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    OpenPayerNPI Medicare & MedicaidRobert Schoen
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    Robert Schoen — Billing Profile & Reimbursement Data

    NPI 1689652208 · Guilford, CT · Rheumatology Physician

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    Robert Schoen is a rheumatology physician provider located in Guilford, Connecticut. This profile covers 11 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationRobert Schoen
    Address47 Clapboard Hill Rd
    CityGuilford
    StateCT
    ZIP06437
    TaxonomyRheumatology Physician
    NPI EnumeratedJanuary 4, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$1.3M
    Medicaid$0

    Key Findings

    This provider is operating squarely as an infusion-focused rheumatology practice: the top Medicare revenue drivers are biologic therapy codes J0129 ($663K, 49.2%), J1602 ($273.9K, 20.3%), and J3262 ($185.8K, 13.8%), and those three codes together account for 83.3% of the provider's Medicare revenue. The high-dollar drug codes indicate that on‑site administration of biologic agents is the primary service line rather than purely office-based evaluation and management.

    Revenue is highly concentrated in a small set of biologic products: the precomputed top-three share is 83.3% of total Medicare revenue on a $1.3M lifetime Medicare base. That concentration suggests the practice’s financial performance is closely tied to utilization and reimbursement of a few specific injectable/infusion therapies.

    Payer mix is effectively single-payer with respect to public programs: the record shows $1.3M in total Medicare revenue and no Medicaid billing on file, so the provider is functionally Medicare-dependent in this dataset. Lack of any Medicaid billing on file means analysts should treat market exposure to Medicaid populations as negligible in these claims.

    Competitive standing by drug is mixed: J0129 ranks #144 of 1221 providers nationally (88th percentile; typical, unremarkable volume for this code), and J1602 ranks #226 of 1041 (78th percentile; typical, unremarkable volume), indicating above-average but not dominant national positions on those agents. By contrast J3262 is #333 of 618 (46th percentile; typical, unremarkable volume), showing the provider is more modestly represented on tocilizumab compared with peers.

    Infusion administration intensity is an outlier signal for the practice: code 96365 has 586 claims and $32.2K revenue and ranks #280 of 8873 providers nationally (97th percentile; notably above typical national volume), implying robust throughput of IV infusions relative to the national rheumatology cohort. Supporting that operational inference, J7050 (saline) shows 585 claims and ranks #171 of 1837 (91st percentile; typical, unremarkable volume), consistent with frequent IV sessions.

    Office visit activity is present but secondary to infusion services: 99214 and 99213 together account for a small share of revenue ($36.7K and $19.7K respectively) and rank in the mid-to-high national percentiles (#74939 of 479517, 84th percentile; and #63699 of 457151, 86th percentile), suggesting regular follow-up visits but a business model weighted toward drug administration.

    The provider has long tenure in the billing system, with NPI enumeration dated 2006-01-04 (~20 years ago), which provides a prolonged claims history; combining that tenure with a $1.3M Medicare revenue total suggests a stable, small-to-midsize practice that focuses on biologic infusion therapies rather than broad high-volume ambulatory care.

    Taken together, the pattern of relatively high national percentiles for specific biologic administrations (notably J0129 and J1602) alongside a very high percentile for infusion administration (96365) points to a niche competitive position: this clinician is not a nationwide dominant volume leader across all rheumatology codes, but is a specialized, above-typical provider for in-office biologic infusion services.

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    11 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J0129Injection, 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)19,500$30$663K
    J1602Injection, golimumab, 1 mg, for intravenous use24,900$10$273.9K
    J3262Injection, tocilizumab, 1 mg37,160$10$185.8K
    J1745Injection, infliximab, excludes biosimilar, 10 mg5,200$20$124.8K
    99214The 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…380$100$36.7K
    96365The 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.590$60$32.2K
    99213The 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…290$70$19.7K
    99204The 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…60$110$6.6K
    96366The provider administers an intravenous infusion or infusions of a medication for an additional hour or subsequent hours after the first hour to prevent, treat, or diagnose a condition or disease.160$20$2.8K
    96372A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…100$10$1.2K

    Showing 1–10 of 11

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    11 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J01291105,330$30$281.4K
    J160221010,200$10$202.9K
    J326211016,330$1$91.8K
    J17452102,140$30$63.7K
    992146706,48090$90$14.2K
    992136766,44070$60$8.1K
    9636516050$50$4.7K
    992044462,66030$120$4.6K
    9636632060$20$1.4K
    963727527060$10$1K

    Showing 1–10 of 11

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Yale UniversityCTAnesthesiology Physician$0$137.3M
    Yale UniversityCTClinical Medical Laboratory$1.4M$10.4M
    Nauman ChaudhryCTRetina Specialist (Ophthalmology) Physician$5.1M$0
    Juner Colina-biscottoCTRetina Specialist (Ophthalmology) Physician$3.7M$0
    Glenn GandelmanCTCardiovascular Disease Physician$1.7M$593.4K
    Thomas BerenbergCTRetina Specialist (Ophthalmology) Physician$1.5M$0
    Jaime StrachanCTVascular Surgery Physician$1.5M$0
    Stephanie SuginCTRetina Specialist (Ophthalmology) Physician$1.4M$0
    Jeffrey GreenCTCardiovascular Disease Physician$1M$0
    Yale UniversityCTClinical Medical Laboratory$946.4K$390

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Visiting Nurse Association Community Healthcare, IncCTHome Health Agency$0$16.2M
    Preferred Home Health Care And Nursing ServicesCTDurable Medical Equipment & Medical Supplies$0$6.1M
    Shoreline Childrens DentistryCTPediatric Dentistry$0$1.1M
    Town Of GuilfordCTAmbulance$347.1K$526.8K
    Shoreline Endoscopy Center, LLCCTClinic/Center$601.9K$19.2K
    Connecticut Cvs Pharmacy, L.L.C.CTPharmacy$289.9K$1.2K
    Guilford Surgery Center LLCCTAmbulatory Surgical Clinic/Center$222.7K$0
    Howard DistelmanCTOphthalmology Physician$178.6K$0
    Catharine ArnoldCTRheumatology Physician$160.6K$0
    Jodi IndesCTInternal Medicine Physician$107.4K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Connecticut Distribution
    Robert Schoen — 4 of 11 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Connecticut