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NPI 1477584399 · Miamisburg, OH · Rheumatology Physician
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Chacko Alappatt is a rheumatology physician provider located in Miamisburg, Ohio. This profile covers 21 Medicare and 1 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Chacko Alappatt |
| Address | 2960 Ferndown Dr |
| City | Miamisburg |
| State | OH |
| ZIP | 45342 |
| Taxonomy | Rheumatology Physician |
| NPI Enumerated | July 6, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.3M |
| Medicaid | $6.4K |
This provider’s commercial footprint is overwhelmingly Medicare-driven: total Medicare revenue is $3.3M compared with total Medicaid revenue of $6.4K, so the practice operates effectively as a single‑payer (Medicare) revenue center. Medicaid billing is minimal and concentrated entirely in office E/M visits (see below), while Medicare supports the bulk of specialty drug and infusion activity.
Revenue concentration on Medicare is high: the top 3 Medicare codes by revenue account for 67.1% of this provider's total Medicare revenue, led by J1602 ($873.1K, 26.4% of Medicare revenue), J0129 ($754.8K, 22.8%), and J0717 ($592.8K, 17.9%). Those three biologic injection codes dominate Medicare receipts and define the provider’s major revenue drivers.
The code mix indicates a biologics- and infusion-centric rheumatology operation: the highest-revenue Medicare codes are J1602, J0129 and J0717 (all injectable biologics) and the practice also reports substantial administration/infusion activity (96413 $104.3K and 96401 $65.3K). This combination of drug and infusion codes suggests an in-office infusion suite or systematic onsite administration capability rather than a purely office-visits model.
CHACKO ALAPPATT is a national outlier on at least one specific biologic: J1602 ranks #8 of 1041 providers nationally (99th percentile; extreme outlier), indicating volumes for golimumab IV well above typical peers. By contrast, J0129 (rank #108 of 1221, 91th percentile) and J0717 (rank #63 of 848, 93th percentile) are strong but more within the expected high-volume peer range.
The practice also shows unusually high national activity for E/M and infusion administration when compared to peers: Medicare 99214 generated $136.7K (1.6K claims) and ranks #3057 of 479517 providers nationally (99th percentile; extreme outlier), while infusion/chemotherapy administration codes 96413 ($104.3K, rank #41 of 7514) and 96401 ($65.3K, rank #34 of 3868) are likewise described as extreme outliers. These high percentiles across both drug administration and E/M codes point to both high patient throughput and high on-site treatment volume relative to most providers.
Medicaid activity is concentrated and modest: Medicaid revenue is $6.4K, entirely from 99214 (195 claims, $33 avg paid/claim) which represents 100.0% of this provider's total Medicaid revenue. In-state ranking for that Medicaid E/M code is #2855 of 4514 (37th percentile; typical), so the provider is a modest, average contributor to Medicaid E/M volume in-state rather than a dominant Medicaid participant.
Tenure and stability: the provider’s NPI was enumerated on 2006-07-06 (~20 years ago), indicating an established practice history that aligns with the sustained Medicare revenue and developed infusion service lines documented in the claims. This length of enumeration supports interpretation that observed billing patterns reflect an enduring care model rather than a short-term fluctuation.
Strategic implications from the payer mix and code concentration: with top biologic injections generating the majority of Medicare dollars (top 3 = 67.1%) and a negligible Medicaid book ($6.4K), the practice’s revenue profile is highly exposed to changes in Medicare drug reimbursement, prior authorization policies, or shifts in biologic prescribing. Any payer policy change affecting high-volume codes like J1602, J0129, or J0717 could materially alter the practice’s revenue given the concentration documented in the Medicare data.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
21 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J1602 | Injection, golimumab, 1 mg, for intravenous use | 87,310 | $10 | $873.1K |
| 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) | 22,200 | $30 | $754.8K |
| 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) | 148,200 | $1 | $592.8K |
| J3111 | Injection, romosozumab-aqqg, 1 mg | 42,420 | $10 | $339.4K |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 11,170 | $30 | $290.4K |
| 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… | 1,590 | $90 | $136.7K |
| J0897 | Injection, denosumab, 1 mg | 6,180 | $20 | $111.2K |
| 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… | 1,150 | $90 | $104.3K |
| 96401 | The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient. | 1,230 | $50 | $65.3K |
| 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… | 120 | $120 | $13.2K |
Showing 1–10 of 21
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
21 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0717 | 2 | 10 | 50,200 | $1 | $296K |
| J0129 | 3 | 40 | 7,360 | $30 | $290K |
| J3111 | 4 | 20 | 15,540 | $10 | $246.6K |
| J1602 | 1 | 30 | 12,730 | $10 | $167.6K |
| J1745 | 5 | 40 | 4,280 | $30 | $139.5K |
| J0897 | 40 | 230 | 2,880 | $20 | $79.5K |
| 96413 | 1 | 210 | 130 | $90 | $16.8K |
| 99214 | 20 | 20,010 | 100 | $70 | $11.7K |
| 96401 | 1 | 60 | 90 | $50 | $7K |
| 99213 | 5,663 | 20,000 | 70 | $50 | $6.6K |
Showing 1–10 of 21
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 200 | $30 | $6.4K |
How this provider's Medicaid billing volume and revenue compare to other Ohio providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Ohio median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 2,855 | 4,510 | 500 | $60 | $377.8K |
Other providers in the same ZIP code as Chacko Alappatt, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Advanced Medical Equipment, LLC | OH | Customized Equipment (DME) | $0 | $58.4M |
| Kettering Medical Center | OH | General Acute Care Hospital | $0 | $20M |
| Maxim Healthcare Services, Inc. | OH | Home Health Agency | $0 | $18.4M |
| Kettering Independent Medical Group Inc | OH | Orthopaedic Surgery Physician | $0 | $8.4M |
| Stateline Medical Equipment, Inc | OH | Durable Medical Equipment & Medical Supplies | $0 | $7.9M |
| Miami Valley Fire District | OH | Ambulance | $401.1K | $1.4M |
| Isis Medical, Incorporated | OH | Physiological Laboratory | $712.6K | $220.3K |
| Paul Obeng-okyere | OH | Cardiovascular Disease Physician | $371.8K | $0 |
| Rachel Boggus | OH | Pain Medicine (Anesthesiology) Physician | $272.6K | $0 |
| Michael Welker | OH | Orthopaedic Surgery Physician | $184.4K | $0 |
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