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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

Luke Hushagen (NPI 1205369105)

Field	Value
Entity Type	Individual
Organization	Luke Hushagen
Address	2820 Mount Rushmore Rd
City	Rapid City
State	SD
ZIP	57701
Taxonomy	Internal Medicine Physician
NPI Enumerated	April 6, 2017

Payer Source	Total Paid
Medicare	$1.4M
Medicaid	$0

Key Findings

This provider is effectively single-payer in the claims on file: lifetime Medicare revenue is $1.4M while there is no Medicaid billing on file. The top 3 Medicare codes by revenue account for 48.3% of the provider's total Medicare revenue, indicating heavy reliance on a small set of high-revenue services within the Medicare population.

The revenue and code mix point to an outpatient infusion/biologics service line combined with ongoing ambulatory management. High-revenue J-codes such as J3380, J3262, and J1602 (vedolizumab, tocilizumab, and golimumab) dominate the list, and infusion administration codes 96365, 96413, and 96415 are present, consistent with a practice that administers intravenous biologic therapies onsite.

Revenue concentration is pronounced at the top: J3380 alone accounts for $321.3K and 24.0% of this provider's Medicare revenue, while the precomputed top-three share is 48.3%. This underlines that a small number of injectable biologic products drive nearly half of Medicare receipts for this NPI.

On national competitive standing for the leading biologics, this provider shows modest-to-typical volume. J3380 ranks #87 of 620 (86th percentile; typical, unremarkable volume for this code), J3262 ranks #269 of 618 (57th percentile; typical, unremarkable volume), and J1602 ranks #470 of 1041 (55th percentile; typical, unremarkable volume), so the practice is not a dominant national outlier for these drugs despite significant revenue contribution.

In contrast, evaluation-and-management and preventive services are areas of relative strength. 99214 ranks in the 93rd percentile and is flagged as notably above typical national volume, 99211 ranks in the 99th percentile (notably above typical), and annual wellness visit codes G0438 and G0439 rank in the 96th and 93rd percentiles respectively (both described as notably above typical national volume), indicating a substantial role in primary-care E&M and wellness visits for Medicare patients.

Certain high-cost biologics show below-median national placement, suggesting a selective or regional practice profile. For example, J0129 ranks #981 of 1221 (20th percentile; typical, unremarkable volume) and J9312 ranks #266 of 317 (16th percentile; typical, unremarkable volume), which points to uneven uptake across specific agents.

The broader procedural and ancillary mix supports a comprehensive ambulatory model rather than a narrowly specialized clinic. Lab panels (80061, 80053, 84443), DXA imaging (77080), and vaccine administration (90662) are present on the top-25 list, reflecting routine monitoring and preventive care activities that accompany ongoing biologic therapy.

This NPI has an established Medicare presence, enumerated 2017-04-06 (~9 years ago), which indicates a multi-year operating history with Medicare beneficiaries. Given $1.4M in Medicare revenue and no Medicaid billing recorded, payers and network managers should view this provider as Medicare-centric when assessing contracting and care-design opportunities.

Medicare: Complete Services Breakdown

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

53 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J3380	Injection, vedolizumab, intravenous, 1 mg	18,900	$20	$321.3K
J3262	Injection, tocilizumab, 1 mg	44,640	$1	$178.6K
J1602	Injection, golimumab, 1 mg, for intravenous use	14,650	$10	$146.5K
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)	4,080	$30	$134.5K
J9312	Injection, rituximab, 10 mg	1,850	$60	$118.4K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	4,380	$30	$113.9K
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)	19,600	$1	$78.4K
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…	640	$80	$52.9K
J0897	Injection, denosumab, 1 mg	2,760	$20	$49.7K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	240	$130	$30.6K

Showing 1–10 of 53

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 53 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Dakota Distribution

Luke Hushagen — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. state median

53 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J3380	2	10	24,000	$20	$412.6K
J3262	2	10	51,240	$1	$228.4K
J1602	3	10	18,780	$10	$189.1K
J0717	3	10	33,600	$1	$175.6K
J9312	2	10	1,850	$60	$158.7K
J0129	1	10	3,610	$30	$120.4K
J1745	2	10	4,300	$30	$97.2K
J0897	18	40	2,460	$20	$52.8K
J1439	4	10	26,630	$1	$23K
96413	8	10	110	$100	$13.5K

Showing 1–10 of 53

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Monument Health Rapid City Hospital, Inc	SD	Multi-Specialty Clinic/Center	$0	$18.7M
Monument Health Rapid City Hospital, Inc.	SD	General Acute Care Hospital	$0	$11.5M
Monument Health Rapid City Hospital, Inc.	SD	Multi-Specialty Clinic/Center	$0	$5.2M
Rapid City Medical Center, LLP	SD	Multi-Specialty Clinic/Center	$0	$4.5M
Richard White	AR	Hematology & Oncology Physician	$2.2M	$0
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$2M
Jennifer May	SD	Internal Medicine Physician	$1.9M	$0
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$1.8M
Monument Health Rapid City Hospital, Inc.	SD	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.6M
Don Wynn	TX	Pulmonary Disease Physician	$1.4M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Behavior Management Systems, Inc.	SD	Community/Behavioral Health Agency	$0	$19.8M
Community Health Center Of The Black Hills Inc	SD	Federally Qualified Health Center (FQHC)	$0	$10.2M
Jrk Services, Inc	SD	Home Health Agency	$0	$10.1M
Black Hills Pediatrics, LLP	SD	Pediatrics Physician	$0	$9.7M
Rapid City Emergency Services PA	SD	Emergency Medicine Physician	$0	$8.2M
Wellspring Inc.	SD	Psychiatry Physician	$0	$7.4M
Prema Abraham	SD	Retina Specialist (Ophthalmology) Physician	$7.1M	$0
Radiology Associates Prof, LLC	SD	Diagnostic Radiology Physician	$0	$5.3M
City Of Rapid City	SD	Ambulance	$1.4M	$3.7M
Black Hills Oral & Maxillofacial Surgery PC	SD	Oral and Maxillofacial Pathology Dentistry	$0	$3.2M

Luke Hushagen — 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