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.

Rheumatic Disease Center (NPI 1609812544)

Rheumatic Disease Center is a rheumatology physician provider located in Glendale, Wisconsin. This profile covers 0 Medicare and 47 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Rheumatic Disease Center
Address	7080 N Port Washington Rd
City	Glendale
State	WI
ZIP	53217
Taxonomy	Rheumatology Physician
NPI Enumerated	June 21, 2006

Payer Source	Total Paid
Medicaid	$3M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

47 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)	760	$1,390	$1.1M
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)	770	$1,320	$1M
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…	4,770	$60	$262.2K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	260	$830	$216.7K
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…	7,080	$30	$177K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	2,790	$20	$53K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	10,380	$1	$41.5K
85651	The lab analyst performs the typical manual erythrocyte sedimentation rate test using whole blood she places in a slender tube. She records the distance in millimeters that the erythrocytes or red…	10,870	$1	$21.7K
86140	The lab analyst performs the technical lab test to analyze a specimen, typically serum, for the presence of C reactive protein.	10,820	$1	$21.6K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	460	$50	$20.6K

Showing 1–10 of 47

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.

Claims Volume vs. Wisconsin Distribution

Rheumatic Disease Center — 5 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. Wisconsin median

47 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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)	1	10	760	$1,390	$1.1M
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)	1	10	770	$1,320	$1M
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.	108	140	2,200	$90	$358.4K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	4	10	40	$570	$357.5K
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.	141	260	3,590	$20	$232.2K
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…	160	1,630	270	$40	$205.3K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	375	1,760	250	$40	$173.2K
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…	8	60	1,280	$50	$160.9K
96415	In this add on procedure, the provider continues administration of a chemotherapy drug into a vein using an infusion technique. He uses this code to report each additional hour of infusion beyond the…	9	30	900	$90	$133.6K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	189	220	2,770	$20	$120.2K

Showing 1–10 of 47

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Francis Children's Center	WI	Rehabilitation Clinic/Center	$0	$6.1M
Great Lakes Hospice LLC	WI	Community Based Hospice Care Agency	$0	$1.9M
Rahul Sawlani	WI	Diagnostic Radiology Physician	$329.3K	$29.7K
Melissa High	WI	Physical Therapist	$115.4K	$0
Sharon Schulman	WI	Psychologist	$84.8K	$0
Cathy Perkins	WI	Psychosomatic Medicine Physician	$82.4K	$0
James Berman	WI	Dermatology Physician	$77.8K	$0
Paul Smerz	WI	Clinical Psychologist	$45.6K	$0
David Schulz	WI	Psychiatry Physician	$16.9K	$0
Christina Petrou	WI	Optometrist	$12.7K	$0

Rheumatic Disease Center — Billing Profile & Reimbursement Data

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Rheumatic Disease Center — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
John Albert	WI	Rheumatology Physician	$1.2M	$0
Kurt Oelke	WI	Rheumatology Physician	$794.2K	$0
Farrukh Pasha	WI	Rheumatology Physician	$314.9K	$0
Suhail Hameed	WI	Rheumatology Physician	$302.5K	$0
Steven Bergquist	WI	Rheumatology Physician	$90.3K	$0
Jonathan Kushi	WI	Rheumatology Physician	$66.8K	$0
Katherine Finn	WI	Rheumatology Physician	$31.5K	$0