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

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

Kathryn Baker (NPI 1245327295)

Field	Value
Entity Type	Individual
Organization	Kathryn Baker
Address	9555 Sw Barnes Rd Ste 150
City	Portland
State	OR
ZIP	97225
Taxonomy	Rheumatology Physician
NPI Enumerated	October 9, 2006

Payer Source	Total Paid
Medicare	$917.9K
Medicaid	$0

Key Findings

This provider reports Total Medicare revenue of $917.9K and has no Medicaid billing on file, making Medicare effectively the sole public payer represented in the dataset for this NPI. The lack of Medicaid activity suggests limited exposure to state Medicaid managed-care networks and a narrow public-payer mix.

Revenue is highly concentrated in biologic and infusion drugs: the precomputed top-3 Medicare codes account for 58.6% of this provider's total Medicare revenue, with those top codes being J0129, J1602, and J9312. That concentration indicates the practice derives most of its Medicare dollars from high-cost injectable biologics rather than from office E/M services.

The code mix (J0129 abatacept, J1602 golimumab, J9312 rituximab plus notable volumes of J1745 infliximab and J3262 tocilizumab) is consistent with a rheumatology practice that operates an in-office infusion/biologics administration service line. Presence of infusion/chemotherapy administration codes such as 96413, 96365, and the add-on 96415 further supports the conclusion that the provider maintains infusion capacity and bills for drug administration sessions in addition to dispensing high-cost biologics.

Competitive standing across major drug codes is mixed: J1602 (golimumab) ranks #343 of 1041 providers nationally (67th percentile), and J1745 (infliximab) ranks #373 of 1352 providers nationally (72th percentile), indicating above-typical national activity on those products; by contrast J0129 (abatacept) ranks #856 of 1221 (30th percentile) and J9312 (rituximab) ranks #182 of 317 (42th percentile), where the file labels most of these as "typical, unremarkable volume for this code." This pattern points to stronger market presence for some IV biologics but only modest participation on others.

Clinical visit revenue is a small share of the Medicare mix relative to biologic drug revenue: 99214 accounts for $28.2K (3.1% of Medicare revenue) and 99213 accounts for $3.3K (0.4% of Medicare revenue). These figures underscore that billing is dominated by drug and infusion reimbursement rather than by office-based evaluation-and-management visits.

The NPI was enumerated on 2006-10-09 (≈20 years ago), indicating an established billing history; combined with concentrated biologic revenue, this suggests a sustained, long-term infusion-oriented rheumatology practice rather than a newly launched service line.

Operational and contracting implication: because the provider reports no Medicaid billing on file, payers and network managers should view this entity as effectively single-payer (Medicare) in the public claims data and consider that absence when assessing network adequacy, risk adjustment, or efforts to engage the practice for Medicaid business development.

Medicare: Complete Services Breakdown

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

16 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)	5,430	$30	$184.4K
J1602	Injection, golimumab, 1 mg, for intravenous use	18,150	$10	$181.5K
J9312	Injection, rituximab, 10 mg	2,700	$60	$172.8K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	5,020	$30	$130.5K
J3262	Injection, tocilizumab, 1 mg	23,640	$10	$118.2K
J0897	Injection, denosumab, 1 mg	3,300	$20	$59.4K
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…	300	$90	$28.2K
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…	160	$110	$16.4K
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.	260	$50	$13.2K
99204	The provider sees a new 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 provider…	50	$100	$5.2K

Showing 1–10 of 16

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Oregon Distribution

Kathryn Baker — 0 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. state median

16 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	13	20	6,300	$30	$260.7K
J9312	5	10	3,750	$60	$220K
J3262	11	10	31,180	$1	$176.4K
J1602	7	20	13,600	$10	$156.4K
J1745	8	20	3,750	$30	$115.2K
J0897	27	70	2,400	$20	$78.3K
96413	41	90	150	$100	$18.2K
99214	686	6,070	80	$70	$10.3K
96365	12	110	70	$50	$5.8K
99213	2,721	5,480	60	$50	$5.7K

Showing 1–10 of 16

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rashmi Shah	OR	Rheumatology Physician	$801K	$0
David Kirakossian	OR	Rheumatology Physician	$728.7K	$0
Anita Goel	OR	Rheumatology Physician	$452.1K	$0
Neha Rich-garg	OR	Rheumatology Physician	$373.7K	$0
Aprajita Jagpal	OR	Rheumatology Physician	$301.8K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence Health & Services - Oregon	OR	General Acute Care Hospital	$0	$36.9M
Providence Health & Services - Oregon	OR	Clinical Pathology Physician	$0	$11.4M
Columbia Medical Alarm, Inc.	OR	Home Health Agency	$0	$6.1M
Childrens Clinic PC	OR	Pediatrics Physician	$0	$4.7M
West Hills Gastroenterology Equipment Corp	OR	Endoscopy Clinic/Center	$861.3K	$3.2M
Chiropractic Art & Science LLC	OR	Health Service Clinic/Center	$0	$2.7M
Hd Industries, LLC	OR	In Home Supportive Care Agency	$0	$2.7M
Trg, LLC	OR	Diagnostic Radiology Physician	$0	$2.4M
Westside Pediatric Clinic PC	OR	Pediatrics Physician	$0	$2.3M
Carlos Ugalde	OR	Oral and Maxillofacial Surgery (Dentist)	$0	$2.3M

Kathryn Baker — Billing Profile & Reimbursement Data

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Kathryn Baker — 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