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

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

Sheila Villacrucis (NPI 1659083392)

Field	Value
Entity Type	Individual
Organization	Sheila Villacrucis
Address	5957 Gordon Creek Ave
City	Las Vegas
State	NV
ZIP	89139
Taxonomy	Family Nurse Practitioner
NPI Enumerated	December 14, 2022

Payer Source	Total Paid
Medicare	$1.5M
Medicaid	$0

Key Findings

This clinician is effectively a Medicare-only biller: lifetime Medicare revenue is $1.5M while there is no Medicaid billing on file, indicating a single-payer footprint in the available records rather than a mixed payer panel. Analysts should treat Medicaid-related comparisons as not applicable for this provider due to the absence of claims data.

Revenue is highly concentrated in a single HCPCS item: Q4262 accounts for $1.4M and 94.7% of the provider’s total Medicare revenue, and the precomputed top-three codes together account for 98.3% of Medicare revenue. This concentration implies the practice’s financial performance is driven almost entirely by services tied to Q4262 rather than a broad mix of evaluation-and-management or procedure codes.

The top code Q4262 appears central to the provider’s service line profile: Q4262 is an add-on supply/material code for a dual layer impax membrane, and the volume (1.3K claims) and dollar concentration suggest the provider’s operations are focused on supplying or applying this specific wound/skin product rather than typical primary-care encounters. This code mix points to a niche procedural or wound-care supply role rather than a general ambulatory family practice.

Despite the dominant revenue share from Q4262, the provider’s national competitive standing for that code is modest: Q4262 ranks #74 of 141 providers nationally (48th percentile), which the source labels as typical and unremarkable volume relative to peers. In other words, while Q4262 generates nearly all revenue, the provider is not a national outlier or market leader for that code.

Other Medicare codes on file (home visit E/M codes 99349, 99350, 99348 and several wound care and debridement codes) together make up the remaining ~3.6% of Medicare revenue and reflect a secondary service mix of home-based E/M and wound-care procedures. These codes have typical, unremarkable volumes by national rank (percentiles generally in the midrange), which supports the interpretation that these services are ancillary to the provider’s primary revenue driver rather than core revenue contributors.

Tenure is recent but established: the NPI was enumerated on 2022-12-14 (~4 years ago), meaning the provider has been in the Medicare dataset for a multi-year period but is not a long-tenured clinician. Given the high revenue concentration into Q4262 over this tenure, the pattern likely reflects a stable, specialized billing focus since enrollment.

Several codes show only small claim counts and low-dollar contributions (for example 15271 at $10.6K, 99350 at $9.3K and 99213 at $4.5K), reinforcing that most face-to-face evaluation-and-management activity is limited compared with product/supply billing. These modest E/M volumes and payments suggest that patient visits are not the primary source of Medicare revenue for this provider.

From a payer or network management perspective, the provider represents a narrowly focused supplier of a specific wound-care material/service with concentrated financial risk tied to Q4262 reimbursement and utilization trends. Contracting or utilization review strategies should therefore prioritize tracking Q4262 usage, billing practices for related add-on supplies, and any changes in coverage or pricing for that code that would materially affect this provider’s revenue.

Medicare: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Q4262	Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)	1,320	$1,050	$1.4M
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…	510	$90	$43.1K
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.	100	$100	$10.6K
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…	70	$130	$9.3K
99213	The 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…	70	$60	$4.5K
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…	90	$50	$4.4K
99496	The provider manages the care of a patient during the transition to home care after discharge from a healthcare facility. The patient’s care requires high–level medical decision making, contact…	20	$180	$3.9K
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	$100	$1.3K
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.	20	$50	$1.2K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Nevada Distribution

Sheila Villacrucis — 0 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nevada

Full comparison — all codes billed, vs. state median

9 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q4262	5	10	1,300	$980	$3.6M
99350	57	100	100	$120	$33.9K
99349	23	150	100	$80	$23.3K
15271	13	40	80	$110	$17.8K
11042	111	120	120	$70	$11.6K
99213	1,778	3,500	80	$60	$10K
99348	46	100	80	$50	$9.2K
99496	58	140	20	$190	$6.9K
99344	87	100	30	$90	$5.2K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
De Craig Ranch, LLC	NV	General Acute Care Hospital	$0	$3M
Todays Tomorrows Beginning	NV	Mental Health Counselor	$0	$2M
Trang Ngo	NV	Optometrist	$25.6K	$36.9K
Angelica Villahermosa	NV	Family Nurse Practitioner	$48.6K	$0
Reynante Villahermosa	NV	Family Nurse Practitioner	$44.6K	$0
Lori Ott	NV	Occupational Therapist	$10.6K	$0

Sheila Villacrucis — Billing Profile & Reimbursement Data

Sign up for Sheila Villacrucis — Billing Profile & Reimbursement Data policy alerts

Sheila Villacrucis — Billing Profile & Reimbursement Data

Sign up for Sheila Villacrucis — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References