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

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

Monica Lucas (NPI 1376819227)

Field	Value
Entity Type	Individual
Organization	Monica Lucas
Address	1441 Superior Ave
City	Newport Beach
State	CA
ZIP	92663
Taxonomy	Physical Therapist
NPI Enumerated	March 26, 2012

Payer Source	Total Paid
Medicare	$81K
Medicaid	$0

Medicare: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97597	The provider excises devitalized (dead) tissue from an open wound, choosing from a variety of techniques; treatment may include topical application of medicine or materials, wound assessment,…	870	$90	$76.3K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	50	$90	$4.4K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 2 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. California Distribution

Monica Lucas — 1 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. state median

2 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97597	7	440	60	$70	$8.6K
97162	997	3,440	30	$80	$3.6K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Newport Bay Surgery Center, LLC	CA	Ambulatory Surgical Clinic/Center	$1.8M	$242.6K
David Nabi	CA	Vascular Surgery Physician	$1.4M	$0
Ryan Klein	CA	Internal Medicine Physician	$1.3M	$0
Hoag Outpatient Centers, LLC	CA	Ambulatory Surgical Clinic/Center	$1.2M	$0
Howard Mango	CA	Audiologist	$1M	$148K
Rafael Penunuri	CA	Internal Medicine Physician	$1.1M	$0
Melissa Smith	CA	Plastic Surgery Physician	$754.8K	$255K
Newport Beach Endoscopy Center, LLC	CA	Ambulatory Surgical Clinic/Center	$967.7K	$0
George Siegel	CA	Occupational Therapist	$891.6K	$0
Christopher O'carroll	CA	Neurology Physician	$655.3K	$0

Monica Lucas — Billing Profile & Reimbursement Data

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Monica Lucas — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References