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

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

Michael Joseph (NPI 1902919178)

Field	Value
Entity Type	Individual
Organization	Michael Joseph
Address	1027 S Main St Ste 202
City	Joplin
State	MO
ZIP	64801
Taxonomy	Rheumatology Physician
NPI Enumerated	August 15, 2006

Payer Source	Total Paid
Medicare	$5.1M
Medicaid	$0

Key Findings

This provider’s book of business is effectively single‑payer: total Medicare revenue is $5.1M while there is no Medicaid billing on file. The absence of Medicaid activity means Medicare is the sole recorded public payer exposure and dominates the provider’s revenue base. Analysts should treat payer diversification as limited when modeling revenue sensitivity.

Revenue is highly concentrated in a small set of biologic drug codes: the precomputed top‑3 Medicare codes account for 57.2% of the provider’s total Medicare revenue. In particular, J0129 accounts for $1.2M (25.4% of Medicare revenue), J3262 accounts for $844.8K (17.8%), and J1602 accounts for $660.7K (13.9%), indicating a heavy reliance on a handful of injectable biologics. This concentration signals that changes to reimbursement or utilization for these codes would materially affect overall revenue.

The code mix and high revenue for multiple J‑codes point to a practice model centered on in‑office infusion and biologic administration typical of rheumatology infusion services. Dominant drug codes include J0129 (abatacept), J3262 (tocilizumab), J1602 (golimumab) and J1745 (infliximab), and the presence of administration/infusion codes such as 96365 and add‑ons like 96415 supports a staffed infusion capability rather than purely clinic visits. This implies operational investments in drug inventory, infusion nursing, and billing workflows for high‑cost injectables.

Several individual codes show a competitive national footprint, with multiple biologic and service codes labeled as outliers. J3262 ranks #10 of 618 nationally (99th percentile; extreme outlier, far above typical national volume) and J1745 ranks #15 of 1352 (99th percentile; extreme outlier), while J0129 ranks #25 of 1221 (98th percentile; notably above typical national volume). These rankings indicate the provider is a major national volume player for specific biologic therapies rather than a modest local supplier.

Office evaluation and management volume is also unusually high: 99214 generated $308.9K from 3.7K claims and ranks #109 of 479517 providers (100th percentile; extreme outlier, far above typical national volume). This suggests sustained high patient throughput and regular follow‑up visits consistent with management of chronic rheumatologic conditions. Combined with infusion activity, the practice appears to pair frequent clinic visits with ongoing biologic therapy management.

Ancillary testing and monitoring are significant and consistent with rheumatology care pathways: lab codes such as 86235 (ENA panel, $81.6K), 82306 (vitamin D, $60.3K), 86140 (CRP, $22K) and 85651 (ESR, $17.6K; ranks #16 of 2554, 99th percentile; extreme outlier) show nontrivial revenue and frequent use. The pattern of autoimmune serologies, inflammatory markers, metabolic monitoring and CBCs aligns with active management of patients on biologic and immunomodulatory therapies. These diagnostics complement the infusion/drug revenue stream and indicate bundled clinical workflows.

Operational and reimbursement risk is concentrated: because a large share of Medicare revenue derives from specific injectable drugs and infusion services, the provider is exposed to policy changes affecting J‑code reimbursement, site‑of‑care payment differentials, or utilization management. With no Medicaid billing on file to diversify public payer exposure, any Medicare coverage, pricing, or prior‑authorization changes for top drugs like J0129, J3262, or J1602 would have outsized impact on revenue. Payers should monitor utilization and authorization patterns for these codes when evaluating network strategy.

The provider has long tenure in the Medicare program, with an NPI enumerated on 2006‑08‑15 (~20 years ago), indicating an established presence and sustained billing history. Combined with national outlier rankings on multiple high‑revenue codes, this longevity supports the view that the current service mix and operational model are longstanding rather than transient. Analysts can treat observed patterns as persistent unless subsequent data show a marked change.

Medicare: Complete Services Breakdown

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

114 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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)	36,600	$30	$1.2M
J3262	Injection, tocilizumab, 1 mg	168,960	$10	$844.8K
J1602	Injection, golimumab, 1 mg, for intravenous use	60,060	$10	$660.7K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	21,470	$30	$558.2K
J0897	Injection, denosumab, 1 mg	21,900	$20	$394.2K
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…	3,680	$80	$308.9K
J3111	Injection, romosozumab-aqqg, 1 mg	14,700	$10	$117.6K
86769	The lab analyst performs a multiple–step immunoassay to evaluate the patient’s serum for antibodies to severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), which causes coronavirus disease…	2,300	$40	$94.2K
86235	The lab analyst performs an assay to evaluate the patient’s serum for each antibody to an extractable nuclear antigen, also called ENA. Types of ENA antibodies include anti ribonuclear protein,…	4,800	$20	$81.6K
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.	1,440	$40	$60.3K

Showing 1–10 of 114

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 114 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Missouri Distribution

Michael Joseph — 19 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. state median

114 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	2	20	10,880	$30	$443.6K
J1602	3	20	13,150	$10	$266.8K
J3262	1	10	40,980	$1	$236.8K
J3111	6	20	9,240	$10	$122.5K
J1745	2	40	3,060	$30	$118.1K
86235	1	10	4,800	$20	$83.6K
J0897	7	210	2,400	$20	$82.4K
86769	1	10	1,160	$40	$47.3K
83520	2	10	1,220	$20	$33.1K
96413	18	160	140	$100	$19.1K

Showing 1–10 of 114

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vanessa Jarrett	MO	Nurse Practitioner	$2.8K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Matt Ferguson	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$17.9M
Greater Joplin Area Emergency Medical Services System Inc	MO	Land Ambulance	$1.3M	$9.1M
Charlottes Angels, LLC	MO	In Home Supportive Care Agency	$0	$4.4M
Ozark Tri-county Health Care Consortium	MO	Federally Qualified Health Center (FQHC)	$0	$4M
Bokker, Inc.	MO	In Home Supportive Care Agency	$0	$3.7M
Avril Prabakaran	MO	Physical Therapist	$307.3K	$0
Roger Schoenfeld	MO	Urology Physician	$114.2K	$0
Michael Knapp	MO	Family Medicine Physician	$96.8K	$770

Michael Joseph — Billing Profile & Reimbursement Data

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Michael Joseph — 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