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

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

Craig Wiesenhutter (NPI 1205980422)

Field	Value
Entity Type	Individual
Organization	Craig Wiesenhutter
Address	950 W Ironwood Dr
City	Coeur D Alene
State	ID
ZIP	83814
Taxonomy	Rheumatology Physician
NPI Enumerated	January 23, 2007

Payer Source	Total Paid
Medicare	$532.4K
Medicaid	$0

Key Findings

This provider reports $532.4K in total Medicare revenue and has no Medicaid billing on file, making their publicly reported patient mix effectively single‑payer Medicare. The absence of any Medicaid claims on record suggests the provider’s reimbursed activity in state programs is nil in the dataset rather than split across payers.

Revenue is highly concentrated: the precomputed top three Medicare codes account for 97.2% of this provider’s total Medicare revenue. Those top three codes are J0129 ($374.9K, 70.8%), J1602 ($111.5K, 21.1%), and 99213 ($28.2K, 5.3%), indicating most revenue is captured by a very small number of billing lines.

The code mix and descriptions indicate an infusion‑centric rheumatology practice: J0129 (abatacept) and J1602 (golimumab) are biologic injections administered in a supervised setting, supported by infusion/administration codes such as 96365 (initial IV infusion) and J7050 (normal saline). Office visit E/M revenue (99213 and 99214) represents a small share of dollars relative to biologic drug revenue, suggesting the operation is oriented around drug administration rather than office visits as the primary revenue driver.

Competitive standing by code is mixed: J0129 ranks #422 of 1221 providers (65th percentile) and is described as typical, unremarkable volume nationally for that code, indicating a modest national footprint for abatacept administration. J1602 ranks #625 of 1041 providers (40th percentile) with a typical, unremarkable volume for golimumab, while 99213 ranks #26720 of 457151 providers (94th percentile) — also labeled typical, unremarkable — meaning the provider bills E/M visits at a higher relative national percentile despite those visits being a small proportion of total revenue.

Operational metrics show high claim counts with relatively low average payment per claim for the biologics: J0129 has 11K claims at $34 avg paid/claim and J1602 has 11.2K claims at $10 avg paid/claim. These figures indicate the practice generates large aggregate drug revenue through high utilization of administered biologics rather than high per‑claim reimbursement, consistent with an infusion/service‑line model.

Supplemental infusion and administration codes further support an in‑house infusion capability: 96365 produced $12.4K (2.3% of Medicare revenue) and ranks #1053 of 8873 (88th percentile), and J7050 appears with 524 claims and $524 in revenue (0.1% of Medicare revenue) ranking in the 89th percentile. The presence and percentile placement of these codes point to established infusion workflows relative to national peers.

Although Medicare is the only payer on file, the practice’s heavy reliance on a narrow set of biologic drug codes (the top three codes represent 97.2% of Medicare revenue) creates revenue concentration risk: changes in drug pricing, prior authorization rules, or site‑of‑care reimbursement could materially affect total billed dollars. This concentration suggests business performance will be sensitive to payer policies affecting administered biologics.

The provider has an NPI enumerated on 2007-01-23 (~19 years ago), indicating a long tenure in the Medicare dataset and an established billing history. That longevity, combined with a stable pattern of administered biologic drug billing, supports a view of an established, infusion‑focused rheumatology practice with a Medicare‑dominant payer mix.

Medicare: Complete Services Breakdown

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

6 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)	11,030	$30	$374.9K
J1602	Injection, golimumab, 1 mg, for intravenous use	11,150	$10	$111.5K
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…	500	$60	$28.2K
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.	290	$40	$12.4K
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…	30	$90	$2.2K
J7050	Infusion, normal saline solution, 250 cc	520	$1	$520

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Idaho Distribution

Craig Wiesenhutter — 2 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	3	10	9,950	$30	$369.8K
J1602	6	10	15,030	$10	$266.6K
99214	2,262	2,690	90	$70	$10.4K
96365	4	20	80	$40	$7.4K
99213	74	2,770	70	$50	$5.7K
J7050	1	10	90	$1	$60

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Linda Sakai	ID	Rheumatology Physician	$8.7K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Res-care Washington, Inc	ID	In Home Supportive Care Agency	$0	$31.9M
Dirne Health Centers, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$13.6M
Coeur D'alene Pediatrics PA	ID	Pediatrics Physician	$0	$11.6M
Coeur D'alene School District #271	ID	Local Education Agency (LEA)	$0	$9.8M
Ambitions Of Idaho, Inc	ID	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$7.6M
Dirne Health Centers, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$7.1M
Kootenai Health, Inc.	ID	General Acute Care Hospital	$0	$7M
Family Support Services Of North Idaho	ID	Mental Health Counselor	$0	$6.9M
Dirne Health Centers, Inc	ID	Federally Qualified Health Center (FQHC)	$0	$6.7M
Kootenai Health, Inc.	ID	Psychiatry Physician	$0	$6.7M

Craig Wiesenhutter — Billing Profile & Reimbursement Data

Sign up for Craig Wiesenhutter — Billing Profile & Reimbursement Data policy alerts

Craig Wiesenhutter — Billing Profile & Reimbursement Data

Sign up for Craig Wiesenhutter — Billing Profile & Reimbursement Data policy alerts

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