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

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

Marie Rodriguez (NPI 1982990149)

Field	Value
Entity Type	Individual
Organization	Marie Rodriguez
Address	4318 S State St
City	Chicago
State	IL
ZIP	60609
Taxonomy	Gerontology Nurse Practitioner
NPI Enumerated	June 24, 2011

Payer Source	Total Paid
Medicare	$1.7M
Medicaid	$0

Key Findings

This provider’s Medicare billing is concentrated in high-cost biologic and infusion therapies rather than primary care or broad outpatient E/M services, with total Medicare revenue of $1.7M and no Medicaid billing on file. The code mix is dominated by parenteral specialty drugs (J3245, J3380, J1745) and includes a small but visible volume of chemotherapy administration codes, indicating an infusion-centered practice or specialty infusion site.

Revenue concentration is extreme: the precomputed top-three Medicare codes (J3245, J3380, J1745) together account for 91.6% of this provider’s Medicare revenue. Individually those codes report $726K (J3245, 43.6%), $698.7K (J3380, 41.9%), and $100.6K (J1745, 6.0%) in Medicare revenue, so business performance is highly dependent on a narrow set of biologic products.

J3380 (vedolizumab) is the clear national outlier in this profile: it accounts for $698.7K in Medicare revenue from 41.1K claims and the provider ranks #15 of 620 nationally (98th percentile), a label already described as an "extreme outlier, far above typical national volume for this code." This position indicates the provider is operating at a far higher-than-typical scale for vedolizumab administration compared with most peers.

J3245 (tildrakizumab) contributes $726K from 6.6K claims and ranks #41 of 225 nationally (82th percentile) and is characterized in the file as "typical, unremarkable volume for this code." While it is the single largest revenue line by percentage (43.6%), the national ranking and description suggest the J3245 activity is substantial but not uniquely dominant on a national scale.

J1745 (infliximab) contributes $100.6K (6.0% of Medicare revenue) from 3.9K claims and ranks #513 of 1352 (62th percentile), again labeled "typical, unremarkable volume." This indicates modest participation in infliximab infusions relative to the broader national population of providers and that infliximab is a secondary revenue stream behind vedolizumab and tildrakizumab.

Other injectable biologic activity is notable but smaller: J0485 (belatacept) shows 30.8K claims and $92.5K revenue (5.6% of Medicare revenue) while ranking #13 of 20 providers nationally (37th percentile). The combination of very high claim counts with a low average paid/claim ($3) suggests billing based on small per-mg units or low per-unit reimbursement rather than high per-infusion payments, and it represents an additional but non-dominant revenue contributor.

Despite the strong focus on specialty infusions, the provider also reports limited chemotherapy administration and home visit codes (for example 96413 with $28.2K, 96401 with $12K and 99349 with $1.4K), each representing small shares of total Medicare revenue. These smaller E/M and chemotherapy administration entries imply ancillary infusion or oncology services but not a primary oncology practice driving the revenue base.

Payer mix and tenure: this profile is effectively single-payer at present, with $1.7M in Medicare revenue and no Medicaid billing on file, which concentrates reimbursement risk and negotiation leverage around Medicare. The NPI was enumerated on 2011-06-24 (~15 years ago), indicating an established billing history that has evolved toward a narrow, infusion-focused service line over time.

Medicare: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J3245	Injection, tildrakizumab, 1 mg	6,600	$110	$726K
J3380	Injection, vedolizumab, intravenous, 1 mg	41,100	$20	$698.7K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	3,870	$30	$100.6K
J0485	Injection, belatacept, 1 mg	30,830	$1	$92.5K
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…	350	$80	$28.2K
96401	The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient.	270	$40	$12K
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.	90	$40	$3.4K
99349	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	20	$80	$1.4K
96415	In this add on procedure, the provider continues administration of a chemotherapy drug into a vein using an infusion technique. He uses this code to report each additional hour of infusion beyond the…	80	$20	$1.3K
99348	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30…	20	$50	$830

Showing 1–10 of 12

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Illinois Distribution

Marie Rodriguez — 1 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Illinois

Full comparison — all codes billed, vs. state median

12 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J3245	2	10	3,300	$110	$472.2K
J3380	2	30	8,700	$20	$183.8K
J0485	2	10	32,310	$1	$87.4K
J1745	11	60	2,170	$30	$85.1K
99349	393	730	100	$90	$20.7K
96413	22	370	130	$100	$19.3K
99348	327	560	70	$50	$9K
96401	13	170	80	$60	$6.8K
96365	61	410	90	$50	$6.6K
96375	74	290	150	$10	$3.2K

Showing 1–10 of 12

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Metro Infectious Disease Consultants, LLC	IL	Infectious Disease Physician	$0	$44.3M
Natalia Surowaniec	IL	Family Nurse Practitioner	$2.1M	$0
Martha Pawlukowsky	IL	Family Nurse Practitioner	$2M	$1.3K
Margaret Denham	IN	Nurse Practitioner	$1.7M	$0
Walter Marbach	IL	Rheumatology Physician	$1.6M	$53.2K
Brooke Raney	IA	Family Nurse Practitioner	$1.6M	$0
Kristin Elatkin	IL	Family Nurse Practitioner	$1.6M	$5K
Robert Scribner	MI	Gerontology Nurse Practitioner	$1.5M	$0
Vishnu Chundi	IL	Infectious Disease Physician	$978.9K	$354.9K
Kimberly Balshi	FL	Nurse Practitioner	$1.3M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Thresholds	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$13.4M
Nada Aldallal	IL	Pediatrics Physician	$0	$9.5M
Access Community Health Network	IL	Federally Qualified Health Center (FQHC)	$0	$7.5M
Pinkesh Shah	IL	Dentist	$0	$6.7M
Access Community Health Network	IL	Federally Qualified Health Center (FQHC)	$0	$5.8M
Francesca Gattuso	IL	Dentist	$0	$4.4M
Minghui Tang	IL	Dentist	$0	$2.9M

Marie Rodriguez — Billing Profile & Reimbursement Data

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Marie Rodriguez — 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