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

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

Mikael Lagwinski (NPI 1679540363)

Field	Value
Entity Type	Individual
Organization	Mikael Lagwinski
Address	3277 E Louise Dr Ste 350
City	Meridian
State	ID
ZIP	83642
Taxonomy	Rheumatology Physician
NPI Enumerated	March 2, 2006

Payer Source	Total Paid
Medicare	$2.2M
Medicaid	$0

Key Findings

This provider’s Medicare footprint dominates its payer mix: lifetime Medicare revenue is $2.2M while there is "none" on file for Medicaid, making the practice effectively single‑payer (Medicare) at present and concentrated in the traditional Medicare population. That concentration reduces exposure to state Medicaid managed care but increases sensitivity to Medicare reimbursement and biologic-drug pricing trends.

Revenue is highly concentrated in three infusion drugs: J0129 ($543.7K, 25.4%), J9312 ($452.7K, 21.2%), and J1602 ($306.3K, 14.3%) — the precomputed top‑3 share is 60.9% of this provider’s Medicare revenue. This mix indicates that a majority of billing dollars derive from administration of high-cost biologic/infusion therapies rather than office evaluation and management alone.

The procedural and drug mix points to an infusion‑center style rheumatology practice: high-volume biologic codes (J0129, J9312, J1602) are paired with infusion administration CPTs such as 96413 (363 claims, $31.6K) and initial infusion code 96365 (461 claims, $20.3K). Such a pattern is consistent with on-site IV biologic delivery and supports the presence of nursing/infusion capacity rather than a purely consultative office model.

On national competitive standing, the provider is a relatively strong player for rituximab infusions: J9312 ranks #24 of 317 providers nationally (93th percentile; typical, unremarkable volume for this code), indicating above-average national activity for that agent. J0129 (rank #205 of 1221, 83th percentile) and J1602 (rank #149 of 1041, 86th percentile) both sit above median national volumes but are described as typical, suggesting robust but not dominant market positions across these biologics.

Two utilization indicators stand out as higher than typical: office E/M code 99214 is both a key office revenue driver (839 claims, $73K, 3.4% of Medicare revenue) and ranks #17504 of 479517 providers (96th percentile; notably above typical national volume), signalling heavier-than-average moderate-complexity visit volume. The add-on infusion code 96415 is an "extreme outlier, far above typical national volume" (536 claims, $10.7K), which together with high 96365/96413 counts implies longer or repeated infusion sessions are a material part of throughput and capacity planning.

Ancillary diagnostic services are concentrated in-office and support the infusion/clinic model: CMP 80053 (1.3K claims, $12.8K) and phlebotomy 36415 (1.5K claims, $11.9K) both rank in the mid‑to‑high national percentiles (96th and 98th respectively, labeled as typical, unremarkable volume), while CRP testing 86140 and ESR 85652 also appear among reported top codes. This pattern indicates the practice performs substantial point-of-care lab work to manage chronic inflammatory disease and infusion safety.

Tenure and experience are long-standing: the NPI was enumerated on 2006-03-02 (~20 years ago), which supports an established practice with existing clinical and infusion infrastructure and likely stable referral relationships over time. Long tenure increases the plausibility that high infusion volumes reflect an entrenched service line rather than a recent shift in practice scope.

From a risk/opportunity perspective, reliance on high-cost biologic administration (top‑3 = 60.9% of Medicare revenue) combined with zero Medicaid billing represents both an operational specialization and a concentration risk; changes in biologic utilization, biosimilar adoption, or Medicare policy would disproportionately affect revenue. The combination of an "extreme outlier" label on 96415 and "notably above typical" volume on 99214 and 96372 suggests monitoring these utilization patterns for capacity, contracting, and reimbursement planning is warranted.

Medicare: Complete Services Breakdown

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

49 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)	16,480	$30	$543.7K
J9312	Injection, rituximab, 10 mg	7,300	$60	$452.7K
J1602	Injection, golimumab, 1 mg, for intravenous use	30,630	$10	$306.3K
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)	44,000	$1	$176K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	6,330	$30	$164.5K
J3111	Injection, romosozumab-aqqg, 1 mg	20,370	$10	$163K
J0897	Injection, denosumab, 1 mg	5,940	$20	$106.9K
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…	840	$90	$73K
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…	360	$90	$31.6K
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.	460	$40	$20.3K

Showing 1–10 of 49

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 49 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Idaho Distribution

Mikael Lagwinski — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. state median

49 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9312	1	10	7,300	$60	$452.2K
J0129	2	10	9,950	$30	$369.8K
J3111	3	10	23,420	$10	$295.7K
J1602	3	10	15,030	$10	$266.6K
J1745	3	10	8,420	$30	$196.9K
J0717	2	10	50,200	$1	$196.2K
J0897	6	30	2,580	$20	$76.2K
96413	5	20	250	$90	$26K
99214	28	2,690	90	$70	$10.4K
96365	3	20	80	$40	$7.4K

Showing 1–10 of 49

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Svetlana Meier	ID	Rheumatology Physician	$2.5M	$0
Eric Palfreyman	OH	Internal Medicine Physician	$1M	$0
Rebecca Privon	MS	Registered Nurse	$62.4K	$0
Camille Buchmiller	ID	Physician Assistant	$61.5K	$0
Kyle George	ID	Medical Physician Assistant	$49.1K	$0
Colette Weber	ID	Physician Assistant	$26.1K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Norco, Inc.	ID	Durable Medical Equipment & Medical Supplies	$0	$41M
Joint School District No. 2	ID	Local Education Agency (LEA)	$0	$34.2M
Chatterbox Speech & Language Center	ID	Speech-Language Pathologist	$0	$10.6M
St. Fillan's, LLC	ID	In Home Supportive Care Agency	$0	$10.5M
Southern Idaho Health Partners LLC	ID	General Practice Physician	$0	$9.2M
Gem State Developmental Center LLC	ID	Developmentally Disabled Services Day Training Agency	$0	$9.1M
Addus Healthcare, Inc.	ID	In Home Supportive Care Agency	$0	$6.1M
Northwest Neurobehavioral Health, LLC	ID	Clinical Social Worker	$0	$5.2M
Idaho Pediatric Therapy Clinic PLLC	ID	Physical Therapist	$0	$3.1M
Cpapnow Inc	ID	Durable Medical Equipment & Medical Supplies	$0	$3.1M

Mikael Lagwinski — 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