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

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

Phong Nguyen (NPI 1699836726)

Field	Value
Entity Type	Individual
Organization	Phong Nguyen
Address	1860 Town Center Dr Ste 130
City	Reston
State	VA
ZIP	20190
Taxonomy	Rheumatology Physician
NPI Enumerated	December 13, 2006

Payer Source	Total Paid
Medicare	$4.2M
Medicaid	$0

Key Findings

This provider’s Medicare revenue totals $4.2M while there is no Medicaid billing on file, so the practice is effectively single-payer in the available data and has no documented Medicaid footprint to diversify payer mix. The absence of Medicaid billing may limit visibility into low-income patient volumes and suggests analysts should treat the profile as Medicare-centric when assessing market access or network participation in-state.

Revenue is highly concentrated in a small set of injectable biologics: the precomputed top 3 codes account for 59.5% of this provider's total Medicare revenue. Specifically, J0717 accounts for $1.1M (24.9%), J0129 for $806K (19.0%), and J0897 for $657.7K (15.5%), indicating dependency on in-office administration of high-cost J‑code drugs.

The code mix points to an infusion/injection-focused rheumatology operation: large revenues tied to J0717, J0129, J0897, J3262 and J1745 are consistent with in-office administration of biologic therapies and disease-modifying injections rather than a purely ambulatory visit model. High-volume billing on chemotherapy/infusion administration codes such as 96401 ($137.1K) and add-on infusion code 96415 ($6.6K) further supports that the practice runs infusion services and performs scheduled parenteral drug administrations.

Several individual codes show national-level dominance or markedly higher-than-typical volume: J0717 ranks #11 of 848 (99th percentile; extreme outlier) and J0897 ranks #57 of 10057 (99th percentile; extreme outlier), signaling unusually high national volume for these specific products. J0129 also performs notably above typical national volume, ranking #81 of 1221 (93th percentile), so the practice is a major national outlier for multiple biologic injections used in rheumatology care.

Beyond drug administration, the practice bills substantial office E/M and procedure volume that is also unusual relative to peers. 99214 appears as an extreme outlier ($205.2K; ranks #1284 of 479517, 100th percentile) and 20610 joint injection work shows extreme outlier volume ($53.5K; ranks #241 of 39752, 99th percentile), indicating the provider combines high visit volume and procedural joint care with infusion services.

There are additional high-percentile signals in chemotherapy/infusion and related codes: 96401 ($137.1K) ranks #7 of 3868 (100th percentile; extreme outlier) and 96413 ($89.9K) ranks #184 of 7514 (98th percentile; notably above typical national volume). These rankings reinforce that the practice operates a high-throughput administration suite for injectable or infused agents, which has important operational, staffing, and revenue-cycle implications.

Tenure data show the NPI was enumerated on 2006-12-13 (~20 years ago), indicating long-standing registration and potentially established referral relationships and operational infrastructure for the services observed. This longevity, coupled with the concentration in infusion and injection codes, suggests a mature rheumatology practice that has developed a specific service line around biologic administration.

Concentration risk is material: with 59.5% of Medicare revenue coming from three J‑codes and total Medicare revenue of $4.2M, shifts in drug utilization, payer coverage, or site-of-care reimbursement for a small number of products could meaningfully affect overall revenue. Analysts should flag exposure to changes in biologic administration patterns and consider monitoring utilization trends for J0717, J0129, and J0897 closely.

Medicare: Complete Services Breakdown

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

30 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)	264,400	$1	$1.1M
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)	24,430	$30	$806K
J0897	Injection, denosumab, 1 mg	36,540	$20	$657.7K
J3262	Injection, tocilizumab, 1 mg	75,870	$10	$379.4K
J3111	Injection, romosozumab-aqqg, 1 mg	29,190	$10	$233.5K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	8,690	$30	$225.9K
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…	2,010	$100	$205.2K
J1602	Injection, golimumab, 1 mg, for intravenous use	17,650	$10	$194.2K
96401	The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient.	2,210	$60	$137.1K
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…	790	$110	$89.9K

Showing 1–10 of 30

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 30 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Virginia Distribution

Phong Nguyen — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. state median

30 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	3	30	10,450	$30	$407.3K
J3262	10	20	75,870	$1	$383.3K
J0717	2	30	74,500	$1	$361.7K
J1745	10	30	4,540	$30	$200.2K
J3111	6	20	19,740	$10	$190.2K
J1602	8	20	13,430	$10	$176.7K
J0897	3	340	2,820	$20	$89.3K
J7327	21	40	40	$550	$32K
96413	8	230	250	$100	$28.5K
J3304	13	20	1,380	$10	$28.3K

Showing 1–10 of 30

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Claude Abujrab-saba	VA	Rheumatology Physician	$2.9M	$0
Alexia Gospodinoff	VA	Rheumatology Physician	$812.5K	$0
Brandon Miller	VA	Rheumatology Physician	$409.8K	$0
Carlton Miller	VA	Rheumatology Physician	$371.9K	$2.2K
Cynthia Morgan	DC	Rheumatology Physician	$50.5K	$53.6K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Reston Hospital Center LLC	VA	General Acute Care Hospital	$0	$14.9M
Reston Surgery Center, LP	VA	Ambulatory Surgical Clinic/Center	$2.8M	$869.2K
Dhruv Pateder	VA	Orthopaedic Surgery of the Spine Physician	$607.7K	$0
Ahmad Noori	VA	Nephrology Physician	$341.1K	$190.1K
Mark Tekrony	VA	Neurology Physician	$349.6K	$0
Theodore Sebastien	VA	MOHS-Micrographic Surgery Physician	$335.3K	$0
Andrew Siegel	VA	Ophthalmology Physician	$333.2K	$0
James Reeves	VA	Orthopaedic Surgery Physician	$307.6K	$0
Charles Seal	VA	Orthopaedic Surgery Physician	$301.5K	$0
Lavanya Nutankalva	VA	Infectious Disease Physician	$298.8K	$0

Phong Nguyen — 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