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

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

Mylene Lilian Gonzales (NPI 1396345948)

Field	Value
Entity Type	Individual
Organization	Mylene Lilian Gonzales
Address	4700 Ogeechee Dr
City	Johns Creek
State	GA
ZIP	30022
Taxonomy	Gerontology Nurse Practitioner
NPI Enumerated	October 31, 2020

Payer Source	Total Paid
Medicare	$4.1M
Medicaid	$0

Key Findings

This provider’s billing profile is overwhelmingly wound-care and product-focused: Q4217 (woundfix / biowound add-on) accounts for $4.1M revenue with 4K claims and a $1021 avg paid/claim, representing 99.0% of this provider's total Medicare revenue. The presence of skin-substitute code 15271 and debridement codes (11042, 11043, 97597), together with several home/residence E/M codes (99350, 99348, 99349, 99344, 99342), indicates services are centered on advanced wound treatment often delivered in home or residence settings and billed as both product and procedure.

Revenue is highly concentrated: the precomputed top-3 Medicare codes account for 99.6% of this provider's total Medicare revenue, with Q4217 alone making up 99.0% and the next two codes, 99350 and 15271, contributing 0.4% and 0.2% respectively. That concentration implies that changes affecting those few codes — coverage policy, reimbursement rate changes, or prior‑authorization rules — would materially affect the provider’s entire Medicare revenue stream.

In payer-mix terms the practice is effectively single-payer Medicare: lifetime Medicare revenue is $4.1M and there is no Medicaid billing on file (none below). Analysts should treat Medicaid management and in‑state competitive positioning as not applicable for this NPI because there is no Medicaid activity to evaluate.

Competitive standing on the primary codes is modest-to-visible at the national level but not extreme: Q4217 ranks #13 of 65 providers nationally and is described in the source as “typical, unremarkable volume for this code” (81th percentile). Supporting codes are similarly described as typical: 99350 ranks #2040 of 7304 (72th percentile) and 15271 ranks #529 of 1157 (54th percentile), indicating above‑median participation for the home‑visit and skin‑substitute lines but without an outlier profile.

Despite the high aggregate revenue, almost all other billed codes contribute trivial shares individually — for example 99350 generates $15.9K (0.4% of Medicare revenue) and 15271 $7.5K (0.2%). Many ancillary procedure and home‑visit codes appear at low absolute revenue and low national percentiles (for example 11043: $2.7K, ranks #1918 of 2062, 6th percentile), and the source characterizes these volumes as typical/unremarkable rather than as statistical outliers.

The provider’s NPI was enumerated on 2020-10-31 (~6 years ago), indicating a relatively recent registration window; the rapid attainment of $4.1M in Medicare revenue concentrated in Q4217 suggests the practice’s operational model was likely established early with a focus on wound product usage and associated home-based care. This tenure context is relevant for assessing business growth trajectory and how quickly product-driven workflows were scaled.

From a utilization-management and contracting perspective, the firm’s economics are highly sensitive to Q4217 and the small set of wound-product codes: because Q4217 is an add-on billed per square centimeter and accounts for the vast majority of revenue, payer interventions that restrict, audit, or change reimbursement for add-on wound products would have an outsized impact. Conversely, monitoring of home/residence E/M codes (e.g., 99350, 99348) is also warranted because they appear consistently in the mix even though they represent a small share of revenue.

No codes in the top-25 list are flagged as “extreme outlier” or similarly exceptional in the source; the plain-English characterization for the listed codes is uniformly typical or unremarkable. That pattern suggests the provider’s activity level is explainable within normal national variation for these service types, albeit with an unusually concentrated revenue dependency on a single add-on product code.

Medicare: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Q4217	Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter (add-on, list separately in addition to primary procedure)	4,000	$1,020	$4.1M
99350	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60…	130	$120	$15.9K
15271	The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the patient’s trunk, arms, and/or legs up to an area of 100 cm2. This code covers up to the first 25 cm2.	70	$100	$7.5K
99348	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30…	110	$50	$5.6K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	40	$80	$3.4K
11043	The provider uses surgical instruments to remove the dead tissue in muscle and/or fascia, including any debridement of the epidermis, dermis, and subcutaneous tissue, for the first or only 20 cm2 or…	20	$150	$2.7K
99349	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	30	$90	$2.5K
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,…	20	$70	$1.3K
99344	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider spends at least…	10	$90	$1.1K
99342	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a low level of medical decision making or the provider spends at least 30…	20	$50	$880

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 10 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Georgia Distribution

Mylene Lilian Gonzales — 0 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. state median

10 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q4217	2	10	4,030	$1,050	$4.2M
11043	26	30	40	$140	$17.9K
99349	204	260	80	$80	$15.6K
99350	43	160	50	$120	$15.3K
15271	12	40	50	$100	$9K
11042	172	240	70	$70	$8.3K
97597	134	150	50	$50	$4.5K
99348	36	160	50	$50	$4.1K
99342	22	30	20	$50	$2.7K
99344	97	110	20	$90	$2.6K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Susan Dixon-sibley	GA	Family Nurse Practitioner	$323K	$0
Ayesha Faruqi	GA	Internal Medicine Physician	$262.5K	$0
Jordan Fain	AL	Family Nurse Practitioner	$24.8K	$0
Monte Douglas	AR	Physician Assistant	$22.3K	$0
Chastity Heath	MS	Family Nurse Practitioner	$22.2K	$0
Dana Powers	KY	Family Nurse Practitioner	$2.2K	$0

Nearby Providers

Other providers in the same ZIP code as Mylene Lilian Gonzales, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northside Psychological Services, Inc.	GA	Mental Health Counselor	$0	$11.3M
The World Of Pediatrics	GA	Pediatrics Physician	$0	$930.7K
Tendercare Pediatrics	GA	Pediatrics Physician	$0	$531.4K
Brenda Jean-baptiste	GA	Professional Counselor	$0	$385.8K
Thomas Backer	GA	Cardiovascular Disease Physician	$379.5K	$0
Dalma Torres	GA	General Practice Dentistry	$0	$377.9K
Thomas Bat	GA	Family Medicine Physician	$227.3K	$0
Terence Moraczewski	GA	Family Medicine Physician	$215.4K	$0
Ayesha Harrell	GA	Professional Counselor	$0	$195.5K
Jessica Yi	GA	Pediatric Dentistry	$0	$180.2K

Mylene Lilian Gonzales — Billing Profile & Reimbursement Data

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Mylene Lilian Gonzales — 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