Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

Our Lady of the Lake Hospital Inc.

General Acute Care Hospital·Baton Rouge, LA·NPI: 1366436123SharePrint Report

Red Flags Explained

Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:

Rate Outlier

Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.

These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.

Risk Assessment

Bills $177.86 per claim for 99283 (Emergency dept visit, moderate complexity) — 4.2× the national median of $42.48.

Bills $261.92 per claim for 99284 (Emergency dept visit, high complexity) — 3.8× the national median of $69.51.

Bills $280.37 per claim for 99285 (Emergency dept visit, high/urgent complexity) — 3.3× the national median of $85.65.

Billing in the top 1% nationally for 3 procedure codes: 74177, 74176, 20610.

This is a statistical summary, not an accusation. See our methodology.

Compared to General Acute Care Hospital Peers

Total spending distribution among 156 providers in this specialty

P25MedianP75P90

This provider's total spending of $205.7M is at the 50th percentile among 156 General Acute Care Hospital providers.

Active Billing Period:2018-012024-12(84 months)

Total Paid

$205.7M

$205,685,425

Total Claims

3.8M

Beneficiaries

3.2M

1.2 claims/patient

Avg Cost/Claim

$54

#435 of 618K providers by total spending(top <0.1%)

🔍 Analysis

Provider Overview

Our Lady of the Lake Hospital Inc. is a General Acute Care Hospital provider based in Baton Rouge, LA. From the 2018–2024 period, this provider received $205.7M in Medicaid payments across 3.8M claims.

Why This Matters

This provider received $205.7M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 25,710 Medicaid beneficiaries for a full year at average per-enrollee costs.

78% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$18.8M
+15%
2019
$21.5M
-12%
2020
$19.0M
+81%
2021
$34.5M
+11%
2022
$38.2M
+5%
2023
$40.2M
-17%
2024
$33.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99283 (Emergency dept visit, moderate complexity)) accounts for 22% of total spending.

99283Top 10%

Emergency dept visit, moderate complexity

$45.9M

258K claims · 22.3%

Your Cost: $177.86/claim|Median: $42.48
4.2× median
99284Top 5%

Emergency dept visit, high complexity

$37.4M

143K claims · 18.2%

Your Cost: $261.92/claim|Median: $69.51
3.8× median
99285Top 10%

Emergency dept visit, high/urgent complexity

$19.6M

70K claims · 9.5%

Your Cost: $280.37/claim|Median: $85.65
3.3× median
74177Top 1%

CT abdomen and pelvis with contrast

$7.6M

6K claims · 3.7%

Your Cost: $1,227.18/claim|Median: $65.76
18.7× median
99282Top 25%

Emergency dept visit, low complexity

$7.4M

57K claims · 3.6%

Your Cost: $131.49/claim|Median: $37.72
3.5× median
G0378Top 25%

Hospital observation service, per hour

$7.3M

17K claims · 3.6%

Your Cost: $421.62/claim|Median: $99.39
4.2× median
70450Top 5%

CT head/brain without contrast

$6.0M

18K claims · 2.9%

Your Cost: $336.47/claim|Median: $45.53
7.4× median
99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$5.8M

195K claims · 2.8%

Your Cost: $29.52/claim|Median: $37.81
0.8× median
99212Normal range

Office/outpatient visit, low complexity

$5.0M

193K claims · 2.4%

Your Cost: $25.76/claim|Median: $25.06
1.0× median
93005Top 25%

Electrocardiogram, tracing only, without interpretation

$4.9M

106K claims · 2.4%

Your Cost: $45.55/claim|Median: $7.50
6.1× median
96375Top 25%

Therapeutic/prophylactic/diagnostic IV push, each additional substance

$3.5M

71K claims · 1.7%

Your Cost: $48.67/claim|Median: $14.92
3.3× median
99214Normal range

Office/outpatient visit, est. patient, mod-high complexity

$3.5M

77K claims · 1.7%

Your Cost: $44.83/claim|Median: $53.41
0.8× median
96374Normal range

Therapeutic/prophylactic/diagnostic IV push, single substance

$3.2M

107K claims · 1.6%

Your Cost: $30.33/claim|Median: $21.76
1.4× median
71045Top 10%

Chest X-ray, single view

$2.8M

68K claims · 1.4%

Your Cost: $41.21/claim|Median: $4.93
8.4× median
87428Normal range

SARS-CoV-2 COVID-19 antigen detection, immunoassay, each

$2.8M

108K claims · 1.4%

Your Cost: $25.99/claim|Median: $39.63
0.7× median
96372Top 10%

Therapeutic injection, subcutaneous/intramuscular

$2.6M

74K claims · 1.3%

Your Cost: $35.71/claim|Median: $9.56
3.7× median
99211Top 25%

Office/outpatient visit, minimal complexity

$2.5M

103K claims · 1.2%

Your Cost: $24.63/claim|Median: $12.93
1.9× median
41899Normal range

Unlisted procedure, dentoalveolar structures

$2.4M

4K claims · 1.2%

Your Cost: $550.63/claim|Median: $763.43
0.7× median
71046Top 5%

Chest X-ray, 2 views

$2.1M

29K claims · 1.0%

Your Cost: $72.85/claim|Median: $8.92
8.2× median
96413Top 25%

Chemotherapy administration, IV infusion, up to 1 hour

$1.9M

13K claims · 0.9%

Your Cost: $149.02/claim|Median: $75.28
2.0× median
80053Normal range

Comprehensive metabolic panel

$1.9M

259K claims · 0.9%

Your Cost: $7.22/claim|Median: $7.24
1.0× median
74176Top 1%

CT abdomen and pelvis without contrast

$1.7M

1K claims · 0.8%

Your Cost: $1,124.41/claim|Median: $60.19
18.7× median
80307Normal range

Drug test, presumptive, by chemistry analyzers

$1.4M

34K claims · 0.7%

Your Cost: $41.32/claim|Median: $35.43
1.2× median
43239Top 25%

Upper GI endoscopy with biopsy

$1.4M

5K claims · 0.7%

Your Cost: $297.12/claim|Median: $151.68
2.0× median
85025Normal range

Complete blood count (CBC) with differential, automated

$1.3M

251K claims · 0.6%

Your Cost: $5.05/claim|Median: $4.71
1.1× median
87426Top 25%

SARS-CoV-2 COVID-19 antigen detection, immunoassay

$1.3M

34K claims · 0.6%

Your Cost: $36.71/claim|Median: $30.04
1.2× median
96361Normal range

IV infusion, hydration, each additional hour

$1.2M

25K claims · 0.6%

Your Cost: $47.10/claim|Median: $38.92
1.2× median
U0003Normal range

Infectious disease detection (COVID-19)

$945K

14K claims · 0.5%

Your Cost: $69.51/claim|Median: $63.08
1.1× median
20610Top 1%

Arthrocentesis, aspiration/injection, major joint

$779K

2K claims · 0.4%

Your Cost: $395.48/claim|Median: $29.03
13.6× median
87804Normal range

Influenza virus detection, rapid test

$751K

57K claims · 0.4%

Your Cost: $13.14/claim|Median: $12.59
1.0× median