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

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

Carly Skamra (NPI 1275670275)

Field	Value
Entity Type	Individual
Organization	Carly Skamra
Address	20800 Swenson Dr Ste 175
City	Waukesha
State	WI
ZIP	53186
Taxonomy	Rheumatology Physician
NPI Enumerated	January 30, 2007

Payer Source	Total Paid
Medicare	$943.5K
Medicaid	$0

Key Findings

This provider’s Medicare business is the sole reported public-payer revenue stream: total Medicare revenue is $943.5K while Medicaid is listed as none (no Medicaid billing on file), indicating an effectively single‑payer public profile and material dependence on Medicare reimbursement for public-payer volume. That concentration means analyses of access to lower‑income populations or state‑program utilization will be limited by absence of Medicaid data.

Revenue concentration is high: the precomputed top 3 Medicare codes by revenue account for 63.7% of this provider’s total Medicare revenue. Those three codes are J1602 ($293.7K, 30.7%), J0129 ($192.1K, 20.1%), and J3262 ($122.9K, 12.9%), which together drive the majority of billed Medicare dollars and should be the focus for contract negotiations or drug‑cost management.

The code mix and top revenue drivers indicate a biologic/infusion‑centric rheumatology practice: the largest single revenue code is J1602 (golimumab) with $293.7K and 26.7K claims, followed by J0129 (abatacept) $192.1K and J3262 (tocilizumab) $122.9K. Multiple high‑revenue injectable biologic codes (including J9312 rituximab $85.1K and J1745 infliximab $79.5K) plus infusion administration codes such as 96365 and chemotherapy/infusion codes 96413/96415 point to on‑site drug administration and management of complex inflammatory or autoimmune therapies.

Operational footprint appears to include routine in‑office monitoring and phlebotomy: 36415 (blood draw) shows 831 claims and $6.6K revenue and ranks #4188 of 86467 providers nationally (95th percentile), while lab panels and immunology tests (85025, 82565, 84450, 84460, 82040, 86140) appear repeatedly in the top codes. This pattern supports an integrated outpatient model that bundles biologic administration with on‑site lab monitoring rather than referring all testing externally.

Competitive standing across key biologics is mixed: J1602 ranks #187 of 1041 providers nationally (82th percentile) and is described as typical/unremarkable volume despite being the largest revenue driver, suggesting above‑median national activity for that specific drug but not dominance; by contrast J0129 ranks #843 of 1221 (31th percentile) and J3262 ranks #448 of 618 (28th percentile), both characterized as typical volumes and indicating modest market presence for those agents. Some monoclonal antibody codes are low relative to peers (e.g., J9312 ranks #306 of 317, 3th percentile), so this provider is a strong recycler of a small set of biologics rather than a broad national leader across many agents.

Clinical visit volume and chronic care management show concentration in mid‑level established visits: 99214 accounts for 626 claims and $52K (5.4% of Medicare revenue) and ranks #32798 of 479517 providers nationally (93th percentile), which indicates relatively high throughput of moderate‑complexity established‑patient visits consistent with ongoing biologic management and follow‑up. New patient visits (99204) and lower‑level established visits (99213) are present but contribute far smaller revenue shares, reinforcing a follow‑up/maintenance practice profile.

Tenure and professional stability are evident: NPI enumerated (registered) on 2007-01-30 (~19 years ago), which supports a long‑standing practice presence in the market and may correlate with established referral relationships and repeat biologic infusion patients. That longevity strengthens the inference that current billing patterns reflect a steady outpatient rheumatology infusion practice rather than a recent shift in service line.

The absence of Medicaid activity paired with concentrated biologic revenue exposes payer‑mix risk: reliance on Medicare ($943.5K total Medicare revenue) without Medicaid billing reduces diversification of public‑payer reimbursement and could influence negotiations with commercial plans or institutional contracts that value multi‑payer share. For payers and network planners, this profile suggests the provider is an experienced, Medicare‑focused rheumatology infusion site that may not serve a Medicaid population under the reported NPI.

Medicare: Complete Services Breakdown

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

44 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J1602	Injection, golimumab, 1 mg, for intravenous use	26,700	$10	$293.7K
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)	5,650	$30	$192.1K
J3262	Injection, tocilizumab, 1 mg	24,580	$10	$122.9K
J9312	Injection, rituximab, 10 mg	1,350	$60	$85K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	3,060	$30	$79.5K
J0897	Injection, denosumab, 1 mg	2,880	$20	$54.7K
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…	630	$80	$52K
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.	250	$50	$11.1K
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…	110	$90	$10.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	830	$10	$6.6K

Showing 1–10 of 44

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 44 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Wisconsin Distribution

Carly Skamra — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. state median

44 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	10	10	8,170	$30	$286.2K
J9312	8	10	2,580	$60	$234.8K
J1602	3	10	11,900	$10	$206.3K
J3262	7	10	35,280	$1	$191.4K
J1745	13	20	6,060	$30	$168.9K
J0897	19	60	2,220	$20	$69.3K
96413	37	80	110	$90	$12.7K
86235	6	20	110	$20	$10.7K
82784	8	10	240	$10	$10.1K
99214	112	9,800	80	$70	$9.2K

Showing 1–10 of 44

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Douglas Hempel	WI	Rheumatology Physician	$1.9M	$0
Mark Pearson	WI	Rheumatology Physician	$972.6K	$0
Nicole Jodat	WI	Medical Physician Assistant	$114.1K	$0
Taraneh Mehrani	WI	Rheumatology Physician	$34K	$0
Maggie Weissman	WI	Nurse Practitioner	$23.3K	$0
Juliana Shah	WI	Adult Health Nurse Practitioner	$15.5K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grace Machi	WI	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$5.5M
Kci Usa, Inc.	WI	Durable Medical Equipment & Medical Supplies	$0	$4.8M
Oak Medical Sc	WI	Internal Medicine Physician	$0	$4M
Waukesha School District	WI	Local Education Agency (LEA)	$0	$3.3M
Lss Aspen Center LLC	WI	Substance Abuse Rehabilitation Facility	$0	$2.9M
Planned Parenthood Of Wisconsin	WI	Ambulatory Family Planning Facility	$0	$2.5M
Lincare Inc.	WI	Durable Medical Equipment & Medical Supplies	$0	$1.6M
Matt Talbot Recovery Services, Inc	WI	Substance Abuse Rehabilitation Facility	$0	$1.3M
Loganathan Elangovan	WI	Nephrology Physician	$642.5K	$0
Aswin Kumar	WI	Diagnostic Radiology Physician	$387K	$100

Carly Skamra — 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