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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

Adrian Michael (NPI 1992844989)

Field	Value
Entity Type	Individual
Organization	Adrian Michael
Address	1770 Tierra De Mesilla
City	La Mesilla
State	NM
ZIP	88046
Taxonomy	Rheumatology Physician
NPI Enumerated	February 6, 2007

Payer Source	Total Paid
Medicare	$575.8K
Medicaid	$0

Key Findings

This provider is effectively a single-payer Medicare practice: total Medicare revenue is $575.8K and there is no Medicaid billing on file. That concentration means commercial or Medicare Advantage exposure (not shown here) would be important to understand, and the absence of Medicaid suggests limited billing to that population.

Revenue is highly concentrated in a very small set of drug-administration codes: the precomputed top‑3 Medicare codes account for 91.4% of the provider's Medicare revenue, with J0129 alone representing $474.4K (81.7% of Medicare revenue). The other two top drivers are J0897 ($34.6K, 5.9%) and 99214 ($21.9K, 3.8%), indicating a narrow revenue base centered on a small number of services.

Clinical/service-line implications point to in-office biologic administration and infusion services consistent with Rheumatology Physician taxonomy: J0129 is abatacept injection and J0897 is denosumab injection, and administration/infusion codes such as 96365 and 96372 also appear in the top codes. This mix suggests the practice operates as an infusion/biologic clinic where drug administration is the primary revenue driver rather than visit-only outpatient care.

Volume metrics reinforce the drug-administration focus: J0129 shows 14.4K claims at a $33 avg paid/claim yielding $474.4K, while J0897 shows 1.9K claims at a $18 avg paid/claim yielding $34.6K. Those claim counts indicate a high-frequency, lower-unit-payment drug billing pattern rather than a schedule dominated by high-value single encounters.

Competitive standing by national rank is mixed but not extreme: J0129 ranks #272 of 1221 providers nationally (78th percentile) which the data labels as typical/unremarkable volume, indicating an above‑median but not dominant role for this code at the national level. By contrast, the E/M code 99215 ranks #15668 of 145531 (89th percentile), suggesting this provider reports relatively high-complexity established-patient visits compared with peers.

None of the top codes are labeled statistical outliers in the supplied data; most are described as "typical, unremarkable volume for this code" at their peer percentiles. That phrasing implies the provider's patterns fit within expected peer variation rather than representing extreme deviation, though the extreme concentration in J0129 remains notable operationally.

Visit-based E/M revenue is present but small versus drug administration: 99214 accounts for $21.9K (3.8% of Medicare revenue) and 99215 accounts for $21.3K (3.7% of Medicare revenue), each well below the share contributed by J0129. This indicates the practice derives the majority of Medicare dollars from biologic drug billing with office visits contributing a minority of revenue.

The provider has an established NPI tenure—enumerated 2007-02-06 (~19 years ago)—which supports an interpretation of an experienced, stable practice likely built around infusion/biologic services in the local market. That longevity, combined with the concentrated Medicare revenue mix, suggests operational specialization rather than broad multiservice outpatient care.

Medicare: Complete Services Breakdown

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

9 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)	14,380	$30	$474.4K
J0897	Injection, denosumab, 1 mg	1,920	$20	$34.6K
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…	250	$90	$21.9K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	170	$130	$21.3K
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.	250	$50	$11.9K
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…	90	$90	$7.8K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	40	$160	$6.7K
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…	30	$50	$1.3K
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…	100	$10	$1.1K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New Mexico Distribution

Adrian Michael — 0 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. state median

9 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	2	10	9,930	$30	$358.6K
J0897	35	50	3,150	$20	$113.2K
96413	37	40	170	$90	$17.7K
99214	554	2,700	90	$70	$12.9K
99215	95	960	40	$110	$7.8K
99213	1,848	2,440	60	$50	$7.3K
96365	6	40	80	$40	$6K
99205	59	340	20	$140	$4.3K
96372	62	300	40	$10	$720

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
El Paso County Hospital District	TX	General Acute Care Hospital	$0	$21.4M
John Pitcher	NM	Ophthalmology Physician	$5.1M	$0
Richard Kinsey	TN	Anatomic Pathology & Clinical Pathology Physician	$3.3M	$147.3K
Mark Carmichael	CA	Hematology & Oncology Physician	$3.1M	$0
Howard Martin	TX	Dermatopathology (Pathology) Physician	$3M	$0
Daniel Kasuga	TX	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Richard Hwang	TX	Retina Specialist (Ophthalmology) Physician	$2.6M	$0
Cary Chisholm	TX	Anatomic Pathology & Clinical Pathology Physician	$2.5M	$24.7K
Joseph Furlong	TX	Diagnostic Radiology Physician	$2.4M	$39.7K
Ryan Robetorye	AZ	Clinical Pathology/Laboratory Medicine Physician	$2.3M	$0

Adrian Michael — Billing Profile & Reimbursement Data

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Adrian Michael — 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

Frequently Asked Questions

References