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.

Upward Health Of Louisiana LLC (NPI 1871144725)

Field	Value
Entity Type	Organization
Organization	Upward Health Of Louisiana LLC
Address	6221 S Claiborne Ave Ste 537
City	New Orleans
State	LA
ZIP	70125
Taxonomy	General Practice Physician
NPI Enumerated	September 23, 2019

Payer Source	Total Paid
Medicaid	$6.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99499	Use 99499 to report evaluation and management services for which there is no specific code available.	16,820	$290	$4.9M
97799	Use 97799 to report procedures related to physical medicine or rehabilitation services that do not have a specific code.	113,640	$10	$1M
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…	7,130	$90	$620.2K
G0155	Services of clinical social worker in home health or hospice settings, each 15 minutes	6,120	$50	$324.4K
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…	300	$1	$610
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…	180	$1	$370
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	20	$1	$40
1125F	The provider measures the severity of pain in a patient with cancer who receives chemotherapy or radiotherapy during the measurement period. Report this code if the patient experiences pain.	60	$0	$0
1126F	The provider measures the severity of pain in a patient with cancer who receives chemotherapy or radiotherapy during the measurement period. Report this code if the patient does not experience pain.	70	$0	$0
3074F	No Summary found for this code	3,040	$0	$0

Showing 1–10 of 26

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

Upward Health Of Louisiana LLC — 3 of 7 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

26 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97799	Use 97799 to report procedures related to physical medicine or rehabilitation services that do not have a specific code.	1	10	56,830	$10	$484.4K
T1016	Case management, each 15 minutes	1	30	2,450	$140	$429.4K
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…	477	2,890	980	$40	$246.8K
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…	3,026	3,230	1,120	$30	$204.3K
G0155	Services of clinical social worker in home health or hospice settings, each 15 minutes	1	10	850	$50	$122.5K
99499	Use 99499 to report evaluation and management services for which there is no specific code available.	1	60	160	$120	$99.3K
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…	350	700	180	$60	$77K
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…	1,024	1,280	180	$50	$64.8K
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…	524	910	440	$40	$61.6K
99205	The provider sees a new 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 provider…	249	350	120	$90	$38.4K

Showing 1–10 of 26

Nearby Providers

Other providers in the same ZIP code as Upward Health Of Louisiana LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
City Of New Orleans	LA	Ambulance	$933.5K	$44M
Odyssey House Louisiana, Inc	LA	Substance Abuse Rehabilitation Facility	$0	$38.5M
Resources For Human Development	LA	Community/Behavioral Health Agency	$0	$28.2M
Bridge House Corporation	LA	Substance Abuse Rehabilitation Facility	$0	$16.5M
Odyssey House Louisiana, Inc	LA	Substance Abuse Rehabilitation Facility	$0	$8.1M
Odyssey House Louisiana, Inc	LA	Federally Qualified Health Center (FQHC)	$0	$5.4M
Payne's Home Care Service, Inc	LA	In Home Supportive Care Agency	$0	$4.9M
Eric Royster	LA	Pain Medicine (Anesthesiology) Physician	$79.3K	$10.3K

Upward Health Of Louisiana LLC — Billing Profile & Reimbursement Data

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Upward Health Of Louisiana 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

Nearby Providers

Frequently Asked Questions

References