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

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

Paul Unger (NPI 1053318766)

Field	Value
Entity Type	Individual
Organization	Paul Unger
Address	111 Colchester Ave
City	Burlington
State	VT
ZIP	05401
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	July 7, 2005

Payer Source	Total Paid
Medicare	$744.6K
Medicaid	$0

Key Findings

This provider is effectively a single‑payer Medicare practice: Total Medicare revenue is $744.6K and there is no Medicaid billing on file, so Medicaid represents zero of reported revenue. The provider's NPI was enumerated on 2005-07-07 (~21 years ago), indicating long tenure in the Medicare program and an established billing history.

Revenue is highly concentrated in a small set of services: the precomputed top 3 Medicare codes by revenue account for 71.3% of this provider's total Medicare revenue. The three revenue leaders are J9312 ($316.8K, 42.3%), J0897 ($118.6K, 15.8%), and 99214 ($98.6K, 13.2%), so these specific infusion drugs and mid‑level E/M visits dominate the practice's receipts.

The code mix points to an infusion‑center oncology practice that also carries a significant ambulatory management load: J9312 (rituximab) and J0897 (denosumab) are infusion/ injectable oncology drugs and together account for a majority of Medicare revenue, while chemotherapy administration codes such as 96413 ($48K, 6.4%) and related add‑ons (96417, 96415) confirm active systemic therapy services. High volumes of E/M codes 99214 and 99215 also show ongoing, higher‑complexity outpatient evaluation and management of established patients.

J9312 is a notable revenue driver but not nationally dominant: the provider billed J9312 in 5K claims for $316.8K (42.3% of Medicare revenue) and ranks #71 of 317 providers nationally (78th percentile; typical, unremarkable volume for this code), suggesting a moderate presence among oncology peers for rituximab administration rather than an outsized national market share. Similarly, J0897 appears as a typical national volume pattern with 6.2K claims and $118.6K revenue (15.8%) and a rank of #2184 of 10057 (78th percentile).

Office visit utilization is an outlier relative to national peers: 99214 has 1.1K claims for $98.6K (13.2%) and ranks #9629 of 479517 (98th percentile; extreme outlier, far above typical national volume for this code), and 99215 has 602 claims for $80.1K (10.7%) and ranks #1188 of 145531 (99th percentile; extreme outlier, far above typical national volume). These rankings indicate unusually high volumes of moderate‑ to high‑complexity outpatient E/M visits compared with the nationwide provider pool.

Operational and revenue risk considerations follow from the concentration in a few high‑value drug codes: J9312 alone contributes $316.8K (42.3%) and with J0897 brings drug revenue to a dominant share of the book, so changes in reimbursement or utilization of those specific agents could materially affect practice revenue. That concentration combined with the absence of Medicaid diversification (no Medicaid billing on file) makes the practice financially exposed to Medicare policy or market shifts affecting these drugs and associated infusion services.

Beyond drugs and E/M, supportive services and routine diagnostics are present but represent a small share of revenue: lab and phlebotomy codes such as 36415 ($8.3K, 1.1%), 80053 ($8.2K, 1.1%), and 85025 ($8.1K, 1.1%) appear among the top codes at typical national percentiles, consistent with standard outpatient oncology monitoring rather than a separate lab‑driven revenue stream. Infusion supply codes like J7050 (636 claims, $636) and small per‑dose antiemetic entries (J2469) further reflect typical throughput operations supporting the infusion services.

Claim counts indicate a high‑throughput infusion and follow‑up clinic: notable volumes include 5K claims for J9312, 6.2K claims for J0897, 1.1K claims for 99214, and 602 claims for 99215, which together portray frequent, repeat encounters and recurring drug administrations. In combination with the high E/M percentiles, this pattern suggests a practice model centered on regular infusion visits coupled with intensive outpatient management of complex oncology patients.

Medicare: Complete Services Breakdown

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

31 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9312	Injection, rituximab, 10 mg	4,950	$60	$316.8K
J0897	Injection, denosumab, 1 mg	6,240	$20	$118.6K
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…	1,070	$90	$98.6K
99215	The provider sees an established 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…	600	$130	$80.1K
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…	470	$100	$48K
J9217	Leuprolide acetate (for depot suspension), 7.5 mg	90	$130	$11.7K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	1,040	$10	$8.3K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	820	$10	$8.2K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	1,020	$10	$8.1K
96401	The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient.	140	$60	$7.6K

Showing 1–10 of 31

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 31 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Vermont Distribution

Paul Unger — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. state median

31 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9312	2	10	5,290	$60	$336.2K
J0897	2	10	7,020	$20	$130.2K
96413	1	10	390	$110	$34.1K
96367	2	10	290	$20	$13.6K
J9217	2	10	100	$130	$13.3K
99214	6	960	90	$70	$10.6K
96401	2	10	140	$60	$8.9K
96365	2	10	110	$50	$8.8K
99215	3	410	40	$110	$7.2K
99213	851	910	80	$50	$6.7K

Showing 1–10 of 31

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
University Of Vermont Medical Center Inc	VT	Internal Medicine Physician	$0	$17.6M
Northeastern Vermont Regional Hospital, Inc	VT	Primary Care Clinic/Center	$0	$2.8M
James Stafford	TX	Radiation Oncology Physician	$1.5M	$0
Porter Hospital, Inc	VT	Family Medicine Physician	$0	$1.3M
Dennis Sanders	VT	Medical Oncology Physician	$1.3M	$0
University Of Vermont Medical Center Inc	VT	General Acute Care Hospital	$0	$780.5K
University Of Vermont Health Network Specialty Care Transport, LLC	VT	Land Ambulance	$144K	$510.7K
Carlos Torres	TX	Anatomic Pathology & Clinical Pathology Physician	$580.7K	$0
Brian Kim	VT	Ophthalmology Physician	$488.3K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Howard Center Inc	VT	Developmentally Disabled Services Day Training Agency	$0	$332.2M
Howard Center Inc	VT	Adolescent and Children Mental Health Clinic/Center	$0	$130.1M
Vermont Department Of Mental Health	VT	Adult Mental Health Clinic/Center	$0	$105.1M
Community Health Centers Of Burlington Inc	VT	Federally Qualified Health Center (FQHC)	$0	$39.8M
Howard Center Inc	VT	Methadone Clinic	$517.9K	$35M
Howard Center Inc	VT	State or Local Public Health Clinic/Center	$0	$23.4M
Transition Ii	VT	Case Manager/Care Coordinator	$0	$17.3M
The Dental Center At Community Health Center Of Burlington	VT	Dental Clinic/Center	$0	$6.7M
City Of Burlington Vermont	VT	Land Ambulance	$677.2K	$4.3M
Spectrum, Inc.	VT	Addiction (Substance Use Disorder) Counselor	$0	$2.4M

Paul Unger — 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