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

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

Elena Flagg (NPI 1174580310)

Field	Value
Entity Type	Individual
Organization	Elena Flagg
Address	329 Mclaws Cir
City	Williamsburg
State	VA
ZIP	23185
Taxonomy	Rheumatology Physician
NPI Enumerated	May 1, 2006

Payer Source	Total Paid
Medicare	$3.8M
Medicaid	$0

Key Findings

This provider’s Medicare activity is the dominant payer footprint: Total Medicare revenue is $3.8M and there is no Medicaid billing on file, so the practice is effectively single‑payer (Medicare) in the datasets available. The absence of Medicaid billing suggests the provider either does not participate in Medicaid or does not submit Medicaid claims, which has implications for Medicaid network capacity in the local market.

Revenue is highly concentrated in a few infused biologic drugs: the precomputed top‑3 share is 59.9% of total Medicare revenue, driven by J0129 ($1.1M, 30.1% of Medicare revenue), J1745 ($607.9K, 16.1%), and J3245 ($517K, 13.7%). This concentration shows most Medicare dollars come from a small set of high‑cost injectable therapies rather than office E/M alone.

The CPT/HCPCS mix is consistent with a rheumatology practice that operates an on‑site infusion/administration service. High‑revenue drug codes (J0129, J1745, J3262, J0717, J1602) together with frequent infusion/administration CPTs and chemotherapy administration codes (96413, 96401, 96415, 96372, 96375) indicate substantial clinic time and resources devoted to intravenous/subcutaneous biologic and infusion delivery.

For several top items this provider is a national outlier, indicating above‑average scale in infusion services. J1745 ranks #11 of 1352 providers nationally and is labeled an "extreme outlier, far above typical national volume," while J0129 ranks #30 of 1221 (98th percentile; "notably above typical national volume"). In addition, 96413 ranks #53 of 7514 (99th percentile; "extreme outlier"), signaling unusually high volumes for infusion administration compared with peers.

Other frequently billed biologic codes show more typical volumes, underscoring a mixed competitive footprint across products. For example, J3245 is a 66th‑percentile placement described as "typical, unremarkable volume," J3262 is described as "typical, unremarkable volume," and J0717 similarly shows typical volumes, so the provider is a dominant player for some agents but not uniformly across all biologics.

Office evaluation and management activity is present but represents a small share of revenue relative to drug/infusion billing. 99214 generated $68.1K (1.8% of Medicare revenue) and ranks in the 95th percentile for national providers (described as "notably above typical national volume"), which, together with the infusion workload, suggests the practice combines ongoing chronic disease management visits with high‑volume infusion services.

Operationally for payers and network planners, this profile flags concentrated clinical and financial exposure to in‑clinic biologic administration. The heavy reliance on licensed drug reimbursements and infusion CPTs (with the top‑3 drug codes accounting for 59.9% of Medicare revenue) means utilization management, prior authorization, and site‑of‑service strategies will materially affect total spend tied to this provider.

The provider has long tenure in the Medicare dataset, with NPI enumerated 2006-05-01 (~20 years ago), indicating an established practice; combined with the high infusion volumes and the national rank outlier signals, this suggests a durable, well‑developed infusion/biologic service line rather than a recent or sporadic billing pattern.

Medicare: Complete Services Breakdown

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

30 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)	34,430	$30	$1.1M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	23,380	$30	$607.9K
J3245	Injection, tildrakizumab, 1 mg	4,700	$110	$517K
J3262	Injection, tocilizumab, 1 mg	85,920	$10	$429.6K
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)	94,800	$1	$379.2K
J0897	Injection, denosumab, 1 mg	15,780	$20	$284K
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…	1,090	$100	$113.8K
J1602	Injection, golimumab, 1 mg, for intravenous use	9,770	$10	$107.5K
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…	730	$90	$68.1K
96401	The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient.	740	$60	$42K

Showing 1–10 of 30

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 30 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Virginia Distribution

Elena Flagg — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. state median

30 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J3245	4	10	4,700	$110	$728K
J0129	1	30	10,450	$30	$407.3K
J3262	6	20	75,870	$1	$383.3K
J0717	11	30	74,500	$1	$361.7K
J1745	2	30	4,540	$30	$200.2K
J1602	14	20	13,430	$10	$176.7K
J0897	12	340	2,820	$20	$89.3K
96413	1	230	250	$100	$28.5K
99214	962	12,890	140	$80	$21K
96401	9	180	110	$60	$11.5K

Showing 1–10 of 30

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laila Rahbar	VA	Rheumatology Physician	$3.2M	$0
Misty White	VA	Family Nurse Practitioner	$1.2M	$0
Audra Albert	VA	Family Nurse Practitioner	$639.8K	$0
Danielle Nabers	VA	Physician Assistant	$99.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Colonial Behavioral Health	VA	Community/Behavioral Health Agency	$0	$21.6M
Riverside Physician Services Inc	VA	Emergency Medicine Physician	$0	$17.3M
Michumi PLLC	VA	Emergency Medicine Physician	$0	$12.4M
Doctors' Hospital Of Williamsburg	VA	General Acute Care Hospital	$0	$12M
Connect Youth And Family Services	VA	Community/Behavioral Health Agency	$0	$6M
James City County Board Of Supervisors	VA	Ambulance	$1.2M	$822.4K
Zantha Marcuson	VA	MOHS-Micrographic Surgery Physician	$886K	$0
Anthony Farah	VA	Ophthalmology Physician	$653.9K	$0
Eric Karlin	VA	Allergy & Immunology Physician	$564.6K	$1.6K
Emily Himes	VA	Dermatology Physician	$463.4K	$0

Elena Flagg — Billing Profile & Reimbursement Data

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Elena Flagg — 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