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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Michael Lee (NPI 1720014749)

Field	Value
Entity Type	Individual
Organization	Michael Lee
Address	1133 21st St Nw Ste 700
City	Washington
State	DC
ZIP	20036
Taxonomy	Specialist
NPI Enumerated	June 23, 2006

Payer Source	Total Paid
Medicare	$438.8K
Medicaid	$0

Key Findings

This provider’s billing is effectively single‑payer: total Medicare revenue is $438.8K and there is no Medicaid billing on file, so Medicaid does not appear to contribute to this clinician’s revenue mix. Analysts should treat performance and market exposure as Medicare‑centric when modeling payer risk or network contracting for this NPI.

Revenue is highly concentrated in a small set of services: the precomputed top‑3 Medicare codes account for 54.6% of total Medicare revenue, with 99214 contributing 24.8%, 93306 contributing 15.0%, and 93880 contributing 14.9%. This concentration means changes in utilization, reimbursement, or policy for any of those three codes would materially affect overall earnings.

The code mix points to a procedural cardiology/diagnostic imaging and ambulatory care operation: high‑revenue items include echo imaging (93306), noninvasive vascular duplex (93880), SPECT nuclear cardiology (78452), and multiple ECG/stress test codes (93015, 93245, 93351). In parallel, substantial E/M volume (99214 and 99204) indicates a significant clinic/office visit workload that complements the diagnostic services.

The provider shows national high‑volume status on a subset of codes but more typical volumes on others. Notably, 99214 ranks in the 98th percentile nationally and is described as “notably above typical national volume,” and 93880 also ranks in the 98th percentile and is “notably above typical national volume,” whereas 93306 sits at the 78th percentile and is characterized as typical. These rankings suggest the clinician is a major national outlier for routine office visits and arterial duplex testing, but more of a typical performer for echo services.

There is clear operational adoption of remote physiologic monitoring (RPM): 99457 (824 claims, $35.4K, 8.1% of Medicare revenue) ranks in the 92nd percentile, 99454 (619 claims, $28.5K, 6.5%) ranks in the 90th percentile, and 99458 (360 claims, $12.2K, 2.8%) ranks in the 75th percentile. This pattern indicates an established RPM program contributing meaningful recurring revenue and suggests investment in home monitoring workflows and billing infrastructure.

Ambulatory clinic activity is a material part of the book of business: 99214 appears 1K times with $108.7K revenue and 99204 contributes $20.2K (4.6% of revenue) and ranks in the 96th percentile. High counts and high percentile ranks on E/M codes imply sustained patient visit volume and a steady stream of evaluation and management revenue supporting procedural services.

Operationally and strategically, the absence of any Medicaid billing on file points to either nonparticipation in Medicaid or a patient panel that is overwhelmingly Medicare/ commercially insured; this limits exposure to Medicaid rate schedules and reduces state‑level Medicaid network leverage. Analysts evaluating local market share or contracting for Medicaid should note there is no in‑state Medicaid activity to benchmark.

This NPI has longevity in the dataset—enumerated on 2006-06-23 (~20 years ago)—which supports interpretation of the observed mix as the product of an established practice rather than a new entrant. The combination of long tenure, concentrated revenue in a few high‑impact codes, and notable RPM adoption frames this provider as an established, Medicare‑focused cardiology/diagnostic service operator with targeted national outlier status on selected procedures.

Medicare: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	1,030	$110	$108.7K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	410	$160	$65.7K
93880	Duplex scanning of arteries for the evaluation of blood flow is a type of non–invasive vascular diagnostic process. A physician can visualize and selectively assess the flow patterns of peripheral…	380	$170	$65.3K
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	110	$410	$43.1K
99457	The provider manages treatment using data from remote physiologic monitoring. The service requires at least one real–time interactive communication with the patient or caregiver during the month and…	820	$40	$35.4K
99454	The provider supplies one or more devices for remote physiologic monitoring that occurs for 16 to 30 days in a 30–day period.	620	$50	$28.5K
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…	160	$130	$20.1K
99458	The provider manages treatment using data from remote physiologic monitoring. The service requires at least one real–time interactive communication with the patient or caregiver during the month.…	360	$30	$12.2K
93245	In this procedure, the provider applies an electrocardiographic, or ECG recorder, to a patient who wears it for more than seven days, up to 15 days, to help detect abnormal heart rates and…	40	$250	$11K
93015	The provider supervises the recording of the electrical activity of the heart to examine any abnormality in its functioning by obtaining blood pressure and electrocardiograph readings at regular…	160	$60	$9.3K

Showing 1–10 of 20

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. District of Columbia Distribution

Michael Lee — 4 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. state median

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
93306	21	80	240	$110	$32.4K
78452	8	40	60	$340	$22.6K
99233	621	650	90	$100	$17.6K
99214	13	1,400	90	$100	$15.3K
99457	2	20	100	$40	$11.2K
93880	2	60	40	$130	$11.1K
93245	4	20	30	$240	$11K
99232	392	640	70	$70	$10K
99454	1	20	180	$50	$9.7K
J2785	13	30	150	$40	$6.8K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Whc Physician Group LLC	DC	General Practice Physician	$0	$93.8M
Medstar Medical Group Ii LLC	MD	General Practice Physician	$0	$91.5M
Medstar Heart Institute LLC	DC	Surgery Physician	$0	$4.8M
Howard Hauptman	MD	Rheumatology Physician	$2.9M	$0
Whc Physician Group LLC	DC	Psychiatry Physician	$0	$2.7M
Javad Khalilzadeh	DC	Gastroenterology Physician	$463K	$1.4M
Kelly Orwat	SC	Internal Medicine Physician	$1.3M	$0
Stephen Ronson	MD	Specialist	$1.2M	$0
Maral Skelsey	MD	Dermatology Physician	$1.1M	$0
Prashanth Rao	MD	Cardiovascular Disease Physician	$1.1M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Health Management, Inc.	DC	Home Health Agency	$0	$70.9M
Asap Services Corporation	DC	Home Health Agency	$0	$44.3M
Palisades Healthcare Partners Inc	DC	Home Health Agency	$0	$4.7M
Mindflower Limited Liability Company	DC	Professional Counselor	$0	$3.6M
Altasource Management Company, LLC.	DC	Case Management Agency	$0	$2.2M
Suburban/nrh Medical Rehabilitation Inc	DC	Rehabilitation Clinic/Center	$0	$1.8M
Capitol Oms PLLC	DC	Dentist	$0	$1.7M
Thomas Shin	DC	Oral and Maxillofacial Surgery (Dentist)	$0	$1.6M
Therapeutic Links Behavioral Health Services, LLC	DC	Clinical Social Worker	$0	$1.2M
Bio-medical Applications Of The District Of Columbia, Inc.	DC	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$936.8K

Michael Lee — 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