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

Why is the Medicaid comparison limited to Unspecified Location 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. Unspecified Location (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.

David Lobo (NPI 1255689980)

Field	Value
Entity Type	Individual
Organization	David Lobo
Address	1 Hospital Court
City	Oshawa
State	XX (Unspecified Location)
ZIP	L1G2B
Taxonomy	Internal Medicine Physician
NPI Enumerated	August 28, 2012

Payer Source	Total Paid
Medicare	$22.5K
Medicaid	$0

Key Findings

This provider’s lifetime Medicare billing is very small in absolute terms: total Medicare revenue is $22.5K and there is no Medicaid billing on file, so the provider operates effectively as a single-payer (Medicare-only) billing entity in the available data. The absence of any Medicaid claims limits analysis of dual-payer exposure and indicates minimal participation in state Medicaid networks based on the records provided.

Revenue is highly concentrated in a few inpatient E/M codes: the precomputed top three Medicare codes account for 67.6% of this provider’s total Medicare revenue, with 99232 alone representing $9.9K (43.9% of Medicare revenue). This concentration suggests a small set of service types drive the majority of billed dollars rather than a broad mix of outpatient procedures.

The specific top CPTs (99232, 99239, 99222) are all hospital inpatient/observation E/M and discharge management codes, which implies the provider’s billings are centered on inpatient rounds, initial hospital evaluations, and discharge-day management rather than ambulatory office procedures. The code mix points toward an inpatient-focused practice pattern (hospital visits and discharge care) rather than procedure-driven specialty billing.

Claim counts and per-claim payments for the top codes reinforce the inpatient E/M profile: 99232 shows 170 claims at $58 avg paid/claim, 99239 shows 31 claims at $90 avg paid/claim, and 99222 shows 25 claims at $101 avg paid/claim. These figures indicate modest per-encounter payments typical of E/M hospital services and low overall volume in dollar terms.

On competitive standing for these codes, the provider is a modest participant nationally rather than a dominant player: 99232 ranks #53841 of 177383 providers (69th percentile) and is described as "typical, unremarkable volume for this code," 99239 ranks #42406 of 62398 providers (31st percentile) labeled "typical, unremarkable volume for this code," and 99222 ranks #62855 of 117621 providers (45th percentile) also labeled "typical, unremarkable volume for this code." These rank/label pairs show no outlier dominance in national comparisons.

Several inpatient codes appear at the lower end of national rank distributions (for example, 99223 ranks #127256 of 139583 providers — 6th percentile — and 99233 ranks #106754 of 128818 providers — 16th percentile) but are still described in the file as "typical, unremarkable volume for this code." That pattern indicates infrequent use of the highest-complexity initial or subsequent hospital visit codes in this provider’s billings rather than a statistical anomaly.

The provider’s NPI was enumerated on 2012-08-28 (~14 years ago), indicating a long-tenured enrollment in the provider registry despite the modest Medicare billing footprint. Combined with the small lifetime Medicare revenue, tenure suggests either limited clinical effort billed to Medicare or billing activity concentrated in a narrow set of inpatient services rather than rapid growth or broad payer participation.

Medicare: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	170	$60	$9.9K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	30	$90	$2.8K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	30	$100	$2.5K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	30	$90	$2.5K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	50	$40	$1.9K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	10	$130	$1.6K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	20	$60	$1.2K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes. Note: this provider's state, "XX," is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; the State panel below benchmarks against other providers coded under the same designation.

View: State1 / 2

Claims Volume vs. Unspecified Location Distribution

David Lobo — 2 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Unspecified Location

Full comparison — all codes billed, vs. state median

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99232	4	10	110	$60	$6.9K
99222	4	10	40	$100	$3.9K
99223	7	10	10	$140	$1.6K
99231	2	0	N/A	$N/A	$N/A
99233	4	0	N/A	$N/A	$N/A
99238	1	0	N/A	$N/A	$N/A
99239	3	0	N/A	$N/A	$N/A

David Lobo — Billing Profile & Reimbursement Data

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David Lobo — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References