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

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

Paul Lalicata (NPI 1326257700)

Field	Value
Entity Type	Individual
Organization	Paul Lalicata
Address	37 Route 236
City	Kittery
State	ME
ZIP	03904
Taxonomy	Denturist
NPI Enumerated	May 22, 2007

Payer Source	Total Paid
Medicaid	$455.9K
Medicare	$0

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D5110	N/A	400	$640	$253.9K
D5120	N/A	270	$630	$172.6K
D0140	Limited oral evaluation – problem focused	690	$20	$13K
D5214	N/A	10	$660	$8.5K
D5130	N/A	10	$650	$7.8K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maine Distribution

Paul Lalicata — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. Maine median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D5110	N/A	3	10	180	$610	$170.1K
D5120	N/A	3	10	210	$600	$145.6K
D0140	Limited oral evaluation – problem focused	46	110	460	$20	$33.2K
D5130	N/A	3	10	10	$710	$17K
D5214	N/A	1	10	10	$650	$8.5K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Brett Rankin	ME	Otolaryngology Physician	$153K	$0
Christopher Sarno	ME	Otolaryngology Physician	$108.4K	$0
Kevin Webb	ME	Optometrist	$78.9K	$0
Nicholas Coppins	ME	Family Medicine Physician	$77K	$0
Nathan Jean	ME	Family Medicine Physician	$62.1K	$0
Tyler Lowe	ME	Optometrist	$56.9K	$0
Karen Healy	ME	Optometrist	$56.1K	$0
Heather Moher	ME	Family Medicine Physician	$51.7K	$0
Philip Abraham	ME	Internal Medicine Physician	$45.9K	$0
John Stallman	ME	Otolaryngology Physician	$44.2K	$0

Paul Lalicata — Billing Profile & Reimbursement Data

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Paul Lalicata — Billing Profile & Reimbursement Data

Sign up for Paul Lalicata — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References