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 1982799375)

Key Findings

Field	Value
Entity Type	Organization
Organization	Lovelace Health System, LLC
Address	4701 Montgomery Blvd Ne
City	Albuquerque
State	NM
ZIP	87109
Taxonomy	General Acute Care Hospital
NPI Enumerated	October 3, 2006

Payer Source	Total Paid
Medicaid	$57.7M
Medicare	$0

LOVELACE HEALTH SYSTEM, LLC is effectively a single-payer Medicaid hospital in the available data: there is no Medicare billing on file while total Medicaid revenue is $57.7M, indicating the provider’s measurable payer activity in our dataset is concentrated entirely in Medicaid. This implies analysis of its commercial or Medicare-facing operations cannot be assessed from these files and that Medicaid drives visible revenue flows.

Revenue concentration is high within Medicaid: the precomputed top three Medicaid codes account for 43.6% of the provider’s total Medicaid revenue, signaling that a relatively small set of services—primarily emergency department evaluation and management and mid-to-high acuity ED visits—drive a large share of Medicaid receipts. This concentration suggests operational and financial sensitivity to demand for those core services.

The coding mix and top revenue drivers indicate an acute-care hospital with heavy emergency and obstetric imaging volume. High-revenue ED E/M services 99284, 99285, and 99283 together generate substantial Medicaid revenue (they appear among the top codes and collectively form part of the 43.6% top-3 share), while obstetric ultrasound codes 76805, 76819, 76820, 76817 and fetal monitoring 59025 are also prominent, reflecting sizeable maternal/fetal and general hospital outpatient diagnostic capacity. These patterns are consistent with a general acute care hospital serving emergency, imaging, and obstetrics service lines.

Competitive standing within New Mexico is mixed but generally strong in obstetric and select surgical codes. LOVELACE ranks #2 of 38 providers for 76805 (97th percentile) and #2 of 43 providers for 59025 (98th percentile), which are characterized as notably above typical state volume and indicate a regional leadership role in prenatal imaging and fetal monitoring. Conversely, ED E/M codes 99284 (85th percentile), 99285 (81st percentile), and 99283 (77th percentile) are in the upper-middle range but described as typical, suggesting healthy ED volume but not dominating statewide ED activity.

There are a few service-level outliers where LOVELACE is a clear statewide leader: 58661 (laparoscopic adnexal surgery) ranks #1 of 5 providers and is flagged as notably above typical state volume (100th percentile), indicating the hospital performs a comparatively large share of these gynecologic procedures in-state. This specific procedural dominance may reflect referral patterns or a concentrated surgical capability in gynecologic laparoscopy relative to peers.

Routine imaging and diagnostics supply steady ancillary revenue: high claim counts for tests such as 80053 (36K claims, $898.8K revenue), 85025 (45.4K claims, $590.1K revenue), CT abdomen/pelvis 74177 and CT head 70450, plus ECG 93005, place LOVELACE in upper percentiles (mostly mid-60s to mid-80s) statewide. These codes generate modest individual revenue shares but collectively reinforce the hospital’s role as a high-throughput diagnostic center for Medicaid patients.

Service mix and payer profile create specific business implications: because Medicaid is the only reported public payer here, operational planning, capacity management, and revenue forecasting should prioritize ED throughput, prenatal services, and high-volume diagnostics that drive almost half the Medicaid revenue via the top three codes. Any changes in Medicaid policy, reimbursement, or patient volume for those codes would disproportionately affect the provider’s financial profile given the 43.6% revenue concentration.

The provider has long tenure on file: its NPI was enumerated on 2006-10-03 (~20 years ago), indicating established operations and sufficient time to develop the referral networks and service concentrations evident in the Medicaid code mix. This longevity supports the interpretation that observed service patterns are stable institutional capabilities rather than short-run artifacts.

Medicaid: Complete Services Breakdown

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

303 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.	37,240	$210	$7.9M
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.	19,760	$270	$5.3M
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.	26,940	$150	$4.1M
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.	6,170	$340	$2.1M
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	14,820	$120	$1.8M
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	15,710	$110	$1.8M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	20,530	$80	$1.6M
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	16,000	$80	$1.2M
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	9,320	$130	$1.2M
76825	The provider performs real–time fetal echocardiography, with or without M–mode recording, for complete evaluation of a fetal cardiovascular system.	3,250	$350	$1.1M

Showing 1–10 of 303

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 — 3 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

303 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.	12	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.	14	70	6,920	$210	$3.5M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	10	40	3,670	$80	$3.2M
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.	20	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.	14	60	3,070	$210	$1.4M
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	3	20	2,780	$90	$1.3M
G0378	Hospital observation service, per hour	16	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…	5	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.	22	60	2,820	$110	$799.5K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	4	30	380	$100	$796.5K

Showing 1–10 of 303

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lovelace Health System LLC	NM	General Acute Care Hospital	$0	$45.2M
Lovelace Health System, LLC	NM	General Acute Care Hospital	$0	$31.2M
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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Presbyterian Healthcare Services	NM	Internal Medicine Physician	$0	$240.8M
Heritage Home Healthcare Services, Inc.	NM	Home Health Agency	$0	$141.5M
Home Medical Equipment Specialists LLC	NM	Durable Medical Equipment & Medical Supplies	$0	$100M
The New Beginnings LLC	NM	Adult Day Care Clinic/Center	$0	$85.1M
We Care Agency, Inc.	NM	In Home Supportive Care Agency	$0	$60.1M
Adelante Development Center, Inc.	NM	Personal Care Attendant	$0	$57M
Eye Associates Of New Mexico Ltd	NM	Ophthalmology Physician	$0	$46.9M
Southwest Labs LLC	NM	Clinical Medical Laboratory	$1.1M	$41.5M
Southwest Medical Associates, LLC	NM	General Practice Physician	$0	$41.4M
Tspc-nm, LLC	NM	Nursing Care Agency	$0	$28.9M

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