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NPI 1013059781 · Washington, DC · Gynecologic Oncology Physician
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Edward Tanner is a gynecologic oncology physician provider located in Washington, District of Columbia. This profile covers 20 Medicare and 2 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Edward Tanner |
| Address | 5275 Loughboro Rd Nw Bldg D |
| City | Washington |
| State | DC |
| ZIP | 20016 |
| Taxonomy | Gynecologic Oncology Physician |
| NPI Enumerated | February 12, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $786.3K |
| Medicaid | $2.1K |
EDWARD TANNER is primarily a Medicare-focused Gynecologic Oncology physician by revenue: total Medicare revenue is $786.3K versus total Medicaid revenue of $2.1K, indicating Medicare dominates this provider’s payer mix and Medicaid represents a negligible share of lifetime billing. The provider’s NPI has been enumerated since 2007-02-12 (~19 years ago), indicating long-standing activity in the market.
Revenue concentration on Medicare is extremely narrow: the precomputed top 3 Medicare codes account for 95.7% of this provider’s total Medicare revenue, which signals the practice is highly centered on a small set of services rather than a broad mix of outpatient care. On Medicaid the top 3 codes account for 100.0% of Medicaid revenue, reinforcing the limited scope of services billed to that payer.
Pembrolizumab (J9271) is the dominant Medicare revenue driver: J9271 alone represents $645K and 83.0% of the provider’s Medicare revenue, implying the practice primarily delivers high-cost immunotherapy infusions to Medicare beneficiaries and is structured to deliver oncology infusion services. This single-code concentration aligns with a specialized oncology infusion business model rather than generalist outpatient care.
The secondary Medicare drugs — Q5107 (bevacizumab-awwb, $73.7K, 9.5% of Medicare revenue) and E/M visits (99214, $25.2K, 3.2% of Medicare revenue) — together with infusion/chemotherapy codes (96413 and add-ons) indicate a mix of drug administration plus associated evaluation and management, consistent with a medical oncology practice that couples high-cost biologic infusions with periodic clinic visits and infusion administration services.
On competitive standing for top Medicare codes, the provider’s rank for J9271 is #687 of 1841 (62nd percentile), which positions them as a typical-volume national participant for pembrolizumab rather than a market leader or outlier. Q5107 ranks #32 of 78 (60th percentile), also a typical-volume performer within a small national cohort of providers billing that biosimilar. 99214 ranks at the 75th percentile nationally (#117722 of 479517), indicating above-average office visit volume relative to all providers reporting that E/M code.
Medicaid billing is minimal but concentrated in standard oncology services: Medicaid revenue is driven by 99214 (85.0% of Medicaid revenue, $1.8K) and 96413 (15.0% of Medicaid revenue, $323). The provider ranks #262 of 305 in-state for 99214 (14th percentile), suggesting low relative Medicaid E/M volume among in-state peers; for 96413 the in-state rank is #9 of 9 (0th percentile), indicating the provider is among the smallest Medicaid billers for that chemotherapy code in-state.
Claim counts and low per-claim Medicare payments on supportive and ancillary codes (for example multiple high-count J-codes with $0 or very low avg paid/claim reported) suggest the practice bills many ancillary medication administrations where reimbursement per unit is small or bundled, while relying on a few high-revenue drug codes for the bulk of top-line Medicare receipts. This pattern is consistent with an infusion center model where a small set of expensive oncology drugs drive most revenue and many routine supportive medications are billed with low unit payments.
Tenure and service mix together imply a mature, specialized oncology practice: with NPI enumeration since ~19 years ago and concentrated billing in high-cost oncologic injectable therapies, the provider likely focuses on advanced gynecologic oncology treatments (immunotherapy and biologics) rather than general outpatient care or broad Medicaid service provision.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
20 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 15,000 | $40 | $645K |
| Q5107 | Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg | 3,350 | $20 | $73.7K |
| 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… | 260 | $100 | $25.2K |
| 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 | $110 | $16.3K |
| 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… | 30 | $170 | $4.8K |
| 96417 | 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 administration of a different chemotherapy… | 70 | $50 | $3.6K |
| 96367 | The provider administers an additional intravenous infusion or infusions, after an initial infusion, of a different medication or substance for a period up to one hour to prevent, treat, or diagnose… | 80 | $20 | $2K |
| 96375 | Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the… | 150 | $10 | $2K |
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 20 | $70 | $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… | 50 | $20 | $1.1K |
Showing 1–10 of 20
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
20 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J9271 | 2 | 10 | 25,100 | $40 | $1.1M |
| Q5107 | 1 | 10 | 3,350 | $20 | $75.2K |
| J3490 | 1 | 10 | 40 | $1,820 | $63.8K |
| 99214 | 257 | 1,400 | 90 | $100 | $15.3K |
| 96413 | 5 | 20 | 60 | $120 | $11.4K |
| 99232 | 564 | 640 | 70 | $70 | $10K |
| 99213 | 1,171 | 1,200 | 50 | $70 | $8.5K |
| 99205 | 144 | 330 | 30 | $170 | $5.6K |
| 96417 | 2 | 10 | 80 | $60 | $4.3K |
| 96375 | 4 | 10 | 150 | $10 | $2.2K |
Showing 1–10 of 20
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 50 | $40 | $1.8K |
| 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… | 20 | $20 | $320 |
How this provider's Medicaid billing volume and revenue compare to other District of Columbia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. District of Columbia median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 9 | 10 | 3,140 | $110 | $399.6K |
| 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… | 262 | 310 | 750 | $70 | $321.6K |
Other providers in the same ZIP code as Edward Tanner, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Lucy Webb Hayes National Training School For Deaconesses & Missionarie | DC | General Acute Care Hospital | $0 | $19.1M |
| Jeffrey Steinberg | DC | Foot & Ankle Surgery Podiatrist | $13.3M | $0 |
| Friendship Place | DC | Case Management Agency | $0 | $5.6M |
| Wisconsin Ave Psychiatric Center Inc | DC | Psychiatric Hospital | $0 | $3.1M |
| Iona Senior Services | DC | Adult Health Nurse Practitioner | $0 | $1.1M |
| Mary Ella Carter | DC | Plastic Surgery Physician | $942.2K | $0 |
| Jaydot LLC | DC | Case Management Agency | $0 | $820.6K |
| Brandi Page | DC | Radiation Oncology Physician | $761K | $0 |
| Joshua Yamamoto | DC | Cardiovascular Disease Physician | $688.3K | $0 |
| Wisconsin Avenue Psychiatric Center | DC | Psychiatry Physician | $0 | $678K |
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