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

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

Nikila Kumar (NPI 1295095495)

Field	Value
Entity Type	Individual
Organization	Nikila Kumar
Address	4550 E Bell Rd Ste 170
City	Phoenix
State	AZ
ZIP	85032
Taxonomy	Rheumatology Physician
NPI Enumerated	May 22, 2012

Payer Source	Total Paid
Medicare	$3M
Medicaid	$0

Key Findings

The provider’s Medicare billing mix is dominated by injectable biologic and infusion drugs consistent with rheumatology practice patterns: high-revenue J-codes such as J0129 (abatacept), J0897 (denosumab), J3262 (tocilizumab) and several other monoclonal antibody therapies appear throughout the top codes, indicating routine in-office administration of biologics rather than a primarily office-visit–only model. This pattern suggests the practice operates infusion/administration services or an infusion suite as a core service line.

Revenue is highly concentrated in a small number of drug-administration codes: the precomputed top 3 Medicare codes account for 46.8% of this provider’s total Medicare revenue, with J0129 contributing 18.2%, J0897 contributing 15.0%, and J3262 contributing 13.6% of Medicare revenue. That concentration means a large portion of the $3M lifetime Medicare revenue is driven by a few high-cost injectable therapies.

Payer mix is effectively single-payer Medicare: lifetime Medicare revenue is $3M and there is no Medicaid billing on file. For payer-strategy or network negotiations, this provider should be treated as Medicare-centric with no recorded Medicaid presence to date.

Competitive standing is code-specific and mixed: for J0897 the provider ranks #160 of 10057 providers nationally (98th percentile; extreme outlier), marking unusually high national volume for denosumab administration, while J0129 ranks #212 of 1221 (83th percentile; typical, unremarkable) and J3262 ranks #93 of 618 (85th percentile; typical, unremarkable). In plain terms, the provider is a national high-volume outlier for J0897 but a more typical-volume participant for other leading biologics.

Clinical-delivery capability is reinforced by elevated chemotherapy/infusion administration CPT activity: 96413 ranks #135 of 7514 providers (98th percentile; notably above typical national volume), 96401 ranks #174 of 3868 (96th percentile; notably above typical), and 96415 ranks #133 of 4959 (97th percentile; notably above typical). Coupled with J9312 (rituximab) and infliximab entries, these signals point to meaningful infusion throughput beyond routine injections, consistent with a practice that manages complex biologic and infusion regimens.

Office visit volume for both new and established patients is high relative to peers: 99214 ranks #3057 of 479517 (99th percentile; extreme outlier) and 99205 ranks #1123 of 66257 (98th percentile; extreme outlier), indicating above-typical E/M visit activity for both established and new patients. This suggests the practice maintains a sizable active patient panel and substantial visit-level throughput in addition to infusion services.

Biosimilar utilization is present but secondary to originator biologics: Q5104 (infliximab-abda) and Q5121 (infliximab-axxq) appear in the top codes but contribute smaller shares of revenue (3.1% and 1.0% respectively), with rankings that are moderate rather than dominant. The data imply selective biosimilar use alongside continued administration of multiple branded biologics.

The provider has an established operational history—NPI enumerated 2012-05-22 (~14 years ago)—and the lifetime Medicare revenue profile ($3M) combined with concentrated biologic and infusion billing suggests a mature rheumatology practice that relies heavily on in-office drug administration as a core revenue driver. Analysts should expect stability in infusion-dependent service lines and limited near-term Medicaid exposure given the absence of Medicaid billing on file.

Medicare: Complete Services Breakdown

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

62 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)	16,030	$30	$544.9K
J0897	Injection, denosumab, 1 mg	24,960	$20	$449.3K
J3262	Injection, tocilizumab, 1 mg	81,440	$10	$407.2K
J1602	Injection, golimumab, 1 mg, for intravenous use	33,090	$10	$330.9K
J9312	Injection, rituximab, 10 mg	5,000	$60	$320K
J3111	Injection, romosozumab-aqqg, 1 mg	21,630	$10	$173K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	5,710	$30	$148.5K
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…	1,590	$90	$139.8K
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)	29,800	$1	$119.2K
Q5104	Injection, infliximab-abda, biosimilar, (renflexis), 10 mg	3,040	$30	$91.3K

Showing 1–10 of 62

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 62 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Arizona Distribution

Nikila Kumar — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arizona

Full comparison — all codes billed, vs. state median

62 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	10	30	14,700	$30	$494.5K
J3262	8	20	74,500	$1	$367.2K
J1602	9	30	24,040	$10	$316.2K
J0717	17	20	36,100	$1	$246.6K
J9312	1	20	3,250	$60	$212.6K
J3111	15	40	19,530	$10	$178.8K
J0897	13	260	2,940	$20	$115.6K
Q5104	3	10	3,720	$30	$108.7K
J1745	7	40	2,980	$30	$103.9K
86235	13	20	130	$20	$59.5K

Showing 1–10 of 62

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Arizona Arthritis & Rheumatology Associates P C	AZ	Rheumatology Physician	$0	$11.2M
Nehad Soloman	AZ	Rheumatology Physician	$5.1M	$0
Alexander Hu	AZ	Internal Medicine Physician	$3.8M	$0
Areena Swarup	AZ	Rheumatology Physician	$3.6M	$0
Saima Chohan	AZ	Rheumatology Physician	$3.5M	$0
John Tesser	AZ	Rheumatology Physician	$3M	$0
Daniel Kreutz	AZ	Rheumatology Physician	$2.8M	$0
Mona Amin	AZ	Rheumatology Physician	$2.7M	$0
Joonhee Lim	AZ	Rheumatology Physician	$2.3M	$0
Andrew Sharobeem	AZ	Rheumatology Physician	$2.3M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
New Hope Of Arizona, Inc	AZ	Community/Behavioral Health Agency	$0	$50.2M
Privia Medical Group Arizona, LLC	AZ	Family Medicine Physician	$0	$45.6M
Clinica La Familia, PC	AZ	Internal Medicine Physician	$0	$39.4M
Urgent Home Care Inc	AZ	Nursing Facility/Intermediate Care Facility	$0	$32.6M
View Point Sunshine Village LLC	AZ	Alzheimer Center (Dementia Center)	$0	$29.4M
Radadvantage A Professional Corporation	AZ	Diagnostic Radiology Physician	$0	$28.3M
Vhs Acquisition Subsidiary Number 1 Inc	AZ	General Acute Care Hospital	$0	$24.3M
Neighborhood Outreach Access To Health	AZ	Federally Qualified Health Center (FQHC)	$0	$16.2M
Honorhealth Medical Group, LLC	AZ	Family Medicine Physician	$0	$10.1M
Extended Care Portfolio Multistate Pool Tenant, LLC	AZ	Assisted Living Facility	$0	$7.7M

Nikila Kumar — 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