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

Why is the Medicaid comparison limited to Georgia 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. Georgia (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 Sutej (NPI 1053353052)

Field	Value
Entity Type	Individual
Organization	Paul Sutej
Address	980 Johnson Fy Rd Ne Ste 220
City	Atlanta
State	GA
ZIP	30342
Taxonomy	Rheumatology Physician
NPI Enumerated	June 12, 2006

Payer Source	Total Paid
Medicare	$2.4M
Medicaid	$0

Key Findings

This Rheumatology Physician in ATLANTA, GA shows $2.4M in lifetime Medicare revenue and has no Medicaid billing on file (none below), so the available payer data for this provider is effectively single-payer (Medicare). The provider’s NPI was enumerated on 2006-06-12 (~20 years ago), indicating roughly two decades of billing history to analyze.

Revenue is highly concentrated in a small set of infused biologic drugs: J1602 ($566.8K, 23.6%), J9312 ($482.4K, 20.0%), and J0129 ($395.3K, 16.4%) together account for 60.0% of this provider’s total Medicare revenue. This concentration means a majority of revenue is tied to a few high-cost injectable therapies rather than E/M visits or routine office procedures.

The code mix indicates an infusion-centric rheumatology operation: multiple high-revenue J‑codes for biologics (J1602, J9312, J0129, J1745, J3262, J0897) appear prominently alongside infusion/chemotherapy administration codes such as 96413 ($42.4K, rank/percentile 85th) and 96365 ($27.7K, rank/percentile 96th). Office E/M codes are present but represent a much smaller share of revenue (99214 $52.7K, 2.2%; 99213 $30K, 1.2%), reinforcing that drug administration is the primary service line.

For specific drugs this provider is a high-volume national participant: J1602 ranks #35 of 1041 providers nationally (97th percentile) and is described as notably above typical national volume, while J9312 ranks #18 of 317 (95th percentile) and is also notably above typical national volume. By contrast, J0129 ranks #391 of 1221 (68th percentile) and is labeled typical/unremarkable, indicating that market leadership is concentrated in two biologics rather than uniformly across all infused agents.

Several other biologic and infusion codes show above-typical activity: J1745 (rank #116 of 1352, 91st percentile) and J0897 (rank #741 of 10057, 93rd percentile) are both described as typical/unremarkable in volume but are still high percentile placements, suggesting steady use of multiple injectable agents in addition to the top two. The presence of multiple high-percentile J‑codes implies diversified biologic administration activity within the practice’s infusion program.

Operationally, the provider bills very large counts of certain drug claims (for example, J1602 56.7K claims and J3262 43.7K claims) but with relatively low average paid per claim for some items (J1602 $10 avg paid/claim; J3262 $5 avg paid/claim). This pattern points to revenue driven by drug units and price rather than high per-encounter E/M reimbursement, which has implications for sensitivity to changes in drug reimbursement, unit pricing, or biosimilar substitution.

The mix of chemotherapy/infusion administration activity (96413 and 96365) together with high-volume biologic J‑codes suggests the practice likely operates an in‑office infusion capacity or partners closely with infusion services; these operation characteristics explain why infusion administration CPTs rank in the upper percentiles (96413 85th, 96365 96th). For payer or network strategy, this positions the provider as a candidate for contracting focused on infusion reimbursement and specialty drug channels.

Because there is no Medicaid billing on file (none below), the provider’s competitive standing and risk exposure should be evaluated primarily in the Medicare context; lack of Medicaid activity reduces exposure to state Medicaid rate variability but also indicates limited public payer diversification in this dataset. Analysts should therefore weigh Medicare drug reimbursement trends and national volume rankings (notably above typical for J1602 and J9312) when assessing financial and competitive risk.

Medicare: Complete Services Breakdown

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

30 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J1602	Injection, golimumab, 1 mg, for intravenous use	56,680	$10	$566.8K
J9312	Injection, rituximab, 10 mg	7,660	$60	$482.4K
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)	11,630	$30	$395.3K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	8,980	$30	$233.4K
J0897	Injection, denosumab, 1 mg	12,720	$20	$229K
J3262	Injection, tocilizumab, 1 mg	43,720	$10	$218.6K
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)	20,800	$1	$83.2K
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…	560	$100	$52.7K
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…	400	$110	$42.4K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	460	$70	$30K

Showing 1–10 of 30

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 30 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Georgia Distribution

Paul Sutej — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. state median

30 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	12	30	9,660	$30	$403.6K
J9312	3	10	4,620	$60	$307.4K
J1602	3	30	17,200	$10	$240.1K
J3262	9	10	45,840	$1	$233.4K
J0717	16	20	38,000	$1	$199.3K
J1745	3	30	2,160	$30	$96.6K
J0897	26	290	2,460	$20	$90.2K
96413	27	160	170	$90	$20.3K
99214	1,274	13,640	120	$80	$17.8K
96365	17	210	110	$50	$10.8K

Showing 1–10 of 30

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
William Chafin	GA	Rheumatology Physician	$3.3M	$0
Taylor Mader	SC	Rheumatology Physician	$3.1M	$0
Dean Stephens	GA	Rheumatology Physician	$2.7M	$0
Charles Degenhardt	GA	Rheumatology Physician	$2.4M	$0
Durga Adhikari	SC	Rheumatology Physician	$2.4M	$0
Marta Bognar	GA	Rheumatology Physician	$2.3M	$0
Brent Flickinger	GA	Rheumatology Physician	$2.3M	$0
Kathleen Flint	SC	Rheumatology Physician	$2.3M	$0
Colin Edgerton	SC	Rheumatology Physician	$1.9M	$0
John Brittis	SC	Rheumatology Physician	$1.9M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Scottish Rite Children's Medical Center	GA	Pediatric Hematology & Oncology Physician	$0	$493.4M
Life Hope Labs LLC	GA	Clinical Medical Laboratory	$8.3M	$7.3K
The Childrens Center For Digestive Health Care LLC	GA	Pediatric Gastroenterology Physician	$0	$8.1M
Northside Emergency Associates, LLC	GA	Emergency Medicine Physician	$0	$6.1M
Atlanta Perinatal Consultants, LP	GA	Neonatal-Perinatal Medicine Physician	$0	$4.8M
Stephanie Vanderveldt	GA	Ophthalmology Physician	$4.1M	$0
David Chin Yee	GA	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Children's Orthopaedics Of Atlanta P.C.	GA	Orthopaedic Surgery Physician	$0	$2.5M
Hyung Cho	GA	Ophthalmology Physician	$2.5M	$0
Sean Koh	GA	Ophthalmology Physician	$2.5M	$0

Paul Sutej — 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