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 Armed Forces Pacific for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Armed Forces Pacific 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. Armed Forces Pacific (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.

Lauren Cruz (NPI 1982342721)

Field	Value
Entity Type	Individual
Organization	Lauren Cruz
Address	Psc 475
City	Fpo
State	AP (Armed Forces Pacific)
ZIP	96350
Taxonomy	Physical Therapist
NPI Enumerated	May 23, 2022

Payer Source	Total Paid
Medicare	$6.3K
Medicaid	$0

Key Findings

The provider’s billed services are concentrated in core physical therapy modalities: neuromuscular reeducation (97112), therapeutic exercise (97110), and manual therapy (97140). The code descriptions indicate a session-based, hands-on rehabilitation practice focused on restoring function and improving mobility rather than procedural or durable-equipment services, consistent with a therapist delivering direct patient treatments.

Medicare revenue is narrowly concentrated: the top three codes (97112, 97110, 97140) account for 100.0% of this provider’s reported Medicare revenue. Individually these codes generated $2.6K (42.1%) for 97112, $2.5K (40.4%) for 97110, and $1.1K (17.5%) for 97140, making them the sole drivers of the $6.3K lifetime Medicare total.

This profile is effectively single-payer at present: Medicare shows $6.3K lifetime revenue while there is no Medicaid billing on file. The absence of any Medicaid activity means payer-mix analyses should treat this provider as Medicare-focused and recognize concentration risk if Medicaid participation or other commercial payers are relevant to competitive assessments.

On a national competitiveness axis the provider is a modest participant for each top code rather than a market leader. 97112 ranks #51200 of 61940 providers nationally (17th percentile; typical, unremarkable volume for this code), 97110 ranks #68022 of 79999 (15th percentile; typical, unremarkable volume for this code), and 97140 ranks #58565 of 65133 (10th percentile; typical, unremarkable volume for this code), signaling volumes in line with many peers rather than outlier status.

The claims and payment pattern reinforces a low-to-moderate volume practice: reported counts are 140 claims for 97110 at $18 avg paid/claim, 101 claims for 97112 at $26 avg paid/claim, and 64 claims for 97140 at $17 avg paid/claim. These per-claim reimbursement levels and modest claim totals are consistent with routine therapy sessions and explain the limited aggregate Medicare revenue.

The provider’s NPI was enumerated on 2022-05-23 (~4 years ago), indicating relatively recent enrollment compared with many long-tenured clinicians. The short tenure on file aligns with the limited lifetime Medicare revenue and modest claim counts, suggesting growth or expansion could still occur as the practice matures.

Operationally, the dominance of 97110 and 97112 implies care delivery organized around repeated therapeutic visits and clinician-delivered exercise and neuromuscular training, while 97140 indicates use of manual hands-on techniques. This mix suggests a service-line focused on rehabilitation sessions rather than one-off procedural interventions or facility-based complex services.

Data gaps constrain broader market conclusions: there is no Medicaid billing on file and total Medicare revenue is only $6.3K, so statewide Medicaid comparisons and scale-based competitive judgments cannot be made from the available records. For payer strategy or market-share work, treat this profile as low-volume Medicare-only data and flag it for re-evaluation if additional payer submissions appear.

Medicare: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	100	$30	$2.6K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	140	$20	$2.5K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	60	$20	$1.1K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes. Note: this provider's state, "AP," is a US military postal designation for Armed Forces stationed in the Asia-Pacific region — not a traditional US state; the State panel below benchmarks against other providers coded under the same designation.

View: State1 / 2

Claims Volume vs. Armed Forces Pacific Distribution

Lauren Cruz — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Armed Forces Pacific

Full comparison — all codes billed, vs. state median

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97110	3	10	140	$20	$4.6K
97112	2	10	100	$20	$2.7K
97140	3	10	110	$20	$1.8K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Stephanie Winslow	AP (Armed Forces Pacific)	Emergency Medicine Physician	$23.3K	$69.6K
Rose-valentine Goncalves	AP (Armed Forces Pacific)	Emergency Medicine Physician	$92.8K	$0
Mark Boone	AP (Armed Forces Pacific)	Pediatric Dentistry	$0	$13.4K
Seung Young Huh	AP (Armed Forces Pacific)	Emergency Medicine Physician	$13.1K	$0
Scott Naples	AP (Armed Forces Pacific)	Medical Physician Assistant	$7.5K	$0

Lauren Cruz — Billing Profile & Reimbursement Data

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Lauren Cruz — 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

Nearby Providers

Frequently Asked Questions

References