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

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

April Erwin (NPI 1194976670)

Field	Value
Entity Type	Individual
Organization	April Erwin
Address	370 E 9th Ave Ste 106
City	Salt Lake City
State	UT
ZIP	84103
Taxonomy	Neurology Physician
NPI Enumerated	October 2, 2008

Payer Source	Total Paid
Medicare	$1.2M
Medicaid	$0

Key Findings

This provider is effectively a single‑payer Medicare practice: lifetime Medicare revenue is $1.2M while Medicaid revenue is listed as none, so there is no recorded Medicaid billing on file. Analysts should treat this profile as Medicare‑centric when assessing payer mix and reimbursement risk.

Revenue is highly concentrated in a very small set of drug administration codes: the precomputed top three Medicare codes account for 98.8% of the provider’s total Medicare revenue, and a single code, J2323, generates $963.6K (80.5% of Medicare revenue). That concentration implies that a large majority of cash flow is tied to administration of a small number of high‑cost biologic therapies.

The code mix and descriptions point to an infusion‑center operational model within neurology: high volumes for J2323 (50.7K claims, $19 avg paid/claim, $963.6K revenue) and measurable volume for J2350 (5.4K claims, $38 avg paid/claim, $205.3K revenue) indicate routine administration of disease‑modifying biologics such as natalizumab and ocrelizumab. Supporting infusion codes are present (for example, 96365 with 182 claims, $48 avg paid/claim, $8.7K revenue and J7040 with 26 claims, $1 avg paid/claim, $26 revenue), consistent with in‑office infusion capacity.

Competitive standing is mixed by code: for the dominant code J2323 the provider ranks #8 of 40 providers nationally (82th percentile; typical, unremarkable volume for this code), reflecting a relatively strong national position among peers who bill that drug despite the vendor’s summary label of typical volume. By contrast, for J2350 the provider ranks #101 of 105 providers nationally (4th percentile; typical, unremarkable volume for this code), indicating it is a minor participant in ocrelizumab administration compared with national peers.

Evaluation/management billing is small relative to infusion revenue, suggesting limited face‑to‑face clinic encounter volume: 99214 shows 148 claims, $93 avg paid/claim, $13.8K revenue (1.1% of Medicare revenue) with a rank of #193258 of 479517 providers nationally (59th percentile; typical, unremarkable volume for this code), and 99215 appears only 15 times for $2K total (0.2% of Medicare revenue). This pattern indicates the practice’s revenue driver is treatment administration rather than high volumes of E/M office visits.

The extreme dependence on a few biologic administration codes creates concentrated operational and reimbursement exposure: with J2323 and J2350 together representing the bulk of billings and the top three codes totaling 98.8% of Medicare revenue, changes in drug supply, payer coverage, or unit pricing for those agents would materially affect the practice’s revenue profile. Analysts should flag the business as sensitive to shifts in biologic utilization or reimbursement.

The provider’s NPI was enumerated on 2008-10-02 (~18 years ago), indicating an established billing history. Combined with the concentrated infusion code mix, this tenure supports the interpretation that the provider operates a specialized neurology infusion service rather than a high‑volume, general neurology clinic.

Medicare: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2323	Injection, natalizumab, 1 mg	50,720	$20	$963.6K
J2350	Injection, ocrelizumab, 1 mg	5,400	$40	$205.3K
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…	150	$90	$13.8K
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.	180	$50	$8.7K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	20	$130	$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…	30	$60	$1.8K
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…	20	$60	$860
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…	30	$20	$590
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…	30	$10	$340
J2930	Injection, methylprednisolone sodium succinate, up to 125 mg	80	$1	$240

Showing 1–10 of 12

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Utah Distribution

April Erwin — 0 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. state median

12 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2323	2	10	32,130	$20	$741.7K
J2350	2	10	5,100	$40	$221.6K
96413	45	50	100	$90	$13.8K
99214	1,226	4,080	80	$80	$11.6K
99215	1,025	1,190	40	$110	$7.5K
99213	3,402	3,680	60	$50	$6.4K
96365	20	80	90	$40	$5.2K
96415	34	40	60	$20	$2K
96375	29	30	50	$10	$990
J2930	2	10	30	$1	$140

Showing 1–10 of 12

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Clhg-acadian LLC	LA	Rural Health Clinic/Center	$0	$5.5M
Dr John Foley LLC	UT	Neurology Physician	$0	$3.9M
Diana Banks	UT	Neurology Physician	$1.6M	$0
John Foley	UT	Neurology Physician	$789.8K	$608K
Timothy West	UT	Neurology Physician	$664.5K	$0
Eric Oberlander	LA	Neurological Surgery Physician	$614.2K	$0
Viktoria Kaplan	UT	Neurology Physician	$517.8K	$0
Charles Bowie	LA	Neurological Surgery Physician	$358.3K	$0
Gerald Calegan	LA	Neurology Physician	$208.5K	$0
Stacey Steeves	UT	Neurology Physician	$196.4K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services Inc	UT	Rehabilitation Clinic/Center	$0	$2.5M
Ihc Health Services Inc	UT	Psychiatry Physician	$0	$830.1K
Shriners Hospitals For Children	UT	Children's Hospital	$0	$605.5K
Daniel Preece	UT	Foot & Ankle Surgery Podiatrist	$267.1K	$0
Avenues Surgery Center, LLC	UT	Ambulatory Surgical Clinic/Center	$236K	$0
Jeffrey Osborn	UT	Cardiovascular Disease Physician	$136.2K	$0
Caleb Sturge	UT	Diagnostic Radiology Physician	$101.3K	$0
Yvonne Hsu	UT	Gynecology Physician	$84.2K	$0
Darren Groberg	UT	Foot & Ankle Surgery Podiatrist	$68K	$0
Richard Matern	UT	Urology Physician	$61.2K	$0

April Erwin — Billing Profile & Reimbursement Data

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April Erwin — 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