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

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

Erin Arnold (NPI 1093767733)

Field	Value
Entity Type	Individual
Organization	Erin Arnold
Address	4709 Golf Rd
City	Skokie
State	IL
ZIP	60076
Taxonomy	Rheumatology Physician
NPI Enumerated	May 17, 2006

Payer Source	Total Paid
Medicare	$3.2M
Medicaid	$0

Key Findings

This provider is effectively single‑payer: lifetime Medicare revenue is $3.2M and there is no Medicaid billing on file. The absence of any Medicaid claims means payer mix is concentrated entirely in Medicare, so Medicaid network access and utilization are not reflected in this profile.

Revenue is highly concentrated in a handful of biologic drug administration codes: the precomputed top‑3 Medicare codes account for 55.3% of the provider's Medicare revenue. Those top three are J0717 ($743.2K, 22.9%), J1602 ($554.6K, 17.1%), and J3262 ($499.4K, 15.4%), indicating that more than half of Medicare dollars derive from a small set of injectable/infused biologics.

The CPT/HCPCS mix points to an in‑office infusion/administration model for high‑cost biologics: leading codes J0717, J1602, J3262, J0129, and J1745 are all biologic injection/infusion drugs. Coupled with multiple chemotherapy/infusion administration codes (96413, 96401, 96415), the pattern suggests the practice operates infusion services or buy‑and‑bill workflows rather than only dispensing self‑administered medications.

For several biologic drugs the provider ranks well above peers nationally, signaling high relative volume: J0717 ranks #35 of 848 providers (96th percentile, noted as "notably above typical national volume"), J1602 ranks #38 of 1041 (96th percentile, "notably above typical national volume"), and J1745 ranks #40 of 1352 (97th percentile, "notably above typical national volume"). These placements indicate the provider is a major national-volume outlier for multiple infused biologics.

There are extreme statistical outliers in non‑drug services that reinforce a high‑service infusion and diagnostics footprint: 96413 (chemotherapy infusion) is described as an "extreme outlier, far above typical national volume" and ranks #96 of 7514 providers (99th percentile), while 76881 (complete joint ultrasound) ranks #9 of 1606 providers (100th percentile, "extreme outlier"). This combination points to unusually high use of both infusion administration and in‑office imaging relative to national peers.

Although biologics and infusion services dominate revenue, the provider also bills routine office evaluation‑and‑management and therapy codes, showing a mixed service offering. For example, 99214 generated $60K (1.8% of Medicare revenue) and ranks in the 93rd percentile nationally, and therapeutic codes such as 97110 and 97112 appear in the top codes list, indicating ancillary rehab/therapy services are billed alongside infusion care.

Tenure is long: the provider's NPI was enumerated 2006-05-17 (~20 years ago). This long enumeration date is consistent with an established practice that could have developed stable referral and infusion service patterns over time.

Implications for payers and contracting: with $3.2M concentrated in biologic administration (top‑3 = 55.3%) and no Medicaid activity, negotiation levers for cost and utilization management should focus on buy‑and‑bill drug administration, infusion throughput, and in‑office imaging/infusion protocols. The provider's high national ranks for several biologic and infusion codes suggest they are an important target for Medicare network strategies but are not a Medicaid resource in the state due to the absence of Medicaid billing.

Medicare: Complete Services Breakdown

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

38 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)	185,800	$1	$743.2K
J1602	Injection, golimumab, 1 mg, for intravenous use	55,460	$10	$554.6K
J3262	Injection, tocilizumab, 1 mg	99,870	$10	$499.4K
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)	11,300	$30	$384.2K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	13,680	$30	$355.7K
J0897	Injection, denosumab, 1 mg	12,780	$20	$230K
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…	950	$110	$103.8K
76881	In this procedure, the provider uses ultrasound to examine the complete joint for any defect or abnormality. The image appears in real time on a monitor, and a permanent image with interpretation is…	1,450	$40	$61K
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…	610	$100	$60K
96401	The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient.	680	$60	$41.5K

Showing 1–10 of 38

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 38 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Illinois Distribution

Erin Arnold — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Illinois

Full comparison — all codes billed, vs. state median

38 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0717	1	40	50,800	$1	$243.1K
J0129	6	50	6,480	$30	$232.4K
J3262	1	20	38,740	$1	$184.2K
J1602	1	40	11,080	$10	$146.9K
J0897	32	410	2,520	$20	$90.8K
J1745	1	60	2,170	$30	$85.1K
J3304	27	80	1,550	$10	$35.6K
J7327	22	60	30	$550	$25.9K
96413	2	370	130	$100	$19.3K
99214	1,206	18,540	110	$80	$17.1K

Showing 1–10 of 38

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lifeline Ambulance LLC	IL	Ambulance	$1.3M	$26.3M
Medtech Lab LLC	IL	Clinical Medical Laboratory	$10.3M	$1.3K
Daniel Gutstein	IL	Family Medicine Physician	$9.3M	$640
Vladimir Urbin	IL	General Practice Physician	$4.2M	$1.1M
Care Clinical Lab Inc	IL	Clinical Medical Laboratory	$1.5M	$3M
Nobel Medical Inc	IL	Durable Medical Equipment & Medical Supplies	$0	$4M
Clear Sounds Inc Hearing Aids Services	IL	Audiologist	$0	$3.7M
Dav-kim Portable X Ray Service Co	IL	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$1.6M	$2.1M
Clear Sounds Inc	IL	Durable Medical Equipment & Medical Supplies	$0	$3M
Medical Diagnostic Services Inc	IL	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$888.4K	$458.5K

Erin Arnold — Billing Profile & Reimbursement Data

Sign up for Erin Arnold — Billing Profile & Reimbursement Data policy alerts

Erin Arnold — Billing Profile & Reimbursement Data

Sign up for Erin Arnold — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References