a Tax Identification Number (TIN) with Lovelace Health System, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lovelace Health System, LLC	NM	General Acute Care Hospital	$0	$57.7M
Lovelace Health System LLC	NM	General Acute Care Hospital	$0	$45.2M
Lovelace Health System LLC	NM	General Acute Care Hospital	$0	$20.1M
Lovelace Health System LLC	NM	Obstetrics Physician	$0	$3M
Lovelace Health System, Inc.	NM	Geriatric Psychiatry Physician	$0	$2.6M
Lovelace Health System LLC	NM	Rural Health Clinic/Center	$0	$1.5M
Yubao Wang	CA	Hematology & Oncology Physician	$612K	$0
Michael Hoskins	NM	Clinical Cardiac Electrophysiology Physician	$254.2K	$0
Michael Bestawros	NM	Clinical Cardiac Electrophysiology Physician	$251.8K	$0
Sean Mazer	NM	Clinical Cardiac Electrophysiology Physician	$251.7K	$0

Nearby Providers

Other providers in the same ZIP code as Lovelace Health System, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laura Veal	NM	Speech-Language Pathologist	$0	$31M
Tasker Hatch Rowan LLC	NM	Dentist	$0	$25M
Onyx Supportive Living LLC	NM	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$22.3M
Presbyterian Healthcare Services	NM	Specialty Pharmacy	$0	$8.7M
A Center For Function And Creativity	NM	Developmentally Disabled Services Day Training Agency	$0	$8.2M
Tasker, Hatch, Rowan, LLC	NM	Pediatric Dentistry	$0	$4.5M
Joyce Jeffries	NM	Oral and Maxillofacial Surgery (Dentist)	$0	$4.3M
Angel Touch Personal Care, Inc.	NM	Home Health Agency	$0	$3.8M
Home Medical Equipment Specialists LLC	NM	Home Infusion Therapy Pharmacy	$0	$3.7M
Making An Impact LLC	NM	Substance Use Disorder Rehabilitation Clinic/Center	$0	$3.5M

Lovelace Health System, LLC — Billing Profile & Reimbursement Data

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Lovelace Health System, 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