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Treatment Tracker

How This Provider Compares

This Provider

Avg in State & Specialty

Providers in this state and specialty were reimbursed, on average, $497 per patient in 2012.
They performed about 18 services per patient. Here’s how this provider compares.
Number of
Patients
1,129
Rank: 1st
out of 90 providers in this state & specialty
Services
Performed
14,533
Rank: 15th
out of 90 providers in this state & specialty
Avg Services
Per Patient
12.9 This Provider
Avg 17.7
Total Paid
by Medicare
$369K
Rank: 20th
out of 90 providers in this state & specialty
Avg Paid
Per Patient
$327 This Provider
Avg $497

Office Visits

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Top Billing

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Medicare reimburses office visits using a five-point scale, with five being the most intensive and costly. The chart below shows what percentage of this provider’s office visits were reimbursed at each level. A higher than average proportion of costly visits is not necessarily an indication of a problem, but it may be worth asking about.

Hover over each slice to see percentage breakdown.

Herbert A. Wilson
Average for Rheumatology Providers in Virginia

Who Patients See Before and After This Provider

Providers often refer their patients to a small network of other providers and organizations. Here’s who patients saw the most patients within 30 days before or after this provider, from Jan. 2012 to June 2013.

Patients saw before

Herbert A. Wilson

Patients saw after

Individuals

ALEISHA JOHNSON

WILLIAM WOOD

KIAN KAZ

GARY TANNER

ROBERT ELGIN

Organizations

LABORATORY CORPORATION ...

RIVERSIDE HOSPITAL INC

This Provider's Services

This provider performed 28 different services in 2012
CATEGORY
Description of Service
Times Performed (or Units) This Service's Rank Patients Unique Visits
Per Patient
Billed to Medicare Payments from Medicare
DRUGS

Injection, abatacept (orencia), 10 mg

Service Code: J0129
Performed in an office
6,350
times performed,
44% of his services

1st 3rd

most performed service for this provider most performed service in this state & specialty

11
patients got this service, 0.97% of his patients
8.6
average number of visits a patient made for this service
(Peers: 7.4)
$158,750an average of $25 per time performed $107,950
an average of $17 per time performed
DRUGS

Injection, denosumab (prolia, xgeva), 1 mg

Service Code: J0897
Performed in an office
4,260
times performed,
29% of his services

2nd 6th

most performed service for this provider most performed service in this state & specialty

43
patients got this service, 4% of his patients
1.7
average number of visits a patient made for this service
(Peers: 1.5)
$140,580an average of $33 per time performed $46,860
an average of $11 per time performed
RADIOLOGY

Bone density measurement using dedicated x-ray machine

Service Code: 77080
Performed in an office
745
times performed,
5% of his services

3rd 21st

most performed service for this provider most performed service in this state & specialty

745
patients got this service, 66% of his patients
1
average number of visits a patient made for this service
(Peers: 1)
$173,585an average of $233 per time performed $46,190
an average of $62 per time performed
EVALUATION AND MANAGEMENT

Established patient office or other outpatient, visit typ... +

Established patient office or other outpatient, visit typically 25 minutes ×

Service Code: 99214
Performed in an office
543
times performed,
4% of his services

4th 5th

most performed service for this provider most performed service in this state & specialty

295
patients got this service, 26% of his patients
1.8
average number of visits a patient made for this service
(Peers: 2.4)
$136,293an average of $251 per time performed $39,639
an average of $73 per time performed
EVALUATION AND MANAGEMENT

Established patient office or other outpatient visit, typ... +

Established patient office or other outpatient visit, typically 15 minutes ×

Service Code: 99213
Performed in an office
354
times performed,
2% of his services

5th 7th

most performed service for this provider most performed service in this state & specialty

251
patients got this service, 22% of his patients
1.4
average number of visits a patient made for this service
(Peers: 1.9)
$59,826an average of $169 per time performed $17,346
an average of $49 per time performed
DRUGS

Injection, zoledronic acid (reclast), 1 mg

Service Code: J3488
Performed in an office
310
times performed,
2% of his services

6th 23rd

most performed service for this provider most performed service in this state & specialty

62
patients got this service, 5% of his patients
1
average number of visits a patient made for this service
(Peers: 1)
$113,150an average of $365 per time performed $54,870
an average of $177 per time performed
DRUGS

Infusion, normal saline solution , 250 cc

Service Code: J7050
Performed in an office
290
times performed,
2% of his services

7th 22nd

most performed service for this provider most performed service in this state & specialty

72
patients got this service, 6% of his patients
2.4
average number of visits a patient made for this service
(Peers: 4.2)
$7,250an average of $25 per time performed $0
an average of $0 per time performed
PATHOLOGY AND LABORATORY

Liver function blood test panel

Service Code: 80076
Performed in an office
270
times performed,
2% of his services

8th 36th

most performed service for this provider most performed service in this state & specialty

