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

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

Kalista Engelman (NPI 1043440944)

Field	Value
Entity Type	Individual
Organization	Kalista Engelman
Address	4440 Broadway Blvd
City	Kansas City
State	MO
ZIP	64111
Taxonomy	Rheumatology Physician
NPI Enumerated	July 26, 2009

Payer Source	Total Paid
Medicare	$1.7M
Medicaid	$0

Key Findings

This provider is effectively single‑payer: recorded lifetime Medicare revenue is $1.7M while Medicaid billing is listed as none, indicating virtually all reimbursed activity in the dataset is through Medicare rather than a mixed Medicaid/Medicare panel. Analysts should treat this profile as Medicare‑centric when modeling payer exposure or network negotiations.

Revenue is highly concentrated in a small set of biologic and infusion drugs: the precomputed top 3 Medicare codes account for 67.9% of the provider's total Medicare revenue, with J0717 contributing $656.8K (37.7%), J0129 contributing $369.8K (21.2%), and J1569 contributing $156.6K (9.0%). This concentration suggests operational and revenue risk tied to utilization or reimbursement changes for a handful of high‑value injectable therapies.

The code mix indicates an infusion‑focused rheumatology practice that routinely administers biologics and immune‑modulating therapies: J0717 (certolizumab pegol) shows 164.2K claims, $4 avg paid/claim, and $656.8K revenue, and J0129 (abatacept) shows 10.9K claims and $369.8K revenue, while administration and chemotherapy/infusion CPTs such as 96413 and 96365 also appear on the top 25 list. Combined drug‑dominant revenue with supporting E/M and infusion administration codes points to a practice model centered on on‑site drug delivery and related outpatient care.

Competitive standing is uneven across products: for J0717 the provider ranks #51 of 848 providers nationally (94th percentile; notably above typical national volume for this code), identifying them as a major national participant for that specific biologic, whereas J0129 ranks #429 of 1221 (65th percentile) and J1569 ranks #217 of 542 (60th percentile), both characterized as typical or unremarkable volumes relative to peers. In short, the provider is a high‑volume outlier for certolizumab pegol but a modest or average participant for other top drugs.

Several procedure codes show divergent peer‑comparative signals that hint at operational focus beyond routine visits: 96372 appears with 992 claims, $11 avg paid/claim, $10.9K revenue and ranks #398 of 58224 providers nationally (99th percentile; extreme outlier, far above typical national volume for this code), indicating unusually high volumes of simple injectable administrations relative to peers. Conversely, some biologic unit codes such as J3262 (tocilizumab) sit at low comparative percentiles (13th) and therefore do not show the same competitive intensity.

Office visit and laboratory services provide a modest but consistent revenue base that supports the infusion activity: 99214 and 99213 together generate $36.9K (2.1%) and $28.9K (1.7%) of Medicare revenue respectively, while common lab panels (85025, 80076, 86140) appear in the top 25, suggesting routine monitoring and outpatient follow‑up accompany the infusion services. These E/M and lab revenues are secondary to drug reimbursements but important for full‑service outpatient management.

Provider tenure is substantial and supports an established outpatient operation: the NPI was enumerated on 2009‑07‑26 (~17 years ago), consistent with a multi‑year practice likely built around infusion services and ongoing biologic management. Longevity reduces concern about transient billing patterns and supports interpretation of the observed concentration as an operational choice rather than a short‑term artifact.

From a risk and strategic perspective, the combination of very high ranked volume for a single biologic (J0717), a concentrated revenue base (67.9% from top three codes), and near‑exclusive Medicare activity (Medicaid: none) suggests this provider’s financial performance and negotiating leverage will be particularly sensitive to Medicare drug reimbursement policies and utilization trends for those specific injectable therapies. Payers evaluating network inclusion or rate arrangements should prioritize contract terms and utilization management for the dominant biologic therapies in this profile.

Medicare: Complete Services Breakdown

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

39 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0717	Injection, certolizumab pegol, 1 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)	164,200	$1	$656.8K
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)	10,880	$30	$369.8K
J1569	Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg	4,350	$40	$156.6K
J9312	Injection, rituximab, 10 mg	2,500	$60	$145K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	3,630	$30	$90.8K
J0897	Injection, denosumab, 1 mg	3,720	$20	$70.7K
J3262	Injection, tocilizumab, 1 mg	16,120	$1	$64.5K
J1602	Injection, golimumab, 1 mg, for intravenous use	3,750	$10	$37.5K
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…	420	$90	$36.9K
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…	310	$100	$30.9K

Showing 1–10 of 39

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 39 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Missouri Distribution

Kalista Engelman — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. state median

39 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	12	20	10,880	$30	$443.6K
J9312	7	10	3,350	$60	$315.8K
J1602	21	20	13,150	$10	$266.8K
J0717	1	10	61,500	$1	$259.7K
J3262	12	10	40,980	$1	$236.8K
J1569	7	10	4,350	$40	$171.2K
J1745	16	40	3,060	$30	$118.1K
J0897	65	210	2,400	$20	$82.4K
96413	35	160	140	$100	$19.1K
99214	994	8,960	100	$80	$13.9K

Showing 1–10 of 39

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Christopher Koenig	KS	Rheumatology Physician	$2.3M	$0
Michael Smith	CO	Rheumatology Physician	$2M	$0
Julian Magadan	MO	Rheumatology Physician	$1.7M	$0
Tina Shah	MO	Rheumatology Physician	$1.6M	$0
Kent Huston	MO	Rheumatology Physician	$1.5M	$0
Shirley Wang	KS	Rheumatology Physician	$1.2M	$0
Ann Warner	MO	Rheumatology Physician	$911.8K	$0
Travis Sifers	MO	Allergy & Immunology (Internal Medicine) Physician	$614.2K	$0
Jeremy Sharp	KS	Rheumatology Physician	$433.9K	$0
Zachary Jacobs	MO	Allergy & Immunology Physician	$416.2K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Whole Person, Inc.	MO	In Home Supportive Care Agency	$0	$203.1M
Community Choice, Inc.	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$19.6M
St Lukes Hospital Of Kansas City	MO	General Acute Care Hospital	$0	$18.7M
United Seating And Mobility LLC	MO	Durable Medical Equipment & Medical Supplies	$0	$8.8M
Midwest Home Health Care, Inc.	MO	Homemaker	$0	$4.3M
Michael Cassell	MO	Retina Specialist (Ophthalmology) Physician	$1.5M	$0
Hillary Bownik	MO	Gastroenterology Physician	$959.9K	$0
Medical Plaza Imaging Associates, LLC	MO	Diagnostic Radiology Physician	$802.8K	$129.4K
Manuel Camejo	MO	Ophthalmology Physician	$924.9K	$0
Mark Allen	MO	Gastroenterology Physician	$853.1K	$0

Kalista Engelman — 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