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Market snapshot

J1561 in TX CY2024

Medicare Part B FFS · CY2024 · as published by CMS

J1561 — Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg

Billing groups
10
Named-group FFS services
244,197
FFS of Medicare
46%
Services YoY
+38.7%
FFS enrollment -1.5%
Estimated all-Medicare volume FFS + estimated MA estimate
~524,203 services

244,197 observed fee-for-service (47%) · ~280,006 estimated Medicare Advantage. Scaled from the observed floor by each state’s fee-for-service share (FFS share as of 2024) — scaled estimate — assumes MA utilization mirrors FFS; not an observation. How we scale

Named-group submitted charges
$48.0M
Named-group allowed amount
$11.8M
Named-group Medicare payments
$9.4M
Avg charge / svc
$196
Avg allowed / svc
$48
Avg payment / svc
$38
Average charge per group
$55 10 groups · avg submitted charge / service $346
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by J1561 services, CY2024
#Physician group City Specialty Providers J1561 svcs Submitted charges Avg charge Medicare $ locked column Share* Phone
1 ROBERT A ZAJAC MD PA SAN ANTONIO NURSE PRACTITIONER 6 50,120 $17,309,493 $345 premium 6.5% (210) 481-2800
2 MHS PHYSICIANS OF TEXAS HUMBLE NEUROLOGY 114 48,678 $6,115,584 $126 premium 6.3% (281) 319-8530
3 MID CITIES NEUROLOGY ASSOCIATES, P.A. FORT WORTH NEUROLOGY 12 37,216 $5,240,013 $141 premium 4.8% (817) 267-6290
4 TALIS HEALTHCARE LLC NEW CASTLE NURSE PRACTITIONER 11 31,840 $5,145,030 $162 premium 4.1%
5 TEXAS NEUROLOGY PA DALLAS NEUROLOGY 13 23,822 $2,977,750 $125 premium 3.1% (214) 827-3610
6 INNOVATIVE INFUSIONS LLC AUSTIN NURSE PRACTITIONER 106 17,866 $4,256,591 $238 premium 2.3% (512) 261-4800
7 UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS DALLAS PHYSICIAN ASSISTANT 3200 14,250 $4,931,877 $346 premium 1.8% (214) 633-5555
8 SHETH, MD, P.A. FRISCO NEUROLOGY 23 11,210 $1,121,000 $100 premium 1.5% (214) 619-1910
9 NORTH TEXAS INFECTIOUS DISEASES CONSULTANTS DALLAS INFECTIOUS DISEASE 11 7,380 $767,520 $104 premium 1.0% (214) 823-2533
10 SANDEEP GUPTA, MD, PA DALLAS ALLERGY/IMMUNOLOGY 10 1,815 $99,825 $55 premium 0.2% (214) 369-1901

*Share of the state's disclosed Medicare-FFS services for the primary code, counted once per clinician. "St" is the state the volume was billed from: a group appears in each state where its clinicians bill Medicare, with that state's volume and share ("City" is the group's registered location). Group figures sum clinicians affiliated with exactly one group; clinicians in several groups are listed in each group's drill-down but not volume-attributed to any single group, so shares reflect attributable volume. See Methods.

Comparing against an all-payer estimate?

These are exact counts from Medicare fee-for-service claims — roughly a third to half of most procedure markets, depending on payer mix. Modeled all-payer databases project the remainder statistically; we publish the audited floor and label it as such. Same market, different denominator. How the numbers reconcile →