114
patients got this service, 10% of his patients
2.4
average number of visits a patient made for this service
(Peers: 2.1)
$7,830an average of $29 per time performed $2,430
an average of $9 per time performed
PATHOLOGY AND LABORATORY

Complete blood cell count (red cells, white blood cell, p... +

Complete blood cell count (red cells, white blood cell, platelets), automated test ×

Service Code: 85025
Performed in an office
269
times performed,
2% of his services

9th 12th

most performed service for this provider most performed service in this state & specialty

105
patients got this service, 9% of his patients
2.6
average number of visits a patient made for this service
(Peers: 2.3)
$7,532an average of $28 per time performed $2,959
an average of $11 per time performed
PATHOLOGY AND LABORATORY

Blood test, basic group of blood chemicals

Service Code: 80048
Performed in an office
256
times performed,
2% of his services

10th Alert

most performed service for this provider 5 or fewer providers in this specialty in VA perform this service

158
patients got this service, 14% of his patients
1.6
average number of visits a patient made for this service
$7,680an average of $30 per time performed $2,304
an average of $9 per time performed
MEDICINE

Infusion of chemotherapy into a vein up to 1 hour

Service Code: 96413
Performed in an office
184
times performed,
1% of his services

11th 14th

most performed service for this provider most performed service in this state & specialty

76
patients got this service, 7% of his patients
2.4
average number of visits a patient made for this service
(Peers: 5.5)
$69,184an average of $376 per time performed $18,584
an average of $101 per time performed
CARDIOVASCULAR SYSTEM

Insertion of needle into vein for collection of blood sample +

Insertion of needle into vein for collection of blood sample ×

Service Code: 36415
Performed in an office
112
times performed,
0.77% of his services

12th 8th

most performed service for this provider most performed service in this state & specialty

79
patients got this service, 7% of his patients
1.4
average number of visits a patient made for this service
(Peers: 2.3)
$1,120an average of $10 per time performed $336
an average of $3 per time performed
MEDICINE

Injection beneath the skin or into muscle for therapy, di... +

Injection beneath the skin or into muscle for therapy, diagnosis, or prevention ×

Service Code: 96372
Performed in an office
72
times performed,
0.5% of his services

13th 33rd

most performed service for this provider most performed service in this state & specialty

44
patients got this service, 4% of his patients
1.6
average number of visits a patient made for this service
(Peers: 1.6)
$3,960an average of $55 per time performed $1,296
an average of $18 per time performed
MUSCULOSKELETAL SYSTEM

Aspiration and/or injection of large joint or joint capsule +

Aspiration and/or injection of large joint or joint capsule ×

Service Code: 20610
Performed in an office
61
times performed,
0.42% of his services

14th 11th

most performed service for this provider most performed service in this state & specialty

39
patients got this service, 3% of his patients
1.3
average number of visits a patient made for this service
(Peers: 1.9)
$11,163an average of $183 per time performed $2,989
an average of $49 per time performed
DRUGS

Injection, methylprednisolone acetate, 40 mg

Service Code: J1030
Performed in an office
53
times performed,
0.36% of his services

15th 17th

most performed service for this provider most performed service in this state & specialty

38
patients got this service, 3% of his patients
1.2
average number of visits a patient made for this service
(Peers: 1.5)
$371an average of $7 per time performed $159
an average of $3 per time performed
EVALUATION AND MANAGEMENT

New patient office or other outpatient visit, typically 4... +

New patient office or other outpatient visit, typically 45 minutes ×

Service Code: 99204
Performed in an office
52
times performed,
0.36% of his services

16th 20th

most performed service for this provider most performed service in this state & specialty

52
patients got this service, 5% of his patients
1
average number of visits a patient made for this service
(Peers: 1)
$20,592an average of $396 per time performed $5,772
an average of $111 per time performed
EVALUATION AND MANAGEMENT

New patient office or other outpatient visit, typically 6... +

New patient office or other outpatient visit, typically 60 minutes ×

Service Code: 99205
Performed in an office
52
times performed,
0.36% of his services

17th 31st

most performed service for this provider most performed service in this state & specialty

52
patients got this service, 5% of his patients
1
average number of visits a patient made for this service
(Peers: 1)
$25,272an average of $486 per time performed $7,332
an average of $141 per time performed
TEMPORARY CODES

Influenza virus vaccine, split virus, when administered t... +

Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) ×

Service Code: Q2038
Performed in an office
49
times performed,
0.34% of his services

18th 77th

most performed service for this provider most performed service in this state & specialty

49
patients got this service, 4% of his patients
1
average number of visits a patient made for this service
(Peers: 1)
$980an average of $20 per time performed $637
an average of $13 per time performed
PROCEDURES

Administration of influenza virus vaccine

Service Code: G0008
Performed in an office
49
times performed,
0.34% of his services

19th 48th

most performed service for this provider most performed service in this state & specialty

