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

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

Timothy Lonesky (NPI 1447478029)

Field	Value
Entity Type	Individual
Organization	Timothy Lonesky
Address	26 Oxford Way
City	Somerset
State	KY
ZIP	42503
Taxonomy	Rheumatology Physician
NPI Enumerated	April 21, 2007

Payer Source	Total Paid
Medicare	$1.5M
Medicaid	$0

Key Findings

This provider is effectively a Medicare-only operator: lifetime Medicare revenue is $1.5M while there is no Medicaid billing on file, so payer mix is single-payer in practice and the practice’s revenue base is concentrated in Medicare fee-for-service. The lack of any Medicaid claims suggests limited or no participation in state Medicaid panels or that services to Medicaid beneficiaries are routed through other entities.

Revenue concentration is high and dominated by biologic drug administration: the precomputed top 3 Medicare codes account for 70.9% of total Medicare revenue, with J0129 alone generating $691.4K (45.5% of Medicare revenue). The next two contributors are J0717 at $249.6K (16.4%) and J1602 at $136K (8.9%), indicating that infusion/administration of injectable biologics is the primary revenue driver.

Service-line profile aligns with a rheumatology infusion/clinic model: the top codes (J0129, J0717, J1602) are high-cost biologic injections commonly used to treat autoimmune and inflammatory conditions, and the presence of additional biologics such as J3262 (tocilizumab), J1745 (infliximab), and J0897 (denosumab) reinforces that trend. Support services consistent with a clinic-based specialty practice appear alongside these drugs — for example, infusion and administration codes 96365 (307 claims, $14.1K) and 96413 (156 claims, $14.5K) are present, as are autoimmune lab codes.

Competitive standing is mixed by code: for J0129 the provider ranks #118 of 1221 nationally (90th percentile), indicating relatively high national volume on that specific agent even though the dataset labels it "typical, unremarkable volume for this code." For J0717 (rank #304 of 848, 64th percentile) and J1602 (rank #508 of 1041, 51th percentile) the provider sits closer to median national peers, so outside of the J0129 position the practice is a modest participant rather than a dominant national player.

Clinical throughput for office visits shows pockets of above-typical volume: 99214 (556 claims, $47.3K) ranks #40804 of 479517 (91th percentile) and the new-patient code 99204 (394 claims, $43.7K) is flagged as an "extreme outlier, far above typical national volume" (rank #481 of 227068, 100th percentile). This suggests the practice not only administers biologics but also manages substantial ambulatory evaluation and management, including a high-than-typical new patient intake.

Laboratory testing mix supports a rheumatology diagnostic workflow: elevated counts and revenue for ENA testing (86235, $33.7K) and CCP testing (86200, $3.3K) alongside ANA and related serologies indicate routine in-house ordering or coordination of autoimmune serology panels to guide biologic therapy decisions. These lab services collectively supplement drug and infusion revenue and reflect standard specialty workup for inflammatory disease.

There are notable high-percentile, code-specific signals to be aware of: 96372 (437 claims) ranks #2065 of 58224 (96th percentile) and is described as "notably above typical national volume for this code," reinforcing strong injection/administration throughput; similarly, 99204 is an "extreme outlier," highlighting atypically high new-patient E/M billing relative to national peers. These flagged standing labels should be considered when benchmarking utilization patterns against peers or assessing operational capacity for infusion and new-patient intake.

The provider has long-standing enrollment in national provider databases, which supports continuity: NPI enumerated on 2007-04-21 (~19 years ago). That tenure, combined with a concentrated biologic-centric revenue profile and accompanying diagnostic labs and E/M volume, is consistent with an experienced rheumatology practice that focuses on office-based biologic administration and associated patient evaluation.

Medicare: Complete Services Breakdown

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

29 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0129	Injection, 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)	20,950	$30	$691.4K
J0717	Injection, 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)	62,400	$1	$249.6K
J1602	Injection, golimumab, 1 mg, for intravenous use	13,600	$10	$136K
J3262	Injection, tocilizumab, 1 mg	23,120	$10	$115.6K
99214	The 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…	560	$90	$47.3K
J0897	Injection, denosumab, 1 mg	2,580	$20	$46.4K
99204	The 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…	390	$110	$43.7K
J3111	Injection, romosozumab-aqqg, 1 mg	4,410	$10	$35.3K
86235	The lab analyst performs an assay to evaluate the patient’s serum for each antibody to an extractable nuclear antigen, also called ENA. Types of ENA antibodies include anti ribonuclear protein,…	1,980	$20	$33.7K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	1,530	$20	$33.6K

Showing 1–10 of 29

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 29 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Kentucky Distribution

Timothy Lonesky — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. state median

29 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	6	30	9,700	$30	$415.4K
J0717	9	30	46,400	$1	$288.1K
J3262	9	10	33,960	$1	$183.8K
J1602	7	20	11,560	$10	$141.6K
J1745	7	10	2,010	$30	$93.6K
J0897	29	80	2,280	$20	$59.6K
J3111	2	10	4,200	$10	$41.7K
96413	19	50	100	$90	$16.7K
99214	484	7,230	110	$70	$14.1K
86235	1	10	500	$20	$12.5K

Showing 1–10 of 29

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Faith Healthcare Inc	KY	Federally Qualified Health Center (FQHC)	$0	$3M
The New London Hospital Association, Inc.	NH	Multi-Specialty Clinic/Center	$0	$3M
The New London Hospital Association, Inc.	NH	Critical Access Hospital	$0	$2.6M
Scott Lewis	KY	Rheumatology Physician	$1.5M	$0
Roneka Ravenell	IN	Rheumatology Physician	$1.3M	$0
Sarah Estes	KY	Family Nurse Practitioner	$981.6K	$0
Dana Mann	KY	Family Nurse Practitioner	$824.8K	$0
Melissa Cheng	KY	Nurse Practitioner	$703.4K	$0
Natasha Smith	KY	Family Nurse Practitioner	$658K	$0
Amanda Evans	KY	Family Nurse Practitioner	$562K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Morrland Healthcare LLC	KY	Community/Behavioral Health Agency	$0	$54.8M
Applied Behavioral Advancements, LLC	KY	Community/Behavioral Health Agency	$0	$29.2M
Protea Behavioral Health Counseling, PLLC	KY	Professional Counselor	$0	$24.4M
Lake Cumberland Regional Hospital, LLC	KY	Internal Medicine Physician	$0	$15.6M
Cumberland Behavior Group, LLC	KY	Community/Behavioral Health Agency	$0	$15.2M
Quest Counseling	KY	Mental Health Counselor	$0	$12.5M
Lake Cumberland Recovery, Inc	KY	Substance Use Disorder Rehabilitation Clinic/Center	$0	$11.8M
Achievements Through Actions	KY	Developmentally Disabled Services Day Training Agency	$0	$10M
Lake Cumberland Surgery Center LP	KY	Ambulatory Surgical Clinic/Center	$1M	$8.7M
Adult Day Health, Inc.	KY	Adult Day Care Clinic/Center	$0	$8.9M

Timothy Lonesky — 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