Rachel Lefebvre, MD
Hand Surgery · Lakeland, FLNPI 1720346034
Payments from drug & device makers
What this record shows
This record is dominated by education: $1,402 of the $2,013 with a category attached, or 69.7%. Micromed Inc accounts for 69.7% of it on its own, with 5 other manufacturers making up the rest. Reporting peaked in 2020 at $1,402 and has fallen 96.9% since, to $44 in 2025. That places this record below the midpoint for hand surgery clinicians in FL, where the typical reported total is $3,372.
Across 21 payments — averaging $95.86 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Micromed Inc$1K
- Arthrex$284
- Axogen$210
- Coastal Medical Technologies LLC$44
- Endo Pharmaceuticals Inc.$41
- Johnson & Johnson$33
What the payments were for
- Travel & lodging$1618%
- Food & beverage$45022%
- Education$1,40270%
General payments by program year
Who reported the general payments
Companies are grouped under their corporate parent — a single manufacturer often files under several CMS reporting entities. Research and ownership payments are counted separately and are not in this table.
| Company | Payments | Total |
|---|---|---|
| Micromed Inc | 2 | $1,402 |
| Arthrex | 8 | $284 |
| Axogen | 7 | $210 |
| Coastal Medical Technologies LLC | 1 | $44 |
| Endo Pharmaceuticals Inc. | 2 | $41 |
| Johnson & Johnson | 1 | $33 |
How this compares
$2,013 in reported general payments places this provider in the 40th percentile of 173 hand surgery providers in Florida.
Medicare billing
What this is not: this is the amount Original Medicare Part B allowed for services this provider billed in 2024. It is not their income. It excludes Medicare Advantage — now more than half of all Medicare enrollment — along with Medicaid and all commercial insurance, and it is gross practice revenue before staff, rent, supplies and malpractice premiums. CMS also suppresses any figure covering ten or fewer patients, so low-volume providers appear smaller than they are.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| Diclofenac Sodium | 27 | $472 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 44 | $194 |
| Sulfamethoxazole-TrimethoprimSulfamethoxazole/Trimethoprim | 26 | $138 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 12 | $67 |
| Meloxicam | 11 | $28 |
Paid to pharmacies, not to this prescriber.
Other hand surgery in Lakeland
- Jorge Orbay-CerratoMiami$12.5M
- Peter EvansStuart$525K
- Nirav GuptaOcala$491K
- Francisco RubioMiami$345K
- Justin ZumstegOrlando$133K
- Maria-Carolina Orbay AranMiami$108K
- Paul PatersonVero Beach$104K
- Helen Hui-ChouMiami$95K
- Philipp StreubelWeston$81K
- Roy CardosoCoral Gables$79K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Billing: Medicare Physician & Other Practitioners, data year 2024. Original Medicare Part B only.
- Identity: NPPES NPI Registry, July 2026.