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

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

William Chafin (NPI 1225122716)

Field	Value
Entity Type	Individual
Organization	William Chafin
Address	700 S Enota Dr Ne
City	Gainesville
State	GA
ZIP	30501
Taxonomy	Rheumatology Physician
NPI Enumerated	October 2, 2006

Payer Source	Total Paid
Medicare	$3.3M
Medicaid	$0

Key Findings

This provider’s Medicare business is highly concentrated: total Medicare revenue is $3.3M and the precomputed top-three codes (J0129, J0717, J3262) account for 82.7% of that Medicare revenue. Those three codes alone generate the lion’s share of income, indicating the practice’s financial performance is driven primarily by a small set of biologic drug administrations.

The code mix shows a clear infusion/biologics-focused rheumatology operation: the top codes are J0129 (abatacept), J0717 (certolizumab pegol), and J3262 (tocilizumab), and meaningful usage of infusion/administration CPTs such as 96365 and 96413 appears in the top-25 list. This pattern—high-dollar biologic drugs combined with infusion administration codes—is consistent with an in-office infusion service model rather than a visit-only outpatient clinic.

Revenue concentration creates operational dependency on drug administration volumes: J0129 accounts for $1.2M (35.6% of Medicare revenue), J0717 accounts for $1.1M (32.0%), and J3262 accounts for $510.2K (15.1%). Because those three codes together represent 82.7% of Medicare revenue, changes in utilization, reimbursement, or drug supply for these specific agents would materially affect overall Medicare revenue.

Competitive standing is uneven across codes. The provider ranks highly on specific biologic codes—J0717 ranks #9 of 848 providers nationally (99th percentile; extreme outlier, far above typical national volume) and J0129 ranks #28 of 1221 (98th percentile; notably above typical national volume)—which indicates national-level prominence for administering those drugs, while other codes such as J3262 rank #51 of 618 (92th percentile; typical, unremarkable volume), reflecting strong but more typical participation.

Service mix includes substantial office-based evaluation-and-management volume in addition to infusions: 99214 generated $102.4K and the provider ranks #7305 of 479517 (98th percentile; extreme outlier), indicating unusually high Medicare E/M activity relative to most clinicians. This combination—high E/M plus high infusion drug revenue—suggests the provider manages both routine longitudinal care and in-office therapeutic infusions for Medicare patients.

The provider is effectively single-payer in scope for public programs: Medicare revenue is $3.3M while Medicaid revenue is none (no Medicaid billing on file), so there is no measurable Medicaid contribution to lifetime public-payer revenue. From a payer-mix perspective, exposure and contracting considerations should be evaluated primarily against Medicare populations and reimbursement dynamics.

Tenure and stability are notable: NPI enumerated (registered) 2006-10-02 (~20 years ago), which indicates long-standing enrollment in the Medicare program and suggests an established practice presence in Gainesville, GA. Long tenure combined with concentrated biologic administration may reflect an ongoing, stable infusion program rather than a recent service expansion.

Several ancillary procedure and lab codes appear among the top-25 but contribute modestly to revenue (for example, 96365 $28.3K, 96413 $23.3K, and common lab codes such as 80053 $9.3K and 85025 $7.5K). These smaller revenue lines support the core infusion/rheumatology service mix—pre-infusion labs, infusion monitoring, and follow-up E/M—rather than representing independent revenue centers.

Medicare: Complete Services Breakdown

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

43 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)	35,480	$30	$1.2M
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)	270,400	$1	$1.1M
J3262	Injection, tocilizumab, 1 mg	102,040	$10	$510.2K
J1602	Injection, golimumab, 1 mg, for intravenous use	17,880	$10	$178.8K
J9312	Injection, rituximab, 10 mg	2,830	$60	$178.5K
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…	1,190	$90	$102.4K
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.	620	$50	$28.3K
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…	250	$90	$23.3K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	1,390	$10	$15.3K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	930	$10	$9.3K

Showing 1–10 of 43

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 43 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Georgia Distribution

William Chafin — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. state median

43 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	1	30	9,660	$30	$403.6K
J9312	9	10	4,620	$60	$307.4K
J1602	12	30	17,200	$10	$240.1K
J3262	1	10	45,840	$1	$233.4K
J0717	1	20	38,000	$1	$199.3K
86235	12	20	310	$20	$49.5K
96413	55	160	170	$90	$20.3K
99214	196	13,640	120	$80	$17.8K
86038	17	20	60	$10	$15K
96365	15	210	110	$50	$10.8K

Showing 1–10 of 43

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Taylor Mader	SC	Rheumatology Physician	$3.1M	$0
Dean Stephens	GA	Rheumatology Physician	$2.7M	$0
Charles Degenhardt	GA	Rheumatology Physician	$2.4M	$0
Paul Sutej	GA	Rheumatology Physician	$2.4M	$0
Durga Adhikari	SC	Rheumatology Physician	$2.4M	$0
Marta Bognar	GA	Rheumatology Physician	$2.3M	$0
Brent Flickinger	GA	Rheumatology Physician	$2.3M	$0
Kathleen Flint	SC	Rheumatology Physician	$2.3M	$0
Colin Edgerton	SC	Rheumatology Physician	$1.9M	$0
John Brittis	SC	Rheumatology Physician	$1.9M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northeast Georgia Medical Center, Inc.	GA	General Acute Care Hospital	$0	$112.9M
Georgia Emergency Department Services, P.C.	GA	Emergency Medicine Physician	$0	$17.9M
S.y.a.h.	GA	Urgent Care Clinic/Center	$0	$6.5M
Pediatric Associates LLP	GA	Pediatrics Physician	$0	$5M
Gainesville Radiology Group, PC	GA	Diagnostic Radiology Physician	$0	$2M
Hall County Georgia	GA	Land Ambulance	$1.6M	$0
Northeast Georgia Physicians Group Urgent Care LLC	GA	Family Medicine Physician	$0	$1.6M
Timothy Carey	GA	Medical Oncology Physician	$1.5M	$0
Gainesville Surg Ctr LP	GA	Ambulatory Surgical Clinic/Center	$1.4M	$0
Gainesville Eye Center, LLC	GA	Ambulatory Surgical Clinic/Center	$1.4M	$0

William Chafin — 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