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    OpenPayerNPI Medicare & MedicaidPhillip Lucas
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    Phillip Lucas — Billing Profile & Reimbursement Data

    NPI 1033175435 · Providence, RI · Orthopaedic Surgery of the Spine Physician

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    Phillip Lucas is a orthopaedic surgery of the spine physician provider located in Providence, Rhode Island. This profile covers 18 Medicare and 1 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationPhillip Lucas
    Address2 Dudley St
    CityProvidence
    StateRI
    ZIP02905
    TaxonomyOrthopaedic Surgery of the Spine Physician
    NPI EnumeratedApril 25, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$116.7K
    Medicaid$8.2K

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    18 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99214The 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…390$90$36.8K
    62323The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)…100$180$17.2K
    64493The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance…80$190$15.7K
    64483This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral).70$210$15K
    27096The provider performs an injection in the joint between the sacrum and ilium on one side of the body, with the aid of imaging equipment to locate the injection site. He injects an anesthetic to…60$130$7.9K
    99203The 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…80$80$6.6K
    72110In this diagnostic procedure, the provider performs at least four X–ray views of the lumbosacral spine to evaluate the patient's spine for the presence of abnormal curves, fractures, or cancer.150$40$6.1K
    99213The 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…70$70$4.9K
    20610In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…30$50$1.6K
    72100The technician takes 2 or 3 views of the vertebrae in the lumbar region which is the lower part of the spine and the sacrum, the area that connects the spine to the pelvis. Lumbosacral spine X–rays…40$30$1.1K

    Showing 1–10 of 18

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    18 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    6232392050$140$13.2K
    6449352050$170$12.8K
    6448372050$190$12.2K
    992141451,950100$80$11.7K
    992139191,95070$60$7.4K
    206108211060$50$4.6K
    2709632030$110$4.1K
    992039358030$70$3.6K
    72082142040$40$1.9K
    7211035030$30$1.5K

    Showing 1–10 of 18

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    1 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99214The 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…70$120$8.2K

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Rhode Island providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Rhode Island median

    1 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    99214The 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…1,2251,730220$70$75.2K

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Phillip Lucas, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Rhode Island HospitalRIGeneral Acute Care Hospital$0$380.8M
    Rhode Island HospitalRIEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center$0$13.2M
    Rhode Island HospitalRIPediatrics Physician$0$5.3M
    University Orthopedics, Inc.RIOrthopaedic Surgery Physician$0$5.3M
    Rhode Island HospitalRIMulti-Specialty Clinic/Center$0$4M
    Rhode Island HospitalRIEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center$0$2.6M
    George DupontRIPediatric Dentistry$0$2.4M
    Rhode Island HospitalRIHematology & Oncology Physician$0$2.3M
    Brian SavoieRIRetina Specialist (Ophthalmology) Physician$1.4M$55.1K
    Chandan LakhianiRIPediatrics Physician$0$1.3M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Rhode Island Distribution
    Phillip Lucas — 1 of 17 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Rhode Island
    Medicaid Revenue by Year vs. Rhode Island Providers
    0 of 2 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Rhode Island Distribution
    Phillip Lucas — 0 of 1 code billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Rhode Island