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

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

William Sullivan (NPI 1144311663)

Field	Value
Entity Type	Individual
Organization	William Sullivan
Address	3 Medical Park Drive
City	Fairhope
State	AL
ZIP	36532
Taxonomy	Rheumatology Physician
NPI Enumerated	September 28, 2006

Payer Source	Total Paid
Medicare	$1.6M
Medicaid	$0

Key Findings

This provider is effectively single-payer in scale: Total Medicare revenue is $1.6M while there is no Medicaid billing on file, so Medicare represents the entirety of recorded public-payer activity for this NPI. The NPI was enumerated on 2006-09-28 (~20 years ago), indicating long standing Medicare participation.

Revenue is highly concentrated in a small set of biologic infusion drugs: the precomputed top-3 Medicare codes account for 63.0% of the provider's Medicare revenue, driven by J0717 ($499.2K, 30.2%), J0129 ($336.6K, 20.4%), and J1745 ($204.5K, 12.4%). This concentration signals a practice model dependent on in-office administration of high-cost biologic agents.

The code mix points to an infusion- and procedure-oriented rheumatology practice rather than one focused solely on office visits: multiple high-revenue J-codes (J0717, J0129, J1745, J3262, J0897) and infusion/chemotherapy administration codes (96413 $25.8K, 96365 $10.2K, 96415 $7.3K) appear in the top-25, consistent with regular IV/subcutaneous drug administration services. These entries suggest the provider operates an infusion suite or administers clinic-based biologics frequently.

Competitive standing on key biologics is mixed: J0717 ranks #96 of 848 providers nationally (89th percentile; typical, unremarkable volume for this code) and J1745 ranks #154 of 1352 (89th percentile; typical, unremarkable volume), indicating near-top-decile national placement for those specific drugs. By contrast, J0129 ranks #469 of 1221 (61th percentile; typical, unremarkable volume), which positions the provider as a more modest national participant for that agent.

Office evaluation-and-management activity is meaningful but secondary to drug administration income: 99214 generated $42.2K (509 claims) and 99213 generated $31.7K (566 claims). Notably, 99213 is classified as "notably above typical national volume" (95th percentile), which signals relatively high visit volume per peer benchmarks despite office E/M revenue being a smaller share of total Medicare revenue.

Several codes are flagged as statistical outliers on the high side for volume: 99213 is described as "notably above typical national volume" (95th percentile), 96415 is "notably above typical national volume" (97th percentile) with $7.3K revenue, and 96372 is also "notably above typical national volume" (97th percentile) with $4.8K revenue. These notations indicate specific procedures and add-on infusion activity where the provider bills at materially higher frequency than most peers.

Claim-level dynamics suggest many low-unit payments across high-claim-volume drugs: for example, J0717 shows 124.8K claims at $4 avg paid/claim for $499.2K revenue, and J3262 shows 38.1K claims at $5 avg paid/claim for $190.4K revenue. The combination of very high claim counts with low per-claim payments is consistent with billing of biologic drugs priced per milligram or unit and administered frequently.

From a payer and network strategy perspective, the absence of Medicaid billing means this provider’s captured public-payer exposure is concentrated in Medicare beneficiaries; payers evaluating network adequacy or specialty access should treat this NPI as a Medicare-focused rheumatology infusion resource rather than a dual-payer outpatient provider given the data on file.

Medicare: Complete Services Breakdown

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

20 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)	124,800	$1	$499.2K
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)	10,200	$30	$336.6K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	7,870	$30	$204.5K
J3262	Injection, tocilizumab, 1 mg	38,080	$10	$190.4K
J0897	Injection, denosumab, 1 mg	9,540	$20	$171.7K
J1602	Injection, golimumab, 1 mg, for intravenous use	10,890	$10	$108.9K
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…	510	$80	$42.2K
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…	570	$60	$31.7K
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…	280	$90	$25.8K
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…	130	$110	$13.5K

Showing 1–10 of 20

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Alabama Distribution

William Sullivan — 3 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. state median

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	12	30	8,530	$30	$390.9K
J0717	3	10	94,400	$1	$360.6K
J3262	7	10	44,890	$1	$229.1K
J1602	15	20	16,100	$10	$189.5K
J1745	4	30	3,020	$30	$107.2K
J0897	32	200	3,120	$20	$97.7K
96413	49	150	150	$90	$20.2K
99214	778	7,330	120	$80	$16.8K
99213	265	6,470	80	$50	$7.9K
96365	40	170	130	$40	$7.5K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baptist Memorial Medical Group Inc	TN	Internal Medicine Physician	$0	$35.6M
Usa Health Physician Billing Services LLC	AL	Pediatric Cardiology Physician	$0	$1.6M
Alan Franklin	AL	Retina Specialist (Ophthalmology) Physician	$1.2M	$0
Imc-diagnostic And Medical Clinic LLC	AL	Internal Medicine Physician	$0	$1.1M
Ray Mclaughlin	AL	Rheumatology Physician	$875.9K	$0
Clifford Tillman	LA	Gastroenterology Physician	$439.4K	$268.7K
Robert Percy	AL	Pulmonary Disease Physician	$384.3K	$0
Mina Jacob	AL	Vascular Surgery Physician	$325.9K	$0
K Varden	AL	Internal Medicine Physician	$311.5K	$0
Hercules Panayiotou	AL	Cardiovascular Disease Physician	$270.7K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bay Pediatric & Adolescent Dentistry	AL	Pediatric Dentistry	$0	$13.8M
Eastern Shore Children's Clinic	AL	Pediatrics Physician	$0	$7.6M
Baldwin Emergency Physicians, P.C..	AL	Emergency Medicine Physician	$0	$6.7M
Dr. Trey's Children's Dentistry	AL	Pediatric Dentistry	$0	$5.9M
Fairhope Pediatrics, Inc.	AL	Pediatrics Physician	$0	$4.1M
Comfort Care Coastal Hospice, LLC	AL	Community Based Hospice Care Agency	$0	$3.4M
Gulf Health Hospitals, Inc	AL	General Acute Care Hospital	$0	$2M
Karl Hakmiller	AL	Cardiovascular Disease Physician	$981.1K	$0
Michael Pursley	AL	Specialist	$583.3K	$0
Craig Peterson	AL	Interventional Cardiology Physician	$515.6K	$0

William Sullivan — 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