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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

Andres Peisajovich (NPI 1689713679)

Field	Value
Entity Type	Individual
Organization	Andres Peisajovich
Address	3820 Masthead St Ne
City	Albuquerque
State	NM
ZIP	87109
Taxonomy	Rheumatology Physician
NPI Enumerated	February 6, 2007

Payer Source	Total Paid
Medicare	$670.6K
Medicaid	$0

Key Findings

This provider is effectively a single-payer Medicare practice: total Medicare revenue is $670.6K and there is no Medicaid billing on file, indicating no material Medicaid presence to influence payer-mix analysis or in-state Medicaid competitive comparisons. Analysts should treat this profile as Medicare-centric for contracting and utilization review purposes.

Revenue is extremely concentrated in a very small set of services: Top 3 Medicare codes by revenue account for 98.0% of this provider's total Medicare revenue. The single code J0717 alone represents $576K (84.0% of this provider's total Medicare revenue), signaling heavy dependence on one billed drug/service for the practice’s revenue stream.

The code mix and dollar concentrations point to a rheumatology practice organized around in-office biologic administration and related management: J0717 (certolizumab pegol injection) is the dominant revenue driver, supported by high-volume office E/M visits coded as 99214 ($57.4K, 8.4%) and frequent subcutaneous/intramuscular drug administration coded as 96401 ($38.8K, 5.7%). This combination suggests clinician-supervised biologic therapy and on-site drug administration rather than primarily consult-only or referral-based management.

Competitive standing on the flagship drug code J0717 is notable by rank but not described as an extreme outlier: the provider ranks #70 of 848 providers nationally (92th percentile; typical, unremarkable volume for this code), which reflects a relatively high national rank while the supplied label characterizes the volume level as typical among peers who bill this code. That pattern suggests the provider participates meaningfully in biologic administration but is not flagged as an exceptional volume outlier by the supplied characterization.

Two supporting codes show above-typical national volumes: 99214 ranks #26890 of 479517 providers nationally (94th percentile; notably above typical national volume for this code) and 96401 ranks #148 of 3868 providers nationally (96th percentile; notably above typical national volume for this code). These labels indicate the provider sees more established E/M visits and administers more subcutaneous/intramuscular drug administrations than most peers, reinforcing the interpretation of active, procedure-forward rheumatology care.

Other billed codes are low-revenue and low-diversity contributors: examples include 99215 ($5.2K), 99204 ($4.6K), 99205 ($2K), 20610 ($1.6K) and J3301 ($171), each representing small fractions of total Medicare revenue and carrying mid-to-low percentile rankings. This limited diversification beyond the top drug and related E/M/administration codes suggests revenue sensitivity to changes in drug utilization or reimbursement for J0717 and related administration codes.

Operational and contracting implications follow from the payment mix: heavy reliance on J0717 implies exposure to drug reimbursement policies, buy-and-bill margins, and step-therapy/utilization management changes for certolizumab pegol; the practice’s higher-than-typical volumes in 99214 and 96401 further imply a clinic workflow built around recurring injections and follow-up visits. Payers evaluating this provider should prioritize review of drug administration claims, supplier arrangements, and frequency of biologic administration in prior authorization or network contracting discussions.

The provider has a long tenure in the Medicare program, with an NPI enumerated on 2007-02-06 (~19 years ago), supporting a sustained billing history. That longevity, combined with the concentrated revenue profile, indicates an established clinical operation focused on ongoing biologic therapy management rather than recent entrants or transient billing patterns.

Medicare: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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)	144,000	$1	$576K
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…	690	$80	$57.4K
96401	The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient.	720	$50	$38.8K
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…	40	$130	$5.2K
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…	40	$120	$4.6K
99205	The provider sees a new 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 provider…	10	$160	$2K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	30	$60	$1.6K
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	170	$1	$170

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New Mexico Distribution

Andres Peisajovich — 3 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. state median

8 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0717	1	10	56,620	$1	$255.7K
99214	100	2,700	90	$70	$12.9K
99215	416	960	40	$110	$7.8K
96401	1	20	100	$50	$6.8K
20610	146	210	50	$50	$4.9K
99204	472	1,210	30	$100	$4.5K
99205	303	340	20	$140	$4.3K
J3301	115	250	150	$1	$290

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Presbyterian Healthcare Services	NM	Internal Medicine Physician	$0	$240.8M
Heritage Home Healthcare Services, Inc.	NM	Home Health Agency	$0	$141.5M
Home Medical Equipment Specialists LLC	NM	Durable Medical Equipment & Medical Supplies	$0	$100M
The New Beginnings LLC	NM	Adult Day Care Clinic/Center	$0	$85.1M
We Care Agency, Inc.	NM	In Home Supportive Care Agency	$0	$60.1M
Lovelace Health System, LLC	NM	General Acute Care Hospital	$0	$57.7M
Adelante Development Center, Inc.	NM	Personal Care Attendant	$0	$57M
Eye Associates Of New Mexico Ltd	NM	Ophthalmology Physician	$0	$46.9M
Southwest Labs LLC	NM	Clinical Medical Laboratory	$1.1M	$41.5M
Southwest Medical Associates, LLC	NM	General Practice Physician	$0	$41.4M

Andres Peisajovich — Billing Profile & Reimbursement Data

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Andres Peisajovich — 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

Nearby Providers

Frequently Asked Questions

References