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NPI 1164464566 · San Luis Obispo, CA · Rheumatology Physician
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Barry Eibschutz is a rheumatology physician provider located in San Luis Obispo, California. This profile covers 26 Medicare and 10 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 | Barry Eibschutz |
| Address | 1039 Murrary St |
| City | San Luis Obispo |
| State | CA |
| ZIP | 93405 |
| Taxonomy | Rheumatology Physician |
| NPI Enumerated | June 11, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $6.6M |
| Medicaid | $583.6K |
This provider’s billing mix is dominated by high-cost biologic and infusion medications, with J9312 (rituximab), J0129 (abatacept), and J3245 (tildrakizumab) among the top revenue drivers on Medicare. The presence of multiple large-volume J-codes alongside infusion procedure codes (e.g., 96365, 96413) indicates the practice operates an active infusion/administration service line rather than a primarily office-visit–based practice.
Top-line Medicare revenue is highly concentrated: the top 3 Medicare codes account for 58.0% of this provider's total Medicare revenue, led by J9312 at $1.5M (22.0% of Medicare revenue), J0129 at $1.2M (18.2%), and J3245 at $1.2M (17.9%). This concentration signals dependency on a few biologic agents for a majority of Medicare receipts, making drug-administration volume the primary commercial driver.
On Medicare this provider is a clear national outlier for several drug codes, with J9312 ranking #1 of 317 providers (100th percentile; extreme outlier) and J3262 ranking #2 of 618 providers (100th percentile; extreme outlier). J0129 (rank #27 of 1221, 98th percentile; notably above typical) and J3245 (rank #12 of 225, 95th percentile; notably above typical) are also well above typical national volumes, indicating market-leading scale for specific biologics.
Payer mix is strongly Medicare-skewed: lifetime Medicare revenue is $6.6M versus Medicaid revenue of $583.6K, so Medicare is the dominant payer by a wide margin. This profile suggests the provider’s business and growth levers are primarily tied to Medicare populations and reimbursement dynamics for infused biologics.
Medicaid billing is even more concentrated around a small set of high-cost drugs: the top 3 Medicaid codes account for 81.6% of this provider's total Medicaid revenue, with J9312 at $216.5K (37.1%), J9310 at $186.7K (32.0%), and 99213 at $73.7K (12.6%). The high average paid/claim reported for J9312 ($4921) and J9310 ($5187) underscores that a small number of expensive infusions are the bulk of Medicaid receipts.
Despite high dollar-per-claim activity, the provider’s competitive standing on Medicaid is modest statewide: J9312 ranks #10 of 13 in-state (25th percentile) and J9310 ranks #5 of 10 (56th percentile), both described as typical or unremarkable in-state volumes. Routine office E&M (99213) similarly sits at a mid-range state rank (#6127 of 14524, 58th percentile), indicating the practice is not a dominant Medicaid leader even though it bills expensive drugs to Medicaid.
Operational throughput on Medicare is notable beyond J-code revenue: the provider reported 1.2K claims for 99213 generating $78.6K and ranks #3981 of 457151 (99th percentile; extreme outlier) for that code, and 96365 shows 1.3K claims and $66.3K with rank #58 of 8873 (99th percentile; extreme outlier). These volumes imply a steady stream of follow-up office visits and frequent infusion sessions, consistent with an infusion-centered rheumatology practice.
