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

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

Brian Lagreca (NPI 1992840128)

Field	Value
Entity Type	Individual
Organization	Brian Lagreca
Address	2475 Village Ln
City	Billings
State	MT
ZIP	59102
Taxonomy	Ophthalmology Physician
NPI Enumerated	February 21, 2007

Payer Source	Total Paid
Medicare	$381.6K
Medicaid	$0

Key Findings

This provider’s Medicare activity is highly concentrated in cataract surgery: the top three codes (66984, 66821, 66982) account for 63.3% of total Medicare revenue, with 66984 alone generating $148.9K (39.0% of Medicare revenue). That concentration indicates the practice’s primary revenue driver is elective cataract procedures rather than broad primary eye care or chronic disease management.

Procedure mix and service line: the dominant codes—66984, 66821, and 66982—are all cataract-related surgical procedures and are supported by pre- and post-operative diagnostic and IOL-measurement services such as 76519 and 92136. The presence of diagnostic imaging (92134, 92133) and photography (92285) alongside high-volume cataract codes suggests an ophthalmology practice structured around surgical cataract care with in‑house testing and follow-up.

Revenue scale and payer mix: Lifetime Medicare revenue is $381.6K while Medicaid revenue is none, so this provider effectively operates as a single‑payer Medicare practice in the available data. That single-payer profile concentrates reimbursement risk on Medicare volumes and policies, and it implies limited or no Medicaid participation in the recorded billing.

Competitive standing on core surgical codes: 66984 ranks at the 80th percentile nationally (characterized in the data as "typical, unremarkable volume for this code"), 66821 is at the 94th percentile (also described as "typical, unremarkable volume"), and 66982 is at the 83rd percentile. These rank/percentile positions indicate steady, above-average surgical volume on cataract procedures but do not position the provider as a national dominant outlier; volumes are consistent with an established cataract surgeon.

Notable statistical outlier in evaluation and management: 99204 (new patient, moderate complexity) appears as an "extreme outlier, far above typical national volume for this code" at the 99th percentile, producing $26.7K and 230 claims. That unusual high rank for new-patient E/M visits could reflect a referral-driven workflow, an influx of new consults related to surgical evaluation, or local market referral patterns that generate disproportionately many new-patient consults relative to peers.

Service breadth and downstream revenue: beyond surgery, the provider bills for IOL calculations (76519, $12.5K, 246 claims) and repeat capsule treatment (66821, $63.4K, 260 claims), indicating the practice performs both preoperative planning and postoperative laser capsulotomy care in-house. This vertical integration of diagnostics, surgery, and follow-up procedures likely supports revenue per surgical episode and explains the concentration in a surgical-service line.

Mixed competitive signals across secondary codes: some ancillary services show high national percentiles—76519 ranks in the 92nd percentile and 92285 in the 91st percentile—while codes like 66991 and 15823 rank in the 20s percentile range. This pattern suggests the provider has particularly strong throughput for certain perioperative services and imaging, but is a more modest participant for some less frequent or specialty procedures.

Tenure and market presence: the provider’s NPI was enumerated on 2007-02-21 (~19 years ago), indicating long-standing enrollment and likely established referral relationships in the Billings, MT market. Combined with the surgical concentration and consistently above-average cataract volumes, the profile is consistent with an experienced ophthalmology surgeon whose practice is oriented around cataract care rather than broad Medicaid-covered services.

Medicare: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	420	$350	$148.9K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	260	$240	$63.4K
66982	The provider inserts an intraocular lens prosthesis after extracapsular cataract extraction using complex techniques and devices. He may perform this by means of an iris expansion device, providing…	60	$460	$29.3K
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…	360	$80	$28.2K
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…	230	$120	$26.7K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	180	$90	$16K
76519	The provider uses A scan ultrasound echography to measure the axial length of the eye and determine the intraocular lens, or IOL calculation prior to cataract surgery.	250	$50	$12.5K
66991	The provider inserts an intraocular lens prosthesis during the same session as extracapsular cataract extraction. The provider also inserts one or more anterior segment aqueous drainage devices in…	20	$470	$10.4K
15823	In this procedure, the provider surgically trims excessive skin that weighs down the upper eyelid, typically to improve the cosmetic appearance of the face and due to the interference of the tissue…	20	$520	$9.9K
92136	The provider uses a noninvasive method to measure the patient’s eye or eyes to get information that the provider then uses to calculate the appropriate power for an intraocular lens (IOL). Selecting…	260	$30	$8.7K

Showing 1–10 of 22

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Montana Distribution

Brian Lagreca — 4 of 22 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. state median

22 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
66991	12	10	50	$1,370	$79.5K
66984	12	120	50	$490	$78.1K
66982	6	30	30	$600	$29.6K
15823	13	10	30	$510	$23.6K
92014	90	170	190	$80	$22.7K
66821	4	70	50	$220	$18.3K
99214	243	1,810	100	$70	$12.4K
92136	19	30	270	$30	$8.9K
99215	714	780	40	$100	$7.9K
76519	1	10	160	$50	$7.8K

Showing 1–10 of 22

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Nathan Steinle	CA	Retina Specialist (Ophthalmology) Physician	$9.5M	$0
Prema Abraham	SD	Retina Specialist (Ophthalmology) Physician	$7.1M	$0
Kyle Thompson	ID	Retina Specialist (Ophthalmology) Physician	$4.5M	$0
Douglas Holmes	WY	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Mitchell Goff	UT	Retina Specialist (Ophthalmology) Physician	$3.8M	$0
Richard Kinsey	TN	Anatomic Pathology & Clinical Pathology Physician	$3.3M	$147.3K
Robert Rifkin	CO	Hematology & Oncology Physician	$3.3M	$0
Brendan Girschek	AZ	Ophthalmology Physician	$3.2M	$0
John Bormes	SD	Ophthalmology Physician	$2.6M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Youth Dynamics, Inc.	MT	Mental Illness Community Based Residential Treatment Facility	$0	$65.4M
New Day, Inc.	MT	Mental Illness Community Based Residential Treatment Facility	$0	$27.7M
Youth Dynamics, Inc.	MT	Professional Counselor	$0	$24.6M
Resource, Support, & Development, Inc.	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$21.3M
Brittany Curl	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$17.5M
Rimrock Pediatric Dentistry	MT	Pediatric Dentistry	$0	$15.2M
Bridges Of Montana	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$12.7M
The Childrens Clinic Of Billings, PC	MT	Pediatrics Physician	$0	$10.9M
Community Option Resource Enterprises, Inc.	MT	Developmentally Disabled Services Day Training Agency	$0	$9.8M
Ryan K. Larsen Dmd & Associates	MT	Dental Anesthesiology	$0	$8.3M

Brian Lagreca — 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