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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

Richard Conklin (NPI 1851394662)

Field	Value
Entity Type	Individual
Organization	Richard Conklin
Address	310 S Penn St
City	Aberdeen
State	SD
ZIP	57401
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	May 24, 2005

Payer Source	Total Paid
Medicare	$994.4K
Medicaid	$0

Key Findings

This provider’s billing is concentrated in Medicare with total Medicare revenue of $994.4K and no Medicaid billing on file; in practical terms the provider operates as effectively single‑payer with Medicare driving all reported publicpayer revenue. The absence of any Medicaid claims suggests limited engagement with Medicaid populations or billing arrangements outside the state Medicaid dataset.

Revenue concentration is pronounced: the precomputed top‑three Medicare codes account for 73.5% of the provider’s Medicare revenue, driven by J9271 ($332K, 33.8%), J9299 ($273.6K, 27.9%), and 99214 ($116K, 11.8%). This heavy share from three codes signals a narrow set of services accounting for most Medicare dollars.

The code mix is characteristic of an oncology practice delivering office‑based immunotherapy and associated outpatient management: large drug administrations (J9271, J9299, J0897) appear alongside evaluation and management and chemotherapy administration codes (99214, 96413, 96417). The prominence of J9271 and J9299 revenue confirms significant use of high‑cost oncology biologics in the practice’s service mix.

Despite large absolute claim counts for the immunotherapy drugs (J9271: 7.5K claims; J9299: 11.4K claims), the provider’s national standing on those drug codes is modest — J9271 ranks #1476 of 1841 providers nationally (20th percentile; typical, unremarkable volume) and J9299 ranks #314 of 505 providers nationally (38th percentile; typical, unremarkable volume). In other words, these immunotherapy administrations drive revenue but do not place the provider among national leaders for those specific drugs.

Evaluation and management activity is an outlier: 99214 shows 1.2K claims, $97 avg paid/claim and $116K revenue, and ranks #7199 of 479517 providers nationally (98th percentile; extreme outlier, far above typical national volume). This unusually high E/M volume relative to national peers suggests a larger-than-typical established patient panel or frequent follow‑up visits in the Medicare population.

Chemotherapy and infusion administration codes are consistently present at typical volumes: 96413 (232 claims, $23.7K revenue, 66th percentile), 96417 (74 claims, $3.7K revenue, 45th percentile), and related infusion codes such as 96365 and 96375 also appear with routine ranks. These entries indicate regular on‑site infusion activity that complements the provider’s immunotherapy drug billing rather than separate, dominant service lines.

The provider’s competitive profile is mixed: they are a modest participant nationally on their top drug codes (low‑to‑mid percentiles for J9271 and J9299) but a national outlier on complex outpatient management (99214, 98th percentile). For payers and network planners this combination signals strong patient management intensity within an oncology service line, without correspondingly dominant market share for specific immunotherapy drugs.

The provider’s NPI was enumerated on 2005-05-24 (~21 years ago), indicating long tenure in the Medicare program; paired with the high 99214 volumes and steady infusion claims, this tenure is consistent with an established practice and referral base that generates frequent follow‑up encounters and ongoing infusion care.

Medicare: Complete Services Breakdown

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

38 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	7,550	$40	$332K
J9299	Injection, nivolumab, 1 mg	11,400	$20	$273.6K
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…	1,200	$100	$116K
J0897	Injection, denosumab, 1 mg	5,160	$20	$98K
J1561	Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg	1,420	$40	$55.4K
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…	490	$70	$32.8K
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…	230	$100	$23.7K
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…	70	$130	$9.3K
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.	130	$50	$6.4K
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	500	$10	$5.9K

Showing 1–10 of 38

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 38 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Dakota Distribution

Richard Conklin — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. state median

38 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	3	10	9,800	$40	$406.7K
J9299	1	10	11,400	$20	$271.9K
J1561	1	10	1,420	$40	$54.8K
J0897	6	40	2,460	$20	$52.8K
90694	95	120	90	$80	$14.2K
96413	3	10	110	$100	$13.5K
99214	7	1,660	90	$70	$11.4K
Q0138	1	10	19,380	$1	$7.6K
99213	60	1,710	80	$50	$6.4K
99204	127	670	30	$100	$5.1K

Showing 1–10 of 38

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sanford Medical Center Fargo	ND	Family Medicine Physician	$0	$75.9M
Sanford Medical Center	SD	Family Medicine Physician	$0	$68.8M
Avera Mckennan	SD	Family Medicine Physician	$0	$10.6M
Nathan Steinle	CA	Retina Specialist (Ophthalmology) Physician	$9.5M	$0
Avera Mckennan	SD	Psychiatry Physician	$0	$9.1M
Prema Abraham	SD	Retina Specialist (Ophthalmology) Physician	$7.1M	$0
Avera Mckennan	SD	Home Infusion Agency	$0	$6.7M
Avera Mckennan	SD	Air Ambulance	$0	$5.3M
Avera St Marys	SD	Multi-Specialty Clinic/Center	$0	$4.6M
Kyle Thompson	ID	Retina Specialist (Ophthalmology) Physician	$4.5M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Adjustment Training Center, Inc.	SD	Developmentally Disabled Services Day Training Agency	$0	$40.3M
Northeastern Mental Health Center	SD	Mental Health Counselor	$0	$10.1M
Vision Care Associates, LLP	SD	Optometrist	$0	$6M
Sanford Health Network	SD	General Acute Care Hospital	$0	$4.4M
John Bormes	SD	Ophthalmology Physician	$2.6M	$0
Avera St. Luke's	SD	Family Medicine Physician	$0	$2.3M
Sanford Health Network	SD	General Acute Care Hospital	$0	$1.9M
Avera At Home	SD	Home Health Agency	$0	$1.6M
Avera St Lukes	SD	General Acute Care Hospital	$0	$1.5M
Ty Hanson	SD	Dermatology Physician	$1.2M	$0

Richard Conklin — 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