The provider has an established NPI tenure (enumerated 2006-06-11, ~20 years ago), which, combined with concentrated biologic administration and high national ranks on multiple J-codes, suggests a long-standing, specialized infusion practice with an entrenched referral base and operational capacity for frequent biologic administrations. Tenure supports the interpretation that observed high volumes reflect sustained clinical focus rather than short-term fluctuation.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
26 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J9312 | Injection, rituximab, 10 mg | 23,180 | $60 | $1.5M |
| 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) | 36,080 | $30 | $1.2M |
| J3245 | Injection, tildrakizumab, 1 mg | 11,100 | $110 | $1.2M |
| J3262 | Injection, tocilizumab, 1 mg | 217,720 | $10 | $1.1M |
| J3111 | Injection, romosozumab-aqqg, 1 mg | 60,690 | $10 | $485.5K |
| J1602 | Injection, golimumab, 1 mg, for intravenous use | 39,890 | $10 | $438.8K |
| 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) | 60,800 | $1 | $243.2K |
| J0897 | Injection, denosumab, 1 mg | 9,840 | $20 | $177.1K |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 6,570 | $30 | $170.8K |
| 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… | 1,210 | $70 | $78.6K |
Showing 1–10 of 26
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 26 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
26 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J3245 | 1 | 20 | 4,100 | $110 | $520.4K |
| J9312 | 1 | 20 | 4,370 | $60 | $382.1K |
| J0717 | 23 | 40 | 65,800 | $1 | $325.4K |
| J0129 | 2 | 80 | 6,610 | $30 | $305.3K |
| J3262 | 1 | 50 | 29,000 | $1 | $203.8K |
| J3111 | 5 | 110 | 14,910 | $10 | $171.8K |
| J1602 | 6 | 70 | 11,550 | $10 | $167.1K |
| J1745 | 12 | 70 | 2,350 | $30 | $96.5K |
| J0897 | 123 | 1,030 | 3,060 | $20 | $91.4K |
| 96413 | 128 | 620 | 170 | $120 | $26.9K |
Showing 1–10 of 26
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.
10 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J9312 | Injection, rituximab, 10 mg | 40 | $4,920 | $216.5K |
| J9310 | Injection, rituximab, 100 mg | 40 | $5,190 | $186.7K |
| 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… | 1,230 | $60 | $73.7K |
| 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… | 490 | $100 | $47.3K |
| 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 | $2,150 | $30K |
| 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. | 600 | $40 | $24.4K |
| 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… | 110 | $30 | $3.2K |
| 96375 | Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the… | 80 | $10 | $1.1K |
| J7050 | Infusion, normal saline solution, 250 cc | 1,040 | $1 | $1K |
| J2920 | Injection, methylprednisolone sodium succinate, up to 40 mg | 60 | $1 | $250 |
How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. California median
10 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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) | 20 | 20 | 240 | $1,870 | $1.2M |
| J9312 | Injection, rituximab, 10 mg | 10 | 10 | 60 | $1,840 | $835.2K |
| J9310 | Injection, rituximab, 100 mg | 5 | 10 | 30 | $2,190 | $260.4K |
| 96375 | Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the… | 444 | 500 | 3,580 | $40 | $230.4K |
| 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. | 343 | 520 | 1,470 | $70 | $193.2K |
| 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… | 179 | 320 | 610 | $60 | $162.5K |
| 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… | 6,127 | 14,520 | 760 | $10 | $122.8K |
| 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… | 112 | 180 | 350 | $40 | $44K |
| J7050 | Infusion, normal saline solution, 250 cc | 148 | 400 | 440 | $10 | $19.7K |
| J2920 | Injection, methylprednisolone sodium succinate, up to 40 mg | 32 | 70 | 50 | $10 | $3.6K |
Other providers in the same ZIP code as Barry Eibschutz, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Community Health Centers Of The Central Coast, Inc | CA | Community Health Clinic/Center | $0 | $31.2M |
| Galileo Surgery Center, LP | CA | Ambulatory Surgical Clinic/Center | $1.4M | $1.1M |
| Michael Heffernan | CA | Dermatology Physician | $2.1M | $0 |
| Joseph Diehl | CA | MOHS-Micrographic Surgery Physician | $1.6M | $0 |
| Jeffrey Wu | CA | Radiation Oncology Physician | $1.4M | $0 |
| Cheryl Ketelsen | CA | Medical Physician Assistant | $1.2M | $0 |
| Christopher Johnson | CA | Urology Physician | $896.5K | $0 |
| Craig Canfield | CA | Urology Physician | $785.9K | $0 |
| Magnetic Resonance Imaging Of San Luis Obispo, Inc. | CA | Diagnostic Radiology Physician | $652.7K | $6.2K |
| Nicholas Caggiano | CA | Surgery of the Hand (Surgery) Physician | $558.5K | $0 |
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