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

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

Latisha Heinlen (NPI 1649430810)

Field	Value
Entity Type	Individual
Organization	Latisha Heinlen
Address	6516 N Olie Ave Ste G
City	Oklahoma City
State	OK
ZIP	73116
Taxonomy	Rheumatology Physician
NPI Enumerated	June 11, 2008

Payer Source	Total Paid
Medicare	$3.6M
Medicaid	$0

Key Findings

LATISHA HEINLEN is listed as a Rheumatology Physician with Medicare lifetime revenue of $3.6M and no Medicaid billing on file; this makes her practice effectively Medicare-only in the available claims data and removes Medicaid as a material payer for profile comparisons. Her NPI was enumerated on 2008-06-11 (~18 years ago), indicating a long-established billing history to Medicare.

Revenue is highly concentrated in a small set of biologic drug administrations: the precomputed top 3 Medicare codes by revenue (J0129, J1602, J3262) account for 70.8% of her total Medicare revenue. Individually these codes generate $1.3M (35.0%) from J0129, $660K (18.2%) from J1602, and $640.4K (17.6%) from J3262, showing that drug administration rather than office E/M visits is the primary revenue stream.

The procedural mix is consistent with an in‑office biologics/infusion service line: top codes J0129 (abatacept), J1602 (golimumab), and J3262 (tocilizumab) are all biologic injections suited to treatment of autoimmune/rheumatic conditions, and the practice also bills infusion administration codes such as 96365 and chemotherapy infusion add‑ons like 96413. This combination of high biologic drug revenue and nontrivial infusion administration claims suggests the provider operates an infusion/office-administered biologics program rather than relying primarily on clinic visits.

On competitive standing, this provider is a national outlier for several specific biologic codes: J0129 ranks #20 of 1221 providers nationally (98th percentile; extreme outlier, far above typical national volume for this code), J1602 ranks #18 of 1041 (98th percentile; notably above typical national volume for this code), and J3262 ranks #25 of 618 (96th percentile; notably above typical national volume for this code). These ranks indicate dominant volume for these specific drugs compared with national peers, implying regional or niche leadership in administering these therapies.

By contrast, standard evaluation-and-management activity is modest and not a primary revenue driver: 99214 shows 364 claims and $29.1K revenue (0.8% of Medicare revenue) and is characterized as typical/unremarkable volume, and 99213 likewise represents a small share ($17.4K, 0.5%). This underlines that office visits are secondary to drug/infusion revenue in her billing profile.

Several non-drug administration codes are also extreme or notable outliers, reinforcing a high-throughput injection/infusion operation: 96365 (859 claims, $40.4K revenue) ranks #126 of 8873 providers nationally (99th percentile; notably above typical national volume for this code) and 96372 (982 claims, $10.8K revenue) ranks #406 of 58224 (99th percentile; extreme outlier, far above typical national volume for this code). High percentile standings on administration codes corroborate that in-office delivery of injected/infused therapies is a central part of service delivery.

From a payer and network strategy perspective, the provider’s heavy reliance on a small set of biologic administrations presents both risk and leverage: because the top 3 codes account for 70.8% of Medicare revenue, utilization management, drug pricing, or shifts to buy-and-bill alternatives for those agents would materially affect revenue. The absence of Medicaid billing means state Medicaid contracting or fee-schedule changes are unlikely to impact this provider’s current revenue base.

Tenure and billing pattern together suggest stability as a specialized infusion/biologic provider: an NPI enumerated on 2008-06-11 (~18 years ago) combined with sustained, high-ranked volumes on multiple specific biologic J‑codes indicates an established practice with an operational focus on administering high-cost rheumatology biologics rather than a transient or low-volume infusor.

Medicare: Complete Services Breakdown

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

20 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)	38,580	$30	$1.3M
J1602	Injection, golimumab, 1 mg, for intravenous use	66,000	$10	$660K
J3262	Injection, tocilizumab, 1 mg	128,080	$10	$640.4K
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)	111,600	$1	$446.4K
J0897	Injection, denosumab, 1 mg	13,800	$20	$248.4K
J3111	Injection, romosozumab-aqqg, 1 mg	19,950	$10	$159.6K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	2,550	$30	$63.8K
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.	860	$50	$40.4K
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…	360	$80	$29.1K
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…	310	$90	$27.4K

Showing 1–10 of 20

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Oklahoma Distribution

Latisha Heinlen — 3 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oklahoma

Full comparison — all codes billed, vs. state median

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	2	10	16,680	$30	$661.9K
J3262	3	10	82,050	$1	$432.8K
J1602	3	20	25,400	$10	$412.3K
J1745	11	10	6,400	$30	$312.2K
J0717	1	10	60,800	$1	$255.6K
J3111	11	20	22,470	$10	$216.7K
J0897	5	70	2,130	$20	$91.2K
96413	20	60	210	$90	$26.4K
99214	1,236	5,560	130	$70	$18.4K
99213	823	5,450	80	$50	$8.7K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Physicians Group LLC	OK	General Practice Physician	$0	$6.8M
Andrew Word	TX	Dermatology Physician	$556.8K	$0
Paul Jacob	OK	Adult Reconstructive Orthopaedic Surgery Physician	$542.4K	$0
Brian Gillis	ME	Colon & Rectal Surgery Physician	$140.3K	$312.7K
Randi Jones	OK	Family Nurse Practitioner	$440.3K	$0
Thomas Mcgarry	OK	Interventional Cardiology Physician	$382.4K	$0
Corey Finch	OK	Family Medicine Physician	$382.1K	$0
Christine Hauck	OK	Family Nurse Practitioner	$377.1K	$0
Lance Smith	OK	Orthopaedic Surgery Physician	$361.4K	$0
Jennifer Berends	OK	Family Medicine Physician	$311.4K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Pathways Unlimited Inc	OK	Clinical Psychologist	$0	$27.7M
Generations Community Services LLC	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$11.7M
Sensational Kids, Inc.	OK	Contractor	$0	$6.8M
Qitek Labs Of Oklahoma LLC	OK	Clinical Medical Laboratory	$6.2M	$10.1K
New Horizon Youth & Family Services, LLC	OK	Community/Behavioral Health Agency	$0	$4.5M
Guidance Counseling Of Oklahoma LLC	OK	Community/Behavioral Health Agency	$0	$4.1M
Dental Depot Of 63rd & Nw Expressway, PLLC	OK	Dental Clinic/Center	$0	$3.4M
Dental Depot Orthodontics Central Okc PLLC	OK	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$3.3M
3-j Enterprises, LLC	OK	Durable Medical Equipment & Medical Supplies	$0	$2.8M
Holloway Group Inc	OK	Multi-Specialty Clinic/Center	$0	$1.7M

Latisha Heinlen — 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