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

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

Kenneth Orourke (NPI 1972588309)

Field	Value
Entity Type	Individual
Organization	Kenneth Orourke
Address	Rheumatology Associates, PA
City	Portland
State	ME
ZIP	04102
Taxonomy	Specialist
NPI Enumerated	December 8, 2005

Payer Source	Total Paid
Medicare	$381.7K
Medicaid	$0

Key Findings

This provider’s Medicare activity is highly concentrated in infusible biologic drugs and related infusion services: J0717 (certolizumab pegol) alone accounts for $259.2K in revenue — 66.9% of the provider’s total Medicare revenue — and the top three Medicare codes together account for 86.7% of total Medicare revenue, indicating a practice model focused on high-cost injectable biologics and associated administration. The prominence of J0897 (denosumab) and chemotherapy/infusion codes among the top line items reinforces a specialty practice that delivers office-based parenteral therapies rather than general primary care.

Revenue concentration is extreme: precomputed data show the top three Medicare codes make up 86.7% of this provider’s Medicare revenue, so most of the $381.7K lifetime Medicare take is driven by a very small set of therapies. That high concentration suggests financial performance and utilization are sensitive to changes in billing or utilization of those few codes rather than broad-based office visit volume.

The provider appears effectively single-payer in scope for public programs: Medicare revenue is $381.7K while there is no Medicaid billing on file, meaning the practice’s public-payer footprint is concentrated entirely in Medicare and it does not participate in Medicaid billing according to available records. This single-payer profile matters for network and access planning because payer negotiations, patient mix, and program compliance will be dominated by Medicare rules and reimbursement.

Competitive standing on the largest drug code is modest at the national level: J0717 ranks #288 of 848 providers (66th percentile) which the data describe as a typical, unremarkable volume for this code; the provider is not a national outlier or market leader for certolizumab administration even though that code generates the majority of its revenue. Other high-revenue codes have lower national percentile positions (e.g., J0897 at the 28th percentile), indicating the practice is a moderate-volume participant rather than a dominant regional or national supplier of these specific injectable therapies.

Billing mix shows relatively low reliance on routine E/M visits compared with drug administration: 99214 and 99213 together contribute a minority share (99214 at $47.5K, 12.3% of Medicare revenue; 99213 at $6.5K, 1.7% of Medicare revenue) which indicates encounters are often driven by treatment administration rather than predominantly by office-based evaluation and management. This operational pattern is consistent with an infusion/office-injection specialty where procedural and drug reimbursement outpace E/M revenue.

Tenure on file is long: the NPI was enumerated on 2005-12-08 (approximately 21 years ago), which supports that this provider has an established billing history and sustained Medicare participation over two decades. Long enumeration combined with a narrow code concentration suggests a stable, focused clinical service line rather than a recent entrant or rapidly shifting practice mix.

Several ancillary services and diagnostics are billed at typical volumes: laboratory panels (80053, 85025), basic injections (96372), and venipuncture (36415) appear in the top codes but each contributes only small amounts (each ~1% or less of Medicare revenue) and are described as typical volumes nationally; these items support infusion-based care but do not materially change the revenue profile.

Medicare: Complete Services Breakdown

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

27 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)	64,800	$1	$259.2K
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…	530	$90	$47.5K
J0897	Injection, denosumab, 1 mg	1,620	$20	$29.2K
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…	150	$100	$14.9K
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…	100	$60	$6.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	550	$10	$4.4K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	380	$10	$4.2K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	390	$10	$3.9K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	410	$10	$3.3K
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…	20	$120	$2.8K

Showing 1–10 of 27

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 27 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Maine Distribution

Kenneth Orourke — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. state median

27 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0717	1	10	64,800	$1	$252.3K
J0897	13	20	2,730	$20	$86.4K
96413	17	30	170	$100	$20.6K
99214	24	2,500	70	$70	$7.2K
96365	20	30	90	$50	$5.6K
99213	604	2,350	50	$50	$4.3K
99205	227	260	20	$140	$4K
99204	420	810	30	$100	$3.6K
96375	15	20	230	$10	$3.1K
20610	131	180	40	$40	$2.9K

Showing 1–10 of 27

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Brian Daikh	ME	Specialist	$1.2M	$0
Rheumatology Associates P.A.	ME	Specialist	$0	$381.2K
Brian Keroack	ME	Specialist	$326.6K	$0
Edward Fels	ME	Specialist	$266.6K	$0
Joshua Keller	ME	Rheumatology Physician	$175K	$0
Stephanie Gartner-fanburg	ME	Rheumatology Physician	$98.5K	$0
Katherine Keller	ME	Specialist	$33.5K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mainehealth	ME	General Acute Care Hospital	$0	$142.6M
Shalom House, Inc.	ME	Mental Illness Community Based Residential Treatment Facility	$0	$81.9M
Mercy Hospital	ME	General Acute Care Hospital	$0	$35.5M
Maxim Healthcare Services, Inc.	ME	Home Health Agency	$0	$28.1M
Quality Care Access, LLC	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$17.2M
Portland Community Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$12.9M
Al-shawk Home Healthcare, LLC	ME	Personal Care Attendant	$0	$7M
Maine Eye Center, PA	ME	Ophthalmology Physician	$0	$6.1M
Hand Of Mercy Health Care, LLC	ME	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.1M
Mainehealth	ME	General Acute Care Hospital	$0	$5.5M

Kenneth Orourke — 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