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

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

David Lefler (NPI 1487609236)

Field	Value
Entity Type	Individual
Organization	David Lefler
Address	1120 Huffman Road
City	Anchorage
State	AK
ZIP	99515
Taxonomy	Nephrology Physician
NPI Enumerated	May 23, 2006

Payer Source	Total Paid
Medicare	$467.5K
Medicaid	$0

Key Findings

DAVID LEFLER’s billing mix is dominated by end stage renal disease (ESRD) management and dialysis services: his top codes are 90960, 90961 and 90966, which reflect monthly ESRD management with face-to-face visits and home dialysis physician management. The presence of substantial volume on dialysis procedure codes such as 90935 and modality-selection code 90945 further indicates an operational focus on providing or overseeing both hemodialysis and alternative dialysis modalities.

Revenue is highly concentrated in a small set of Medicare codes: the top 3 Medicare codes by revenue account for 83.6% of this provider's total Medicare revenue, with 90960 at 45.7%, 90961 at 31.7%, and 90966 at 6.2% of Total Medicare revenue. This concentration shows the practice derives the vast majority of its Medicare income from recurring monthly ESRD management services rather than a broad mix of E/M or procedure codes.

Payer mix is effectively single-payer Medicare: Total Medicare revenue is $467.5K and there is no Medicaid billing on file, so this provider’s publicly visible revenue stream is concentrated entirely in Medicare. The lack of Medicaid activity means the provider’s exposure and contracting negotiations will be driven by Medicare reimbursement and ESRD program dynamics rather than state Medicaid policies.

On national competitive standing for key ESRD codes, this provider is an outlier: 90961 ranks #16 of 6091 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code) and 90960 ranks #77 of 6549 providers nationally (99th percentile; extreme outlier, far above typical national volume for this code). Those ranks indicate unusually high national volume for monthly ESRD management relative to peers and suggest a prominent role in caring for Medicare ESRD patients rather than a modest or typical provider volume.

Procedure-level volumes also show strength in dialysis services: 90945 ranks #9 of 1243 providers nationally (99th percentile; extreme outlier, far above typical national volume for this code), and 90935 ranks #269 of 6114 providers nationally (96th percentile; notably above typical national volume for this code). These high-percentile ranks for both modality selection and hemodialysis procedure codes reinforce that the provider delivers substantial procedural dialysis activity in addition to monthly case management.

Non-dialysis E/M and inpatient services are present but represent a small share of revenue: 99232 accounts for $18.7K (4.0% of this provider's total Medicare revenue) and 99223 accounts for $5.2K (1.1% of this provider's total Medicare revenue). These figures show that while hospital-based evaluation and management care is billed, it is secondary to the ESRD/monthly dialysis service line in this billing profile.

The provider has an established tenure in Medicare billing, with an NPI enumerated on 2006-05-23 (~20 years ago), indicating long-standing participation in Medicare programs. That length of enrollment supports the pattern of recurring, high-volume ESRD service lines rather than a recent or transient billing pattern.

Operational and business implications of this profile include concentrated Medicare dependency and ESRD specialization: with $467.5K in Total Medicare revenue and no Medicaid revenue on file, the practice’s financial performance and capacity planning will be sensitive to Medicare ESRD policy, reimbursement changes, and local referral flows for dialysis care. Payers and network planners should view this provider as a specialized, high-volume Medicare ESRD participant rather than a generalist with broad payer diversification.

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
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	620	$340	$214K
90961	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…	520	$290	$148.4K
90966	The provider manages all the physician related services for one full month for the home dialysis care of a patient who is 20 years old or older and has a condition known as end stage renal disease,…	100	$300	$28.8K
99232	The 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	$80	$18.7K
90935	Hemodialysis is a procedure that involves drawing blood via an intra–arterial or intravenous catheter, then sieving it through a semi permeable membrane to remove the impurities and finally…	250	$70	$18.3K
90945	The provider evaluates the patient and chooses one of several methods to perform dialysis, except hemodialysis.	180	$90	$15.8K
90962	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	80	$200	$15.5K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	30	$180	$5.2K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	40	$50	$1.8K
99222	The 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…	10	$120	$1.4K

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. Alaska Distribution

David Lefler — 3 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alaska

Full comparison — all codes billed, vs. state median

10 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90960	2	10	480	$350	$182K
90961	1	10	130	$290	$57.7K
90966	6	10	120	$310	$42.2K
90935	3	10	240	$70	$16.1K
99232	62	280	80	$80	$14K
90945	1	10	130	$90	$11.6K
99223	122	200	40	$170	$9.5K
90962	1	10	20	$200	$7K
99222	137	150	20	$130	$4.1K
99231	80	140	40	$50	$3.6K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dialysis Associates Of Alaska, LLC	AK	Nephrology Physician	$0	$2M
Stefano Emili	AK	Nephrology Physician	$425K	$0
Shuang Ying Bao	AK	Nephrology Physician	$421.6K	$0
Thuy-trang Ngo	AK	Internal Medicine Physician	$345.8K	$0
Lisa Roberts	AK	Nephrology Physician	$185.5K	$0
Mark Smith	AK	Nephrology Physician	$144.3K	$0
Jeremy Gitomer	AK	Nephrology Physician	$130.3K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Liberty Dialysis - Alaska LLC	AK	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.8M
Ryan, LLC	AK	Dental Clinic/Center	$0	$2.3M
Msm Anchorage LLC	AK	Assisted Living Facility	$0	$1.9M
Anchorage Care Coordination, LLC	AK	Case Manager/Care Coordinator	$0	$1.8M
Agile Care Coordination	AK	Case Management Agency	$0	$1.7M
Kids Dental Tree LLC	AK	Pediatric Dentistry	$0	$1.5M
Kids First Pediatric Therapy	AK	Pediatric Occupational Therapist	$0	$1.3M
St Lawrence Assisted Living Inc	AK	Health Service Clinic/Center	$0	$1.2M
Possibilities, LLC	AK	Case Management Agency	$0	$1.2M
First Care Medical Centers LLC	AK	Urgent Care Clinic/Center	$0	$1.1M

David Lefler — 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