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 Foundation (NPI 1811973100)

Key Findings

Field	Value
Entity Type	Organization
Organization	Ochsner Clinic Foundation
Address	1516 Jefferson Hwy
City	New Orleans
State	LA
ZIP	70121
Taxonomy	General Acute Care Hospital
NPI Enumerated	December 19, 2005

Payer Source	Total Paid
Medicaid	$166.7M
Medicare	$0

This provider is effectively single‑payer in the available data: Medicare shows none (no Medicare billing on file) while Medicaid lifetime revenue is $166.7M, so all recorded CMS-derived revenue comes from Medicaid payor activity. Analysts should treat this profile as a Medicaid-dominant revenue base rather than a balanced Medicare/Medicaid mix when modeling payer exposure or reimbursement sensitivity.

Revenue is highly concentrated in a narrow set of service codes: the precomputed top 3 Medicaid codes account for 61.2% of this provider's total Medicaid revenue. The single largest contributor is 99284 ($48.5M; 33.3%), followed by 99213 ($21.1M; 14.5%) and 99285 ($19.7M; 13.5%), indicating that three codes together drive the majority of Medicaid receipts.

The code mix points to a high-throughput emergency department and hospital-based ambulatory practice: 99284, 99285 and 99283 together produce very large volumes and dollars (with 99284 alone at $48.5M). High-ranking observation and ED-support codes such as G0378 ($1.5M; 1.0%) further reinforce an operational emphasis on emergency care and short-term hospital observation.

Concurrent high volumes of outpatient evaluation-and-management visits suggest a substantial ambulatory footprint: 99213 accounts for $21.1M from 619.8K claims and ranks #1 in-state, and 99214/99215 also appear in the top code list. This combination of high ED E/M and high-volume established-patient visits indicates the provider operates both acute ED services and large outpatient clinic capacity under the hospital umbrella.

The provider is a statewide testing and lab-volume hub: COVID-19 molecular codes U0003 ($5.2M; 3.5%) and 87635 ($3.6M; 2.5%) appear among the top revenue lines, and multiplex influenza and STI testing codes (87502, 87491, 87591) also contribute meaningful revenue. Several lab panels and basic diagnostics (80053, 85025, 93005) rank at or near the top in-state, signaling centralized laboratory and diagnostic throughput supporting both ED and ambulatory encounters.

Competitive standing in Louisiana is dominant on many fronts: 99284 ranks #1 of 266 providers in-state (100th percentile; extreme outlier) and 99213 ranks #1 of 3226 providers in-state (100th percentile; extreme outlier), while numerous other codes show top percentile ranks or #1 placements. Where the report labels volumes as "extreme outlier" or similar, this provider consistently appears far above typical state volumes, marking it as a primary regional resource for those services.

Ancillary treatment and infusion activity are material and concentrated in high-volume billing lines: medication administration codes such as 96374 ($1.9M; 1.3%) and hydration/IV codes like 96361 ($713.9K; 0.5%, rank #1) indicate frequent procedural treatment in outpatient or ED settings. Cardiac monitoring and other diagnostics (93005 at $1.5M; 1.0%) further reflect a high acuity patient mix requiring in‑facility monitoring and procedures.

The provider has long tenure in NPI records, enumerated on 2005-12-19 (~21 years ago), and the scale of Medicaid dollars ($166.7M) plus the concentrated ED/ambulatory/lab code mix point to a large, mature general acute care hospital serving principally Medicaid patients. That longevity combined with dominant statewide ranks suggests entrenched capacity and referral patterns that are important for competitive and network planning analyses.

Medicaid: Complete Services Breakdown

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

457 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.	227,670	$210	$48.5M
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…	619,810	$30	$21.1M
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.	91,740	$220	$19.7M
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.	126,780	$130	$17M
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,…	185,080	$30	$5.4M
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…	93,760	$60	$5.2M
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…	89,610	$40	$3.6M
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…	63,270	$50	$3.3M
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…	41,640	$60	$2.6M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	67,220	$30	$1.9M

Showing 1–10 of 457

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 Foundation — 23 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

457 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.	1	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.	6	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.	5	270	11,250	$90	$1.8M
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	62	70	620	$230	$913.4K
J9271	Injection, pembrolizumab, 1 mg	5	10	160	$3,820	$862.6K
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.	9	30	150	$520	$631.5K
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…	5	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…	9	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.	34	100	760	$100	$441.2K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	27	30	160	$520	$413.4K

Showing 1–10 of 457

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lsu Health Sciences Center Shreveport Faculty Group Practice	LA	Family Medicine Physician	$0	$235.7M
Ochsner Clinic LLC	LA	General Practice Physician	$0	$152.6M
University Health Shreveport LLC	LA	General Acute Care Hospital	$0	$98.1M
Ochsner Clinic LLC	LA	Internal Medicine Physician	$0	$32.2M
Ochsner Medical Center - Northshore, L.L.C.	LA	General Acute Care Hospital	$0	$6.7M
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
Siddhartha Rao	NC	Interventional Cardiology Physician	$944.7K	$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 Foundation — 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