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

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

Douglas Hempel (NPI 1164423844)

Field	Value
Entity Type	Individual
Organization	Douglas Hempel
Address	20800 Swenson Dr Ste 175
City	Waukesha
State	WI
ZIP	53186
Taxonomy	Rheumatology Physician
NPI Enumerated	August 3, 2005

Payer Source	Total Paid
Medicare	$1.9M
Medicaid	$0

Key Findings

This provider is effectively single‑payer in the available data: Total Medicare revenue is $1.9M and there is no Medicaid billing on file, so all billed activity in our dataset is Medicare‑sourced. That concentration means the provider’s financial footprint and payer negotiations are driven entirely by Medicare reimbursement patterns rather than a mix of state Medicaid contracts.

Revenue is highly concentrated in a small set of biologic drug codes: the top 3 Medicare codes account for 71.2% of this provider’s total Medicare revenue, driven primarily by J1602 (59K claims, $648.9K revenue, 33.4%), J0129 (15K claims, $509.2K revenue, 26.2%), and J3262 (44.8K claims, $224.2K revenue, 11.6%). This concentration indicates that a majority of Medicare dollars are derived from administration of high‑cost injectable biologic therapies rather than office evaluation and management.

The CPT/HCPCS mix and code descriptions indicate an infusion‑centric rheumatology practice: frequent use of injectable biologics (J1602, J0129, J3262, J9312, J1745, J0897) alongside infusion administration codes such as 96365 and add‑on 96415, plus chemotherapy/infusion code 96413. Combined with routine laboratory testing codes (e.g., 86235, 86140, 85025), the pattern is consistent with regular biologic infusions and required pre/post infusion monitoring typical of a specialty rheumatology infusion suite.

For J1602 (golimumab) this provider ranks #28 of 1041 nationally (97th percentile; notably above typical national volume), indicating an outsized national presence for that specific drug compared with peers. That single‑code prominence (59K claims and $648.9K revenue) makes J1602 the single largest revenue driver and a clear competitive strength relative to most other Medicare providers.

By contrast, J0129 (abatacept) and J3262 (tocilizumab) show more modest national positions: J0129 ranks #246 of 1221 (80th percentile; typical, unremarkable volume) and J3262 ranks #266 of 618 (57th percentile; typical, unremarkable volume). These placements suggest the provider is a solid, but not dominant, national participant for abatacept and a mid‑tier participant for tocilizumab, reinforcing that the practice’s outperformance is concentrated in specific biologics rather than across the whole drug class.

Evaluation & management codes are present but account for a small share of revenue: 99214 generated $58.8K (3.0% of Medicare revenue) and ranks #25597 of 479517 (95th percentile; notably above typical national volume), while 99213 contributed $16.1K (0.8%). High percentile E/M ranks with relatively low revenue share indicate the clinic performs routine office visits at volumes above many peers, but these visits are secondary to biologic administration in terms of revenue.

Onsite phlebotomy and laboratory monitoring appear to be important operational components: 36415 (1.4K claims, $11.4K revenue) ranks in the 98th percentile, and routine lab codes such as 85025, 84450, 82565, and 82040 each appear with high percentile placements (95th–98th). This pattern supports the inference that the practice conducts frequent lab monitoring for biologic therapy management, which is consistent with specialty rheumatology care pathways.

The provider’s NPI was enumerated on 2005-08-03 (~21 years ago), indicating an established practice tenure. Coupled with $1.9M in lifetime Medicare revenue and a concentrated biologic infusion mix, the data portray a long‑standing rheumatology clinician with an infusion‑oriented business model that could be of interest to payers evaluating specialty network coverage or contract terms for biologic administration services.

Medicare: Complete Services Breakdown

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

43 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J1602	Injection, golimumab, 1 mg, for intravenous use	58,990	$10	$648.9K
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)	14,980	$30	$509.1K
J3262	Injection, tocilizumab, 1 mg	44,840	$10	$224.2K
J9312	Injection, rituximab, 10 mg	2,600	$60	$163.8K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	5,450	$30	$141.7K
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…	710	$80	$58.8K
J0897	Injection, denosumab, 1 mg	2,160	$20	$38.9K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	520	$40	$22.8K
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…	220	$90	$20K
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…	280	$60	$16.1K

Showing 1–10 of 43

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 43 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Wisconsin Distribution

Douglas Hempel — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. state median

43 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	2	10	8,170	$30	$286.2K
J9312	4	10	2,580	$60	$234.8K
J1602	1	10	11,900	$10	$206.3K
J3262	4	10	35,280	$1	$191.4K
J1745	9	20	6,060	$30	$168.9K
J0897	32	60	2,220	$20	$69.3K
96413	15	80	110	$90	$12.7K
86235	3	20	110	$20	$10.7K
82784	5	10	240	$10	$10.1K
99214	68	9,800	80	$70	$9.2K

Showing 1–10 of 43

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mark Pearson	WI	Rheumatology Physician	$972.6K	$0
Carly Skamra	WI	Rheumatology Physician	$943.5K	$0
Nicole Jodat	WI	Medical Physician Assistant	$114.1K	$0
Taraneh Mehrani	WI	Rheumatology Physician	$34K	$0
Maggie Weissman	WI	Nurse Practitioner	$23.3K	$0
Juliana Shah	WI	Adult Health Nurse Practitioner	$15.5K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grace Machi	WI	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$5.5M
Kci Usa, Inc.	WI	Durable Medical Equipment & Medical Supplies	$0	$4.8M
Oak Medical Sc	WI	Internal Medicine Physician	$0	$4M
Waukesha School District	WI	Local Education Agency (LEA)	$0	$3.3M
Lss Aspen Center LLC	WI	Substance Abuse Rehabilitation Facility	$0	$2.9M
Planned Parenthood Of Wisconsin	WI	Ambulatory Family Planning Facility	$0	$2.5M
Lincare Inc.	WI	Durable Medical Equipment & Medical Supplies	$0	$1.6M
Matt Talbot Recovery Services, Inc	WI	Substance Abuse Rehabilitation Facility	$0	$1.3M
Loganathan Elangovan	WI	Nephrology Physician	$642.5K	$0
Aswin Kumar	WI	Diagnostic Radiology Physician	$387K	$100

Douglas Hempel — 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