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

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

Peter Tothy (NPI 1023157278)

Field	Value
Entity Type	Individual
Organization	Peter Tothy
Address	342 E 109th Ave
City	Crown Point
State	IN
ZIP	46307
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	February 5, 2007

Payer Source	Total Paid
Medicare	$1.8M
Medicaid	$0

Key Findings

This provider’s reimbursement profile is effectively single‑payer: lifetime Medicare revenue is $1.8M and there is no Medicaid billing on file, so Medicare dominates the visible public-payer footprint for this NPI. Analysts should treat the entity as Medicare-dependent when modeling payer mix or population access.

Revenue is highly concentrated in a small set of Medicare drugs and services: the precomputed top 3 Medicare codes by revenue account for 63.7% of the provider’s total Medicare revenue, and a single code, J9271, contributes $765.4K or 46.1% of Medicare revenue. That concentration indicates the practice’s financial picture is driven heavily by a single high-cost oncology drug.

The CPT/HCPCS mix is consistent with an infusion‑centric hematology/oncology practice: J9271 (pembrolizumab) and chemotherapