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 1831284280)

Key Findings

Field	Value
Entity Type	Organization
Organization	Lourdes Hospital LLC
Address	520 N 4th Ave
City	Pasco
State	WA
ZIP	99301
Taxonomy	Critical Access Hospital
NPI Enumerated	October 3, 2006

Payer Source	Total Paid
Medicaid	$34M
Medicare	$0

This provider is effectively single-payer in the datasets: there is no Medicare billing on file while total Medicaid revenue is $34M. The absence of Medicare activity versus meaningful Medicaid receipts indicates the provider’s financial footprint in these feeds is concentrated in state-funded programs rather than federal Medicare reimbursements.

Medicaid revenue is heavily concentrated in emergency department evaluation-and-management codes: the top three Medicaid codes (99283, 99284, 99285) together account for 61.3% of this provider’s total Medicaid revenue. Individually those codes generated $6.7M (99283, 23.4%), $5.6M (99284, 19.8%), and $5.1M (99285, 18.0%), signaling a narrow set of services driving the majority of billed Medicaid dollars.

The code mix and top-revenue items point to an ED-centric acute-care operation: high revenue from 99283/99284/99285 is supported by high-cost imaging and diagnostics such as 74177 ($2.4M, 8.3%), 70450 ($576K, 2.0%), and 80053 ($878.4K, 3.1%). This pattern is consistent with a facility that manages unscheduled acute presentations and on-site diagnostic workups rather than elective procedural lines.

State-level competitive standing for the ED codes is solid but not dominant. 99283 ranks #33 of 234 providers in-state (86th percentile), 99284 ranks #61 of 225 (73rd percentile), and 99285 ranks #70 of 192 (64th percentile), which collectively indicate above-typical to typical volumes across emergency visit complexity but not top-of-market dominance.

Rehabilitation and therapy services are a notable secondary revenue stream relative to in-state peers: 97110 produced $1.2M (23.2K claims) and ranks #29 of 476 providers (94th percentile), while 97140 produced $770.6K (13.8K claims) and ranks #27 of 335 (92nd percentile). These ranks and volumes suggest a comparatively strong outpatient or inpatient therapy footprint for the provider within the state.

Laboratory and basic imaging contribute predictable ancillary revenue rather than driving the business: 80053 ($878.4K, 3.1%), 85025 ($600.6K, 2.1%), 84484 ($191.6K, 0.7%), and chest radiography 71045 ($279.5K, 1.0%) appear as routine high-volume diagnostics that support ED and inpatient workups. Their presence reinforces the characterization of the site as a lower-volume acute-care hospital with on-site diagnostic capability.

Observation and supportive care codes show consistent use of short-stay and infusion services: hospital observation G0378 ($348.6K, 1.2%) and additional-hour IV fluids 96361 ($189K, 0.7%) along with medication administration 96374 ($272.2K, 1.0%) indicate throughput that includes observation stays and parenteral therapies. These items align with the ED-to-observation clinical flow implied by the dominant E/M and imaging codes.

Longitudinal tenure and taxonomy support a stable rural safety-net profile: the NPI was enumerated 2006-10-03 (~20 years ago) and the provider taxonomy is Critical Access Hospital. Combined with the Medicaid-only billing footprint, this suggests a longstanding, community-focused acute-care role that is dependent on Medicaid reimbursement streams rather than Medicare volume.

Medicaid: Complete Services Breakdown

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

262 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.	42,470	$160	$6.7M
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.	24,360	$230	$5.6M
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.	12,920	$400	$5.1M
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.	3,540	$670	$2.4M
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…	23,240	$50	$1.2M
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.	32,530	$30	$878.4K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	13,760	$60	$770.6K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	35,330	$20	$600.6K
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.	3,200	$180	$576K
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…	13,080	$40	$523K

Showing 1–10 of 262

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 — 0 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

262 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	33	110	5,950	$270	$2.6M
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.	61	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.	33	230	6,220	$100	$1.8M
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.	70	190	5,130	$100	$1.8M
S9485	Crisis intervention mental health services, per diem	17	20	3,730	$310	$1.8M
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.	63	140	2,830	$150	$1.1M
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…	33	100	1,940	$70	$1M
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.	81	170	2,120	$40	$779.1K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	53	100	3,660	$100	$635.7K
96366	The provider administers an intravenous infusion or infusions of a medication for an additional hour or subsequent hours after the first hour to prevent, treat, or diagnose a condition or disease.	59	70	2,010	$210	$620.1K

Showing 1–10 of 262

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lourdes Hospital LLC	WA	Psychiatric Hospital	$0	$22.4M
Lourdes Hospital LLC	WA	Internal Medicine Physician	$0	$8.7M
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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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