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

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

Edmund Lacour (NPI 1285689463)

Field	Value
Entity Type	Individual
Organization	Edmund Lacour
Address	1118 Ross Clark Cir
City	Dothan
State	AL
ZIP	36301
Taxonomy	Rheumatology Physician
NPI Enumerated	May 24, 2006

Payer Source	Total Paid
Medicare	$3.7M
Medicaid	$0

Key Findings

This provider’s Medicare footprint is the dominant public-payer presence: total Medicare revenue is $3.7M while there is no Medicaid billing on file. In operational terms the practice is effectively single‑payer (Medicare) in the public claims dataset, so analyses of public payer mix should treat Medicare as the primary revenue source.

Revenue concentration is high and dominated by biologic drug J‑codes: the top three Medicare codes (J0129, J0897, J3262) account for 50.2% of this provider’s total Medicare revenue. Those three codes appear individually as J0129 ($774.7K revenue, 21.0%), J0897 ($544.5K revenue, 14.8%), and J3262 ($533.7K revenue, 14.5%), indicating half of Medicare dollars are driven by a small set of injectable biologics.

The code mix points to an office-based infusion/biologic management practice consistent with rheumatology and osteoporosis care: high-revenue J‑codes (abatacept J0129, denosumab J0897, tocilizumab J3262 and romosozumab J3111) dominate, and administration/infusion codes such as 96365, 96413, and 96415 are present. Combined with diagnostic/monitoring codes like 77080 (DXA) and lab panels, this pattern suggests clinical services are focused on ongoing in-office biologic injections and related monitoring rather than episodic procedural work.

Competitive standing is mixed across codes: J0897 (denosumab) is a national outlier—rank #100 of 10057 providers nationally (99th percentile; extreme outlier, far above typical national volume)—which indicates unusually large denosumab administration relative to peers. By contrast J0129 and J3262 both rank in the 93rd percentile (J0129 rank #92 of 1221; J3262 rank #43 of 618) and are labeled as typical or unremarkable at those percentiles, so the provider is a standout specifically on denosumab while being a high‑volume but more typical participant on some other biologics.

Visit and administration volumes support a high-throughput infusion clinic model: 99213 appears with 1.4K claims and $85K revenue (2.3% of Medicare revenue) and is flagged as an extreme outlier (rank #2688 of 457151, 99th percentile), while 99214 (858 claims, $73.8K, 2.0%) and 96365 (662 claims, $27.8K, 0.8%) are notably above typical. In addition 96372 is an extreme outlier (1.4K claims, $13.6K) which together with E/M volumes implies frequent short encounters and many procedure‑administration events per clinical day.

Ancillary diagnostics and monitoring are present but represent smaller revenue streams: DXA (77080) shows 367 claims and $12.5K revenue (0.3%) and lab codes such as 80053 (1.1K claims, $10.6K) and 82306 (179 claims, $5.2K) appear at high national percentiles. These items are consistent with longitudinal management of osteoporosis and rheumatologic conditions and support the inference that the practice bundles drug administration with in‑office monitoring.

Tenure is long: the provider’s NPI was enumerated 2006-05-24 (~20 years ago), indicating an established practice history in the market. This longevity, combined with concentrated biologic administration, suggests an entrenched care model focused on chronic disease management rather than a new or transient service line.

From an operational risk and competitive perspective, reliance on a small group of high‑revenue biologic codes creates concentration exposure: with the top three codes representing 50.2% of Medicare revenue and Medicare representing the entire public-payer dataset, the practice’s revenue is sensitive to changes in coverage, formulary status, or utilization patterns for those specific injectables. Analysts should weigh that concentration when modeling revenue downside or comparing to peers with more diversified payer or service mixes.

Medicare: Complete Services Breakdown

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

53 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0129	Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	23,480	$30	$774.7K
J0897	Injection, denosumab, 1 mg	30,250	$20	$544.5K
J3262	Injection, tocilizumab, 1 mg	106,740	$10	$533.7K
J3111	Injection, romosozumab-aqqg, 1 mg	53,760	$10	$430.1K
J1602	Injection, golimumab, 1 mg, for intravenous use	38,920	$10	$389.1K
J0717	Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	69,600	$1	$278.4K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	8,150	$30	$211.9K
J9312	Injection, rituximab, 10 mg	2,600	$60	$163.8K
99213	The 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…	1,390	$60	$85K
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…	860	$90	$73.8K

Showing 1–10 of 53

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 53 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Alabama Distribution

Edmund Lacour — 13 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. state median

53 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	2	30	8,530	$30	$390.9K
J0717	6	10	94,400	$1	$360.6K
J9312	3	10	2,800	$60	$262.7K
J3262	1	10	44,890	$1	$229.1K
J1602	2	20	16,100	$10	$189.5K
J3111	1	10	18,900	$10	$177.3K
J1745	3	30	3,020	$30	$107.2K
J0897	3	200	3,120	$20	$97.7K
86235	14	20	380	$20	$37.9K
86038	6	10	60	$10	$20.3K

Showing 1–10 of 53

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sai Avula	AL	Internal Medicine Physician	$540.7K	$0
Donavon Wewers	AL	Internal Medicine Physician	$489.9K	$0
William Hundley	AL	Internal Medicine Physician	$236K	$0
John Stone	AL	Endocrinology, Diabetes & Metabolism Physician	$174.8K	$0
April Tate	AL	Primary Care Nurse Practitioner	$67.9K	$0

Nearby Providers

Other providers in the same ZIP code as Edmund Lacour, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Houston County Healthcare Authority	AL	Internal Medicine Physician	$0	$9.6M
State Of Alabama Department Of Public Health	AL	Home Health Agency	$0	$6.9M
Wiregrass Hospice, LLC	AL	Community Based Hospice Care Agency	$0	$5.8M
Dothan Ambulance Service	AL	Land Ambulance	$1.7M	$3.9M
Southeast Alabama Maternity Care Program	AL	Exclusive Provider Organization	$0	$5.1M
Houston County Healthcare Authority	AL	General Acute Care Hospital	$0	$4.9M
Houston County Health Dept Fp Clinic	AL	Public Health or Welfare Agency	$0	$4.4M
Southern Alabama Surgery Center LLC	AL	Ambulatory Surgical Clinic/Center	$3.8M	$94.3K
Houston County Healthcare Authority	AL	Clinical Medical Laboratory	$591.7K	$2.1M
Eye Partners, PC	AL	Optometrist	$0	$2.4M

Edmund Lacour — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References