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

Why is the Medicaid comparison limited to Washington 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. Washington (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.

Lourdes Hospital LLC (NPI 1659861060)

Lourdes Hospital LLC is a internal medicine physician provider located in Pasco, Washington. This profile covers 0 Medicare and 113 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Lourdes Hospital LLC
Address	520 N 4th Ave
City	Pasco
State	WA
ZIP	99301
Taxonomy	Internal Medicine Physician
NPI Enumerated	May 11, 2018

Payer Source	Total Paid
Medicaid	$8.7M
Medicare	$0

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

113 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	46,160	$60	$2.6M
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…	32,500	$60	$1.9M
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.	16,770	$70	$1.2M
99392	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…	5,210	$90	$484.5K
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.	11,180	$40	$447.4K
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…	5,270	$80	$400.2K
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…	4,130	$90	$359.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3,080	$90	$282.9K
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…	2,310	$80	$180K
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…	5,890	$20	$129.7K

Showing 1–10 of 113

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Washington Distribution

Lourdes Hospital LLC — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. Washington median

113 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.	82	230	5,440	$90	$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.	96	230	6,220	$100	$1.8M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	77	140	2,410	$110	$593.3K
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…	63	1,820	480	$60	$379.6K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	117	130	890	$100	$337.8K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	97	120	590	$230	$331.2K
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…	65	1,860	610	$40	$295.5K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	56	60	240	$380	$276.1K
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…	53	140	490	$40	$268.5K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	660	930	680	$60	$259.2K

Showing 1–10 of 113

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lourdes Hospital LLC	WA	Critical Access Hospital	$0	$34M
Lourdes Hospital LLC	WA	Psychiatric Hospital	$0	$22.4M
William Forsythe	WA	Emergency Medicine Physician	$667.6K	$0
Barbara Blankenship	WA	Diagnostic Radiology Physician	$380.6K	$0
Mark Merrell	WA	Orthopaedic Surgery Physician	$368.3K	$0
Christopher Reynolds	AZ	Diagnostic Radiology Physician	$308.9K	$0
David Vance	WA	Urology Physician	$241.9K	$0
Cheta Nand	WA	Sleep Medicine (Internal Medicine) Physician	$239.9K	$0
James Go	FL	Otolaryngology Physician	$238.5K	$0
William Waites	WA	Physician Assistant	$217K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tri-cities Community Health	WA	Dentist	$0	$16.1M
Tri-cities Community Health	WA	Federally Qualified Health Center (FQHC)	$0	$13.2M
City Of Pasco	WA	Land Ambulance	$450.5K	$12M
Thompson. Ferguson. Steinhart. James, PLLC	WA	Dentist	$0	$12.3M
House, Lee, Mast, Mcdonald And Nelson, PC	WA	Pediatric Dentistry	$0	$6.2M
Total Renal Care Inc	WA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$5.1M
Tri-cities Community Health	WA	Case Manager/Care Coordinator	$0	$4.6M
In-home Medical Inc.	WA	Durable Medical Equipment & Medical Supplies	$0	$3.3M
Sophia Chang	WA	Rheumatology Physician	$271.1K	$240
Vicki Haines	WA	Nurse Practitioner	$143.8K	$113.1K

Lourdes Hospital LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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