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

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

Sean Lasalle (NPI 1790715126)

Field	Value
Entity Type	Individual
Organization	Sean Lasalle
Address	105 W 8th Ave
City	Spokane
State	WA
ZIP	99204
Taxonomy	Rheumatology Physician
NPI Enumerated	July 3, 2006

Payer Source	Total Paid
Medicare	$1.7M
Medicaid	$0

Key Findings

This provider’s Medicare footprint is the dominant payer exposure for the practice: lifetime Medicare revenue is $1.7M and Medicaid revenue is none (no Medicaid billing on file), so the reported activity is effectively single-payer Medicare. That concentration means any analysis of service mix, utilization, or referral patterns should be interpreted in the context of Medicare-only claims activity.

Revenue is highly concentrated in three biologic drug codes: J1745 $372.3K (22.2%), J0129 $333.2K (19.8%), and J9312 $332.8K (19.8%); the top 3 Medicare codes together account for 61.8% of the provider’s total Medicare revenue. These three codes are all high-cost biologic injections used in rheumatologic care, indicating that biologic administration is the core revenue driver for the practice.

The code mix and service lines indicate an infusion-centric rheumatology operation: high-revenue biologic injectables (J1745, J0129, J9312) are complemented by infusion administration and chemotherapy/infusion management codes such as 96413 (2.8% of revenue, ranks in the 88th percentile), 96365 (0.7% of revenue, 83th percentile), and 96415 (0.6% of revenue, ranks #97 of 4959 providers nationally; 98th percentile; notably above typical national volume for this code). Together these items point to routine IV/infusion sessions and extended infusion time billed in addition to drug administration.

Competitive standing is uneven by drug: for infliximab (J1745) the provider ranks #34 of 1352 providers nationally (98th percentile; notably above typical national volume for this code), signaling a nationally high-volume position for that particular biologic. By contrast, abatacept (J0129) is at a typical volume level (ranks #497 of 1221, 59th percentile; typical, unremarkable volume) and rituximab (J9312) is a moderately high but not extreme performer (ranks #41 of 317, 87th percentile; typical, unremarkable volume).

The practice also shows above-typical utilization of higher-complexity E/M visits and new-patient visits: 99214 ($71.6K, 4.3% of revenue) ranks #19310 of 479517 (96th percentile; notably above typical national volume), 99215 ($37K, 2.2% of revenue) ranks #6252 of 145531 (96th percentile; notably above typical national volume), and 99205 ($16.4K, 1.0% of revenue) ranks #2701 of 66257 (96th percentile; notably above typical national volume). This pattern suggests the provider bills a larger-than-typical share of mid- to high-complexity office visits alongside infusion services.

Several ancillary lab and monitoring codes are present at above-typical national volumes, consistent with ongoing rheumatologic disease management: 80053 (883 claims, $8.8K revenue) ranks #1792 of 26416 (93th percentile; typical, unremarkable volume), 85025 (830 claims, $6.6K) ranks in the 91th percentile, and 86140 (849 claims, $4.2K) ranks in the 93th percentile. The presence of CMP, CBC, CRP and other monitoring labs supports longitudinal disease monitoring and treatment safety surveillance tied to biologic therapy.

Operationally, the provider appears well-established: the NPI was enumerated 2006-07-03 (~20 years ago), which is consistent with an established referral and patient-management base that could sustain recurring biologic infusion volumes. Given lifetime Medicare revenue of $1.7M and the absence of Medicaid activity, strategic or competitive assessments should treat this entity as a Medicare-focused, long-tenured rheumatology infusion practice.

Medicare: Complete Services Breakdown

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

53 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J1745	Injection, infliximab, excludes biosimilar, 10 mg	14,320	$30	$372.3K
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)	9,800	$30	$333.2K
J9312	Injection, rituximab, 10 mg	6,050	$60	$332.8K
J3262	Injection, tocilizumab, 1 mg	31,800	$10	$159K
J0897	Injection, denosumab, 1 mg	6,960	$20	$125.3K
J1602	Injection, golimumab, 1 mg, for intravenous use	11,950	$10	$119.5K
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…	800	$90	$71.6K
96413	Chemotherapy 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…	450	$110	$46.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	290	$130	$37K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	110	$160	$16.4K

Showing 1–10 of 53

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 53 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Washington Distribution

Sean Lasalle — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. state median

53 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	5	20	5,280	$30	$208.7K
J9312	1	10	3,030	$60	$203.2K
J1602	8	20	7,060	$10	$135.2K
J3262	8	20	31,800	$1	$129.3K
J1745	1	50	3,630	$30	$111.5K
J0897	14	150	1,800	$20	$57.9K
86480	7	10	80	$60	$39.5K
83970	44	80	40	$40	$17K
96413	10	160	80	$110	$15K
99214	221	10,860	100	$80	$13.6K

Showing 1–10 of 53

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Christopher Wright	TX	Rheumatology Physician	$1.4M	$0
Howard Kenney	ID	Rheumatology Physician	$1.2M	$0
Jeffrey Butler	WA	Specialist	$772.9K	$0
Michael Coan	WA	Rheumatology Physician	$543.2K	$0
Eric Mueller	WA	Rheumatology Physician	$339.4K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence Health & Services - Wa	WA	General Acute Care Hospital	$0	$78.7M
Providence Health & Services Washington	WA	Pulmonary Disease Physician	$0	$78.6M
Multicare Health System	WA	General Acute Care Hospital	$0	$55.1M
New Horizon Care Center, Inc.	WA	Substance Abuse Rehabilitation Facility	$0	$20.2M
Spokane Addiction Recovery Centers	WA	Substance Abuse Rehabilitation Facility	$0	$19M
Spokane Emergency Care Physicians PLLC	WA	Emergency Medicine Physician	$0	$13.9M
Spokane Emergency Physicians, Ps	WA	Emergency Medicine Physician	$0	$13.1M
Providence Health & Services Washington	WA	Clinical Medical Laboratory	$1.6M	$9.3M
Spokane Eye Clinic Ps	WA	Multi-Specialty Clinic/Center	$0	$8M
Laboratory Corporation Of America	WA	Clinical Medical Laboratory	$1.6M	$6.1M

Sean Lasalle — 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