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NPI 1134124159 · Milwaukee, WI · Rheumatology Physician
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Daniel Rosler is a rheumatology physician provider located in Milwaukee, Wisconsin. This profile covers 15 Medicare and 3 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Daniel Rosler |
| Address | 2901 W Kinnickinnic River Pkwy |
| City | Milwaukee |
| State | WI |
| ZIP | 53215 |
| Taxonomy | Rheumatology Physician |
| NPI Enumerated | June 16, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $795.5K |
| Medicaid | $8.6K |
Payer mix is heavily weighted to Medicare: the provider reported $795.5K in total Medicare revenue compared with $8.6K in total Medicaid revenue, indicating Medicare is by far the dominant source of billed revenue for this practice. Medicaid activity appears minimal in scale relative to Medicare and is concentrated in a small set of visit codes.
Revenue concentration is high on both payers’ top codes: the top 3 Medicare codes account for 77.4% of this provider's total Medicare revenue, driven primarily by J0129 ($326.4K, 40.9%), J0717 ($166.4K, 20.8%), and J1745 ($125K, 15.7%). On Medicaid the top 3 codes account for 100.0% of Medicaid revenue, with 99214 ($7.3K, 83.0%) and 99213 ($1.4K, 16.1%) making up virtually all Medicaid payments.
Service-line profile aligns with a rheumatology practice that provides in-office biologic and infusion services: the largest Medicare revenue drivers are specialty injectable/infusible biologic codes (J0129, J0717, J1745 and J1602), and multiple infusion/administration procedure codes (96413, 96401, 96365, 96415) also appear on the Medicare list. This mix suggests a workflow that includes drug administration and infusion sessions in addition to outpatient evaluation and management.
Payer-specific service mix differs markedly: Medicare revenue is dominated by high-cost drug administration codes (biologics and infusion-related CPT/HCPCS), whereas Medicaid revenue is concentrated in office evaluation-and-management visits (99214 and 99213). That divergence indicates the provider’s Medicaid panel is primarily managed via clinic visits rather than the high-cost infusion services driving Medicare revenue.
Competitive standing by code is generally modest to typical rather than dominant: J0129 ranks #505 of 1221 (59th percentile) and is described as typical/unremarkable volume nationally; J0717 ranks #486 of 848 (42th percentile) and J1745 ranks #393 of 1352 (71th percentile), both likewise characterized as typical. On Medicaid, 99214 ranks #736 of 1628 in-state (55th percentile) and is labeled typical as well, so the provider appears to be an active but not market-dominant participant for its highest-revenue services.
Clinical-administration exposure is evident: presence of chemotherapy/infusion administration codes such as 96413 ($34K, 4.3% of Medicare revenue) and add-on infusion code 96415 indicates billing for extended infusion time or complex IV administration. While these codes are described as typical, they reinforce that a portion of practice operations and revenue depends on in-office infusion capacity and associated staffing.
Tenure and stability: the NPI was enumerated on 2005-06-16 (~21 years ago), indicating the provider has an established practice history and likely a stable referral network supporting ongoing biologic and office-based care. Long tenure combined with concentrated Medicare biologic billing suggests an entrenched treatment model rather than a recent operational shift.
From a risk and strategic perspective, the practice shows material revenue concentration around a small set of biologic administration codes (top 3 Medicare codes = 77.4% of Medicare revenue), which creates sensitivity to changes in reimbursement, formulary placement, or clinical utilization of those specific agents. Given that most high-revenue codes are characterized as "typical, unremarkable volume" nationally, the profile suggests typical regional competition but meaningful dependence on those drug-administration services for overall practice revenue.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
15 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) | 9,600 | $30 | $326.4K |
| 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) | 41,600 | $1 | $166.4K |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 4,810 | $30 | $125K |
| J1602 | Injection, golimumab, 1 mg, for intravenous use | 11,900 | $10 | $95.2K |
| 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… | 360 | $100 | $34K |
| 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… | 280 | $90 | $23.6K |
| 96401 | The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient. | 210 | $60 | $11.8K |
| 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… | 120 | $60 | $7K |
| 96415 | In this add on procedure, the provider continues administration of a chemotherapy drug into a vein using an infusion technique. He uses this code to report each additional hour of infusion beyond the… | 170 | $20 | $3.4K |
| 99204 | The provider sees a new 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 provider… | 20 | $120 | $2.6K |
Showing 1–10 of 15
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
15 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0129 | 6 | 10 | 8,170 | $30 | $286.2K |
| J1602 | 7 | 10 | 11,900 | $10 | $206.3K |
| J1745 | 10 | 20 | 6,060 | $30 | $168.9K |
| J0717 | 2 | 10 | 41,600 | $1 | $146.6K |
| 96413 | 5 | 80 | 110 | $90 | $12.7K |
| 99214 | 1,031 | 9,800 | 80 | $70 | $9.2K |
| 96401 | 3 | 20 | 110 | $50 | $7.1K |
| 96365 | 89 | 90 | 50 | $50 | $5.8K |
| 99213 | 2,028 | 9,380 | 60 | $50 | $4.7K |
| 20611 | 108 | 150 | 40 | $60 | $4.2K |
Showing 1–10 of 15
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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 | $20 | $7.3K |
| 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… | 80 | $20 | $1.4K |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care… | 10 | $10 | $80 |
How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Wisconsin median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 736 | 1,630 | 270 | $40 | $205.3K |
| 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… | 1,132 | 1,760 | 250 | $40 | $173.2K |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care… | 116 | 120 | 120 | $1 | $650 |
Other providers in the same ZIP code as Daniel Rosler, ranked by combined Medicare and Medicaid revenue.
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