49
patients got this service, 4% of his patients
1
average number of visits a patient made for this service
(Peers: 1)
$1,470an average of $30 per time performed $1,176
an average of $24 per time performed
PATHOLOGY AND LABORATORY

Red blood cell sedimentation rate, to detect inflammation +

Red blood cell sedimentation rate, to detect inflammation ×

Service Code: 85651
Performed in an office
47
times performed,
0.32% of his services

20th 15th

most performed service for this provider most performed service in this state & specialty

41
patients got this service, 4% of his patients
1.1
average number of visits a patient made for this service
(Peers: 1.8)
$611an average of $13 per time performed $235
an average of $5 per time performed
PATHOLOGY AND LABORATORY

Vitamin d-3 level

Service Code: 82306
Performed in an office
26
times performed,
0.18% of his services

21st 50th

most performed service for this provider most performed service in this state & specialty

26
patients got this service, 2% of his patients
1
average number of visits a patient made for this service
(Peers: 1.4)
$2,756an average of $106 per time performed $1,092
an average of $42 per time performed
PATHOLOGY AND LABORATORY

Creatine kinase (cardiac enzyme) level

Service Code: 82550
Performed in an office
24
times performed,
0.17% of his services

22nd 68th

most performed service for this provider most performed service in this state & specialty

13
patients got this service, 1% of his patients
1.8
average number of visits a patient made for this service
(Peers: 1.3)
$552an average of $23 per time performed $120
an average of $5 per time performed
EVALUATION AND MANAGEMENT

Established patient office or other outpatient visit, typ... +

Established patient office or other outpatient visit, typically 10 minutes ×

Service Code: 99212
Performed in an office
23
times performed,
0.16% of his services

23rd 55th

most performed service for this provider most performed service in this state & specialty

21
patients got this service, 2% of his patients
1.1
average number of visits a patient made for this service
(Peers: 1.2)
$2,300an average of $100 per time performed $690
an average of $30 per time performed
PATHOLOGY AND LABORATORY

Uric acid level, blood

Service Code: 84550
Performed in an office
20
times performed,
0.14% of his services

24th 52nd

most performed service for this provider most performed service in this state & specialty

17
patients got this service, 2% of his patients
1.2
average number of visits a patient made for this service
(Peers: 1.3)
$320an average of $16 per time performed $80
an average of $4 per time performed
EVALUATION AND MANAGEMENT

Established patient office or other outpatient, visit typ... +

Established patient office or other outpatient, visit typically 40 minutes ×

Service Code: 99215
Performed in an office
19
times performed,
0.13% of his services

25th 28th

most performed service for this provider most performed service in this state & specialty

17
patients got this service, 2% of his patients
1.1
average number of visits a patient made for this service
(Peers: 1.3)
$6,422an average of $338 per time performed $1,805
an average of $95 per time performed
PATHOLOGY AND LABORATORY

Blood test, thyroid stimulating hormone (tsh)

Service Code: 84443
Performed in an office
17
times performed,
0.12% of his services

26th 64th

most performed service for this provider most performed service in this state & specialty

17
patients got this service, 2% of his patients
1
average number of visits a patient made for this service
(Peers: 1)
$1,020an average of $60 per time performed $408
an average of $24 per time performed
PATHOLOGY AND LABORATORY

Parathormone (parathyroid hormone) level

Service Code: 83970
Performed in an office
14
times performed,
0.1% of his services

27th Alert

most performed service for this provider 5 or fewer providers in this specialty in VA perform this service

14
patients got this service, 1% of his patients
1
average number of visits a patient made for this service
$2,072an average of $148 per time performed $812
an average of $58 per time performed
PATHOLOGY AND LABORATORY

Rheumatoid factor analysis

Service Code: 86430
Performed in an office
12
times performed,
0.08% of his services

28th 84th

most performed service for this provider most performed service in this state & specialty

12
patients got this service, 1% of his patients
1
average number of visits a patient made for this service
(Peers: 1)
$252an average of $21 per time performed $84
an average of $7 per time performed

Sources: Centers for Medicare and Medicaid Services, National Plan and Provider Enumeration System, American Medical Association

Services that begin with a letter come from CMS. All other codes and descriptions of the medical procedures are from the Current Procedural Terminology (CPT®) code set, copyright 2013 American Medical Association. All rights reserved. Where practical, AMA’s consumer friendly translation of the CPT descriptor was used. ProPublica has received permission from the AMA to use these codes on this site.

Notes: This provider has a self-reported specialty of "Rheumatology." In some cases the self-reported specialty may differ from the specialty listed above, which comes from Medicare. Medicare redacted this data for any services provided to fewer than 11 patients.

Incorrect Info? If you are a provider and you believe your address is incorrect, check the listing you created on the National Provider Identifier registry. If you change your listing, send a note to checkup@propublica.org and we will update your information. If you have other questions about this data, send a note to checkup@propublica.org. Here's a link to Medicare's data on this provider.


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