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 Texas for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Texas 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. Texas (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.

Rachel Lai (NPI 1205277753)

Field	Value
Entity Type	Individual
Organization	Rachel Lai
Address	4499 Medical Dr Ste 166
City	San Antonio
State	TX
ZIP	78229
Taxonomy	Nurse Practitioner
NPI Enumerated	July 12, 2013

Payer Source	Total Paid
Medicare	$22.5K
Medicaid	$0

Medicare: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	200	$60	$11.9K
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…	90	$90	$8.7K
93264	The provider, a physician or other qualified healthcare professional, reviews at least weekly downloads of remote monitoring reports for a wireless pulmonary artery pressure sensor, interprets the…	80	$20	$1.8K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Texas Distribution

Rachel Lai — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. state median

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	10,769	32,500	110	$80	$17.6K
99215	1,995	8,730	40	$120	$9.2K
93264	6	20	60	$30	$2.1K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Arnold Vardiman	TX	Neurological Surgery Physician	$532.5K	$0
Javier Roman-gonzalez	TX	Clinical Cardiac Electrophysiology Physician	$528.5K	$0
Jacqueline Schwartz	CA	Clinical Cardiac Electrophysiology Physician	$436.2K	$140
Ismael Sosa	TX	Hospitalist Physician	$422.3K	$0
Donald Atkins	TX	Neurological Surgery Physician	$280.2K	$0
Donald Hilton	TX	Neurological Surgery Physician	$272.7K	$0
John Frierson	TX	Interventional Cardiology Physician	$251.1K	$0
Aaron Terry	TX	Family Medicine Physician	$221.5K	$0
Luke Shen	TX	Transplant Surgery Physician	$204.7K	$0
Christopher Pickett	TX	Interventional Cardiology Physician	$202.7K	$0

Rachel Lai — Billing Profile & Reimbursement Data

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Rachel Lai — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Frequently Asked Questions

References