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

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

April Lopez (NPI 1881023422)

Field	Value
Entity Type	Individual
Organization	April Lopez
Address	3705 N Ware Rd
City	Mcallen
State	TX
ZIP	78501
Taxonomy	Family Nurse Practitioner
NPI Enumerated	November 4, 2013

Payer Source	Total Paid
Medicare	$6.7M
Medicaid	$0

Key Findings

This provider’s Medicare business is material at the provider level: total Medicare revenue is $6.7M while there is no Medicaid billing on file, so the practice effectively operates as a single‑payer (Medicare) billing entity in the available data. Analysts should treat Medicaid comparisons as not applicable for this NPIs’ public billing profile.

Revenue is highly concentrated in three HCPCS Q‑codes: Q4236 accounts for $4M (60.4% of Medicare revenue), Q4262 accounts for $2.2M (32.6% of Medicare revenue), and Q4234 accounts for $415.7K (6.2% of Medicare revenue); together these top three codes represent 99.2% of the provider’s total Medicare revenue. This extreme concentration indicates that a very small set of product/add‑on codes drives nearly all billed Medicare dollars for this NPI.

The code mix and descriptions point to a focused wound‑care/skin‑substitute operation: the top revenue drivers are Q4236, Q4262, and Q4234 (per‑square‑centimeter skin substitute/add‑on codes), supplemented by surgical graft codes such as 15271 and 15275 and adjuncts like 0598T. This pattern suggests the practice primarily provides skin substitute applications and wound management procedures rather than broad primary care, with procedure and supply reimbursement dominating the revenue stream.

On competitive standing for the largest code, Q4236 (Carepatch), the provider ranks #15 of 79 nationally and sits at the 82th percentile; the profile description characterizes this as a typical, unremarkable volume for this code. In plain terms, the provider is a visible but not dominant national participant for Q4236 — above median activity but within the normal range among peers.

For Q4262 and Q4234 the provider’s national placements are more modest: Q4262 ranks #46 of 141 (68th percentile) and Q4234 ranks #15 of 23 (36th percentile), and both are described as typical, unremarkable volumes for those codes. These rank/percentile positions indicate the practice maintains a respectable regional/national presence for specific skin‑substitute products but is not a top outlier or unilateral market leader.

Evaluation and management (E/M) billing is minimal relative to procedure revenue: for example 99213 shows 132 claims with $56 avg paid/claim totaling $7.4K (0.1% of Medicare revenue) and 99205 contributes $1.8K. The small dollar totals and low share for E/M codes reinforce that this NPI’s revenue model is procedure/supply driven rather than office‑visit driven.

The practice uses some advanced or adjunct wound modalities at low volume: 0598T (real‑time fluorescence imaging) appears with 27 claims, $100 avg paid/claim, $2.7K revenue (0.0% of Medicare revenue), and graft preparation or related codes such as 15271 (157 claims, $99 avg paid/claim, $15.5K revenue) are present but together represent a very small portion of total revenue. These entries indicate capability to deliver imaging and graft procedures, but they are not major revenue contributors compared with the top Q‑codes.

The provider’s NPI was enumerated on 2013-11-04 (~13 years ago), indicating a stable tenure in the Medicare program; combined with the narrow code concentration this suggests a sustained, niche procedural practice rather than a recently established or broadly diversified billing operation. Analysts evaluating network contracting or competitive positioning should view this NPI as a long‑standing, specialized wound‑care operator with heavy dependence on a few high‑value skin substitute codes.

Medicare: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Q4236	Carepatch, per square centimeter (add-on, list separately in addition to primary procedure)	3,960	$1,020	$4M
Q4262	Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)	2,080	$1,050	$2.2M
Q4234	Xcellerate, per square centimeter (add-on, list separately in addition to primary procedure)	410	$1,010	$415.7K
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.	160	$100	$15.5K
15002	The provider incises the skin of a body part with an open wound, burn eschar, or scar contracture to prepare the site to receive a skin graft. This procedure helps in repairing an area of the trunk,…	50	$220	$11.2K
15275	The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, up to…	80	$100	$8.5K
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…	130	$60	$7.4K
15004	The provider prepares the skin of a body part with an open wound, burn eschar, or scar contracture to receive a skin graft. This procedure helps in repairing areas of the face, scalp, eyelids, mouth,…	20	$260	$4.9K
0598T	The provider uses real–time fluorescence imaging in a darkened clinical setting to examine a wound. The provider uses this imaging to identify and locate bacterial infection in the wound and to…	30	$100	$2.7K
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…	10	$140	$1.8K

Showing 1–10 of 13

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Texas Distribution

April Lopez — 0 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. state median

13 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q4236	3	10	2,010	$990	$2.5M
Q4262	11	30	1,580	$1,010	$2.5M
Q4234	2	10	1,150	$700	$802.8K
0598T	5	10	40	$120	$11.3K
15271	16	120	70	$100	$9.9K
15002	9	40	30	$220	$9K
15004	21	40	20	$260	$8.7K
15275	27	80	60	$110	$8.5K
99213	9,521	29,790	70	$60	$8.4K
99205	3,663	4,320	30	$150	$5.5K

Showing 1–10 of 13

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mark Le	FL	Diagnostic Radiology Physician	$10.7M	$0
Rohit Adyanthaya	VA	Ophthalmology Physician	$4.1M	$0
Ricky Alaniz	TX	Optometrist	$77.9K	$3.7M
Jeremiah Brown	TX	Retina Specialist (Ophthalmology) Physician	$3.7M	$0
Joseph Khawly	TX	Ophthalmology Physician	$3.2M	$0
Howard Martin	TX	Dermatopathology (Pathology) Physician	$3M	$0
Moises Chica	TX	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
Andres Soriano	FL	Medical Oncology Physician	$2.4M	$0
Darrell Baskin	TX	Ophthalmology Physician	$2.2M	$0
Tejas Desai	TX	Dermatology Physician	$2.2M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Health Care Unlimited, Inc	TX	Home Health Agency	$0	$67.8M
Hjc Home Health Care Services, Inc.	TX	Home Health Agency	$0	$36.8M
Legacy Home Care Services, Inc.	TX	Home Health Agency	$0	$30.6M
El Jardin Provider Services, LLC.	TX	Personal Care Attendant	$0	$28M
Easter Seals Rio Grande Valley	TX	Developmental Disabilities Clinic/Center	$0	$25.1M
Iph Primary Home Care, Inc.	TX	Home Health Agency	$0	$23.8M
Cielo Azul Provider Services, LLC.	TX	Personal Care Attendant	$0	$22M
With Open Arms Healthcare, LLC	TX	Home Health Agency	$0	$20.2M
Fuera Investment Group LLC	TX	Personal Care Attendant	$0	$19.4M
Regency Ihs Hospice Services LLC	TX	Community Based Hospice Care Agency	$0	$15.9M

April Lopez — Billing Profile & Reimbursement Data

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April Lopez — 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