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    v1.0.28
    OpenPayerNPI Medicare & MedicaidRobert Lagrone
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    Robert Lagrone — Billing Profile & Reimbursement Data

    NPI 1417903378 · Nashville, TN · Rheumatology Physician

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    Robert Lagrone is a rheumatology physician provider located in Nashville, Tennessee. This profile covers 14 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
    OrganizationRobert Lagrone
    Address2001 Charlotte Ave
    CityNashville
    StateTN
    ZIP37203
    TaxonomyRheumatology Physician
    NPI EnumeratedMay 25, 2006

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

    Payer SourceTotal Paid
    Medicare$1.8M
    Medicaid$0

    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.

    14 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J1745Injection, infliximab, excludes biosimilar, 10 mg30,530$30$793.9K
    J0717Injection, 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)103,600$1$414.4K
    J3262Injection, tocilizumab, 1 mg42,230$10$211.2K
    J0129Injection, 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)5,630$30$191.3K
    96413Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…710$90$64.9K
    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…500$80$40.4K
    96401The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient.580$50$30.3K
    J0897Injection, denosumab, 1 mg1,320$20$23.8K
    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…380$60$21.6K
    96415In this add on procedure, the provider continues administration of a chemotherapy drug into a vein using an infusion technique. He uses this code to report each additional hour of infusion beyond the…470$20$9.3K

    Showing 1–10 of 14

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    14 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J012925308,810$30$362.8K
    J071752050,400$1$263.1K
    J326281044,440$1$249.7K
    J17451403,270$30$116.4K
    J08972042402,940$20$85K
    964138240150$90$18.9K
    992141,28911,370120$80$16.6K
    9921397011,03080$50$8K
    964012110100$50$6.9K
    992042,5875,49030$100$5.3K

    Showing 1–10 of 14

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Hca Health Services Of Tennessee, Inc.TNGeneral Acute Care Hospital$0$45.9M
    Pediatrix Medical Group Of Tennessee, P.C.TNNeonatal-Perinatal Medicine Physician$0$32.3M
    Saint Thomas Medical PartnersTNInternal Medicine Physician$0$21.9M
    Radiology Alliance PCTNDiagnostic Radiology Physician$0$13.2M
    Emergency Medicine Services Of Tn, PCTNEmergency Medicine Physician$0$12.9M
    Tennessee Maternal-fetal Medicine LLCTNSpecialist$0$12.5M
    The Next Door, Inc.TNSubstance Abuse Rehabilitation Facility$0$8.6M
    Tennessee Oncology PLLCTNHematology & Oncology Physician$0$8.5M
    Vcphcs Ix, LLCTNSubstance Use Disorder Rehabilitation Clinic/Center$257.7K$6.6M
    Tennessee Retina PCTNRetina Specialist (Ophthalmology) Physician$0$6M

    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.

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    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Tennessee Distribution
    Robert Lagrone — 5 of 14 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Tennessee