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    OpenPayerNPI Medicare & MedicaidLee Gonzalez
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    Lee Gonzalez — Billing Profile & Reimbursement Data

    NPI 1326488909 · Bayamon, PR · Sleep Medicine (Internal Medicine) Physician

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    Lee Gonzalez is a sleep medicine (internal medicine) physician provider located in Bayamon, Puerto Rico. This profile covers 25 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationLee Gonzalez
    Address100 Ave Laurel
    CityBayamon
    StatePR
    ZIP00956
    TaxonomySleep Medicine (Internal Medicine) Physician
    NPI EnumeratedJune 27, 2013

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

    Payer SourceTotal Paid
    Medicare$217.8K
    Medicaid$0

    Key Findings

    This provider’s Medicare footprint is modest in scale, with total Medicare revenue of $217.8K and no Medicaid billing on file; the absence of any Medicaid claims means the provider is effectively single-payer (Medicare) in the available data. Analysts should treat payer-mix risk as concentrated in Medicare rather than split across Medicaid.

    Revenue is highly concentrated in a small set of office E/M codes: the precomputed top three Medicare codes account for 54.6% of total Medicare revenue, led by 99214 ($60.2K, 27.6%), 99204 ($31.9K, 14.6%), and 99213 ($26.8K, 12.3%). This concentration indicates that a majority of billed Medicare value is driven by a few high-volume E/M services rather than a broad mix of procedures.

    The code mix points to a dual focus on outpatient E/M and respiratory/sleep diagnostics: notable diagnostic and sleep codes include 95806, G0399, 94729 (280 claims), 94727 (281 claims), and 94060 (284 claims). High counts and revenue from these PFT and sleep-testing codes suggest the provider operates significant pulmonary function and sleep-diagnostic activity alongside office visits.

    Several procedure and hospital codes indicate an inpatient and procedural component to the practice: 99232 and 99233 (subsequent inpatient care), 99222/99223 (initial inpatient care), 99291 (critical care), plus 31624 and 32555 for bronchial lavage and image-guided thoracentesis. The presence of these codes alongside high-volume outpatient testing suggests the provider treats both ambulatory and hospitalized patients rather than exclusively clinic-based care.

    Competitive standing is mixed by service line: the provider is an extreme outlier nationally for 99204 (rank #2400 of 227068, 99th percentile; extreme outlier), indicating unusually high national volume for new-patient moderate-complexity visits, while 99214 (rank #34020 of 479517, 93th percentile) and 94729 (rank #615 of 8928, 93th percentile) sit at high but typical volumes. Pulmonary testing strengths are reinforced by 94727 and 94060 ranking in the 95th percentile (94727 rank #157 of 2942; 94060 rank #423 of 9054), which places this provider well above typical national peers for PFT and spirometry services.

    There are detectable gaps and lower relative presence in some ancillary areas: telehealth originating site fees (Q3014) show limited volume (30 claims, rank #798 of 1090, 26th percentile), and several advanced inpatient codes (e.g., 99223 rank #97462 of 139583, 29th percentile) are lower-ranking, indicating less activity in the highest-complexity initial inpatient admissions. This suggests the provider’s work is concentrated in moderate-complexity new and established visits plus diagnostics rather than heavy telehealth or the highest-acuity inpatient admits.

    Claim counts for pulmonary diagnostics reinforce the operational emphasis on testing: the provider billed 280 claims for 94729, 281 claims for 94727, and 284 claims for 94060, each contributing materially to revenue and supported by high national percentiles for those codes. For payers evaluating network capacity for respiratory and sleep diagnostics, these volumes indicate reliable throughput in those specific service lines.

    The provider has an established NPI with enumeration date 2013-06-27 (~13 years ago), indicating long-term presence in the Medicare program. Combined with a total Medicare revenue of $217.8K, this tenure plus modest overall revenue profile is consistent with a smaller or specialized practice footprint rather than a large multi-provider enterprise, which is relevant for network contracting and capacity planning discussions.

    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.

    25 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…610$100$60.2K
    99204The provider sees a new 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 provider…250$130$31.9K
    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…390$70$26.8K
    99232The 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…230$60$14.1K
    99291Critical care services include the treatment of vital organ failure  or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…80$170$12.8K
    94729In this add on procedure, the provider tests the lungs’ diffusing capacity, the ability to exchange gases, moving oxygen into the bloodstream and letting in carbon dioxide from the bloodstream.280$40$11.8K
    99233The 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…120$90$10.7K
    94727The provider performs a pulmonary function test, or PFT, to assess the patient’s lung volumes using gas dilution or washout techniques that compare a known concentration of an inhaled gas with the…280$30$9.3K
    94060The spirometry test is performed with a spirometer. The instrument displays a graphical representation, known as a spirogram, of the test results. The basic forced volume vital capacity (FVC) test is…280$30$8.2K
    99222The 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…60$100$6.3K

    Showing 1–10 of 25

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 25 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    25 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992334317070$90$9.4K
    99291137040$170$9K
    992323222080$60$7.9K
    99214247050$80$6.6K
    99215315030$110$6K
    99239354030$90$5.3K
    992238020020$130$4.9K
    99213121,53050$60$4.2K
    3255531020$80$4.1K
    9580611040$70$2.7K

    Showing 1–10 of 25

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    New York Queens Medicine And Surgery, P.C.NYPediatrics Physician$0$40.8M
    Sergio DromiFLDiagnostic Radiology Physician$1.7M$0
    Christopher FlyeNCDiagnostic Radiology Physician$1.7M$0
    Jeffrey LiebermanFLDiagnostic Radiology Physician$1.4M$0
    Amjad SafviILVascular & Interventional Radiology Physician$568.9K$765.4K
    Christopher SweetMIDiagnostic Radiology Physician$1.3M$0
    Michael ShriverOHDiagnostic Radiology Physician$1.1M$0
    Adam OlmstedOHDiagnostic Radiology Physician$1.1M$0
    Dinesh SharmaFLClinical Cardiac Electrophysiology Physician$1.1M$0
    Howard KappFLOrthopaedic Surgery Physician$1M$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Lab Clinico Van ScoyPRClinical Medical Laboratory$29.6K$2M
    Laboratorio Clinico Principal IncPRClinical Medical Laboratory$11.5K$1.6M
    United Emergency Medical CorporationPRAmbulance$70.7K$1.4M
    Elsa JustinianoPRDentist$0$1.1M
    Multiple Medical Preventive Group LLC.PRGeneral Practice Physician$0$1.1M
    Dr.hiramvegaayoroa,pscPRPediatric Dentistry$0$835.5K
    Quality Gastroenterology LLCPRGastroenterology Physician$0$757.9K
    Neysha MunizPRSpeech-Language Pathologist$0$708.3K
    Lemuel Martinez-bonillaPRInfectious Disease Physician$9.9K$689.8K
    Ricardo Diaz IrizarryPRPersonal Emergency Response Attendant$0$686.9K

    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. Puerto Rico Distribution
    Lee Gonzalez — 8 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Puerto Rico