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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

Scott Stoerner (NPI 1053507715)

Field	Value
Entity Type	Individual
Organization	Scott Stoerner
Address	4901 Lang Ave Ne
City	Albuquerque
State	NM
ZIP	87109
Taxonomy	Rheumatology Physician
NPI Enumerated	September 17, 2007

Payer Source	Total Paid
Medicare	$1.5M
Medicaid	$0

Key Findings

This provider is effectively single‑payer in the public program mix: lifetime Medicare revenue totals $1.5M while Medicaid revenue is recorded as none, so all public-payor billing on file is Medicare-based. Analysts should treat Medicaid comparators as not applicable for this NPI.

Revenue is highly concentrated in biologic infusion drugs: the top three Medicare codes (J0129, J0717, J9312) together account for 65.9% of this provider's Medicare revenue. Individually those codes contribute 30.9% (J0129), 17.6% (J0717), and 17.3% (J9312) of Medicare revenue, signaling dependence on a small set of high-cost injectable agents.

The code mix and descriptions point to an office-based rheumatology infusion practice: high-revenue biologic drug codes (J0129 abatacept, J0717 certolizumab pegol, J9312 rituximab, J1602 golimumab, J3262 tocilizumab, J1745 infliximab) alongside infusion administration/chemotherapy codes (96413, 96365, 96415) and E/M visits (99214, 99213). This pattern is consistent with ongoing management of rheumatologic conditions using in-office parenteral biologic therapy and associated monitoring.

Despite the concentration in biologics, the provider's competitive standing on those top agents is modest nationally: J0129 ranks #280 of 1221 providers (77th percentile; typical, unremarkable volume for this code), J0717 ranks #277 of 848 providers (67th percentile; typical, unremarkable volume for this code), and J9312 ranks #107 of 317 providers (66th percentile; typical, unremarkable volume for this code). These ranks indicate stable, expected volumes rather than dominance or extreme outlier behavior for these drugs.

Ancillary infusion and administration codes show relatively high percentile placement for some services, suggesting notable throughput in hands‑on administration: 96415 ranks in the 93rd percentile (typical, unremarkable volume), 96372 ranks in the 96th percentile (typical, unremarkable volume), and 96365 ranks in the 89th percentile (typical, unremarkable volume). Together with the drug revenue, these administration code placements reinforce that infusion delivery and extended infusion sessions are an important operational component.

Evaluation-and-management activity is present but represents a small share of revenue relative to drugs and infusion: 99214 generated $34.1K (2.3% of Medicare revenue) and ranks #69840 of 479517 providers (85th percentile; typical, unremarkable volume for this code), indicating routine follow-up visits accompany the infusion business but do not drive the practice's revenue. This split suggests clinical management is supportive to the infusion service-line rather than the primary revenue driver.

The provider's lifetime Medicare scale ($1.5M) combined with long NPI tenure — enumerated 2007-09-17 (~19 years ago) — points to an established practice with sustained Medicare billing over time. Longevity coupled with concentrated biologic administration suggests a stable, specialized outpatient infusion operation rather than a recently launched or transient billing pattern.

Overall, there are no labeled statistical red flags among top codes: most high-revenue codes are characterized as "typical, unremarkable volume" in their respective national percentiles, and no code is described as an extreme outlier. Analysts should interpret the billing profile as a concentrated, clinically specialized rheumatology infusion practice operating within expected national ranges for its principal biologic therapies.

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
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)	14,150	$30	$466.9K
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)	66,400	$1	$265.6K
J9312	Injection, rituximab, 10 mg	4,150	$60	$261.4K
J1602	Injection, golimumab, 1 mg, for intravenous use	16,080	$10	$176.9K
J3262	Injection, tocilizumab, 1 mg	19,800	$10	$99K
Q5104	Injection, infliximab-abda, biosimilar, (renflexis), 10 mg	2,040	$30	$59.2K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	1,710	$30	$44.5K
J0897	Injection, denosumab, 1 mg	2,100	$20	$37.8K
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…	400	$90	$34.1K
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…	200	$90	$18.6K

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. New Mexico Distribution

Scott Stoerner — 3 of 22 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. state median

22 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	3	10	9,930	$30	$358.6K
J0717	2	10	56,620	$1	$255.7K
J9312	1	10	3,700	$60	$225.8K
J1602	2	10	8,900	$10	$132.4K
J3262	2	10	19,800	$1	$117.2K
J0897	32	50	3,150	$20	$113.2K
Q5104	2	10	2,040	$30	$55.9K
J1745	2	10	1,690	$30	$44.5K
96413	18	40	170	$90	$17.7K
99214	283	2,700	90	$70	$12.9K

Showing 1–10 of 22

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
New Mexico Oncology Hematology Consultants, Ltd.	NM	Hematology & Oncology Physician	$0	$4.2M
Gregg Franklin	NM	Radiation Oncology Physician	$2.5M	$0
Shaya Ansari	NY	Diagnostic Radiology Physician	$1.5M	$1K
Pranshu Bansal	AZ	Hematology & Oncology Physician	$1.4M	$0
Ronald Kubica	NM	Medical Oncology Physician	$1M	$0
Annette Fontaine	NM	Medical Oncology Physician	$918.5K	$0
Mrunal Tailor	NM	Diagnostic Radiology Physician	$897.5K	$0
Jose Avitia	NM	Hematology & Oncology Physician	$880.2K	$0
Leroy Pacheco	NM	Rheumatology Physician	$787.7K	$0
Amyn Alidina	NM	Medical Oncology Physician	$785K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Presbyterian Healthcare Services	NM	Internal Medicine Physician	$0	$240.8M
Heritage Home Healthcare Services, Inc.	NM	Home Health Agency	$0	$141.5M
Home Medical Equipment Specialists LLC	NM	Durable Medical Equipment & Medical Supplies	$0	$100M
The New Beginnings LLC	NM	Adult Day Care Clinic/Center	$0	$85.1M
We Care Agency, Inc.	NM	In Home Supportive Care Agency	$0	$60.1M
Lovelace Health System, LLC	NM	General Acute Care Hospital	$0	$57.7M
Adelante Development Center, Inc.	NM	Personal Care Attendant	$0	$57M
Eye Associates Of New Mexico Ltd	NM	Ophthalmology Physician	$0	$46.9M
Southwest Labs LLC	NM	Clinical Medical Laboratory	$1.1M	$41.5M
Southwest Medical Associates, LLC	NM	General Practice Physician	$0	$41.4M

Scott Stoerner — 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