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

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

Erik Swenson (NPI 1720036353)

Field	Value
Entity Type	Individual
Organization	Erik Swenson
Address	8421 Plum Dr
City	Urbandale
State	IA
ZIP	50322
Taxonomy	Rheumatology Physician
NPI Enumerated	May 5, 2006

Payer Source	Total Paid
Medicare	$909.5K
Medicaid	$0

Key Findings

This provider’s Medicare revenue ($909.5K) is the sole payer footprint on file — there is no Medicaid billing on record — so the practice is effectively single‑payer with Medicare as the primary revenue source. The absence of Medicaid billing means analysts should treat comparisons and risk exposures predominantly through a Medicare lens rather than a mixed‑payer profile.

Revenue is highly concentrated: the precomputed top three Medicare codes account for 59.9% of this provider’s total Medicare revenue, with J0897 generating $268.9K (30.5%), J3111 generating $149.5K (17.0%), and J1745 generating $108.7K (12.3%). This concentration indicates that a small set of biologic/injectable drugs drives the majority of clinic revenue and therefore changes to access, utilization, or reimbursement for these agents would disproportionately affect the practice.

The procedural mix is consistent with a rheumatology practice that operates an infusion/injection service line: high‑revenue biologic drug codes (J0897, J3111, J1745), an infliximab biosimilar Q5104 ($63.8K, 7.2%), and multiple chemotherapy/infusion administration codes (96413 $21K, 96401 $17.9K, 96415 $3.2K) appear in the top codes. Complementary services such as DXA imaging (77080 $6.6K) and bone‑health pharmacotherapies align with osteoporosis management alongside autoimmune disease treatment.

J0897 is a clear national outlier for this provider: it accounts for $268.9K (30.5% of Medicare revenue) and the provider ranks #546 of 10057 nationally (95th percentile; notably above typical national volume for this code). By contrast, J3111 and J1745 are higher‑volume but described as typical: J3111 generates $149.5K (17.0%) and ranks #369 of 970 (62th percentile; typical, unremarkable volume), while J1745 generates $108.7K (12.3%) and ranks #462 of 1352 (66th percentile; typical, unremarkable volume).

Office E/M volume is also elevated relative to peers: 99214 contributed $55.2K (6.3%) and ranks #28373 of 479517 (94th percentile; notably above typical national volume), and 99213 contributed $30.6K (3.5%) and ranks #23816 of 457151 (95th percentile; notably above typical national volume). These E/M rankings indicate the provider maintains a robust established‑patient clinic flow in addition to high drug/infusion activity.

Operational details implied by the code mix include both high claim counts of low‑unit, low‑paid drugs and concentrated high‑value biologics: for example, J0717 shows 24K claims but $96K revenue (10.9%) at $4 avg paid/claim, suggesting frequent low‑paid dispensing or coding usage for that agent, while J0897 and J3111 drive larger per‑line revenues. The coexistence of high claim volumes for routine lab codes (e.g., 36415 1K claims, 97th percentile and multiple chemistry panels in high percentiles) further supports an ambulatory clinic that performs in‑office injections, specimen collection, and follow‑up labs.

Tenure and enrollment stability are long: the provider’s NPI was enumerated 2006-05-05 (~20 years ago), indicating longstanding Medicare participation which may correspond with established referral relationships and an entrenched infusion/clinic operation. Given the revenue concentration (59.9% in top three codes) and the notable outlier status on J0897, strategic shifts in biologic prescribing or payer coverage for those agents would likely have an outsized impact on this long‑standing practice.

Medicare: Complete Services Breakdown

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

64 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0897	Injection, denosumab, 1 mg	14,940	$20	$268.9K
J3111	Injection, romosozumab-aqqg, 1 mg	18,690	$10	$149.5K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	4,180	$30	$108.7K
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)	24,000	$1	$96K
Q5104	Injection, infliximab-abda, biosimilar, (renflexis), 10 mg	2,200	$30	$63.8K
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…	670	$80	$55.2K
99213	The 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…	540	$60	$30.6K
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…	220	$100	$21K
96401	The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient.	340	$50	$17.9K
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	180	$50	$8.5K

Showing 1–10 of 64

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 64 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Iowa Distribution

Erik Swenson — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. state median

64 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J3111	4	20	12,180	$10	$112K
J0717	7	20	23,500	$1	$93.9K
J1745	7	20	3,460	$30	$92.3K
J0897	7	190	1,920	$20	$74.1K
Q5104	3	10	1,360	$30	$49.2K
96413	36	80	210	$90	$24K
99214	271	4,690	100	$70	$14.4K
99490	116	330	130	$40	$9K
99213	188	4,740	100	$50	$8K
96401	4	40	90	$50	$7.4K

Showing 1–10 of 64

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Thomas Buroker	IA	Medical Oncology Physician	$9.4M	$0
Kyle Alliman	IA	Ophthalmology Physician	$8.7M	$0
Alex Kartvelishvili	IA	Ophthalmology Physician	$8.1M	$0
Paul Boeke	IA	Ophthalmology Physician	$7.1M	$0
Austin Strohbehn	IA	Retina Specialist (Ophthalmology) Physician	$5.8M	$0
Jeremy Deutsch	KS	Hematology & Oncology Physician	$5.7M	$0
Robert Behrens	IA	Medical Oncology Physician	$5.2M	$0
Matthew Mcknight	IA	Foot & Ankle Surgery Podiatrist	$4.7M	$23.5K
James Singer	IA	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Christopher Haupert	IA	Retina Specialist (Ophthalmology) Physician	$3.9M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mosaic	IA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$177.4M
The Respite Connection, Inc.	IA	Community/Behavioral Health Agency	$0	$38.1M
Unitypoint At Home	IA	Durable Medical Equipment & Medical Supplies	$0	$16.5M
Unitypoint At Home	IA	Home Infusion Therapy Pharmacy	$0	$15.4M
New Beginnings Counseling Service, LLC	IA	Community/Behavioral Health Agency	$0	$6.3M
A-1 Iowa Dental PLLC	IA	Dentist	$0	$5.4M
Urbandale Community School District	IA	Local Education Agency (LEA)	$0	$4.4M
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$3.9M
Acs Medical LLC	IA	Durable Medical Equipment & Medical Supplies	$0	$3.6M
Wellserve Health, Inc.	IA	Community/Behavioral Health Agency	$0	$2.8M

Erik Swenson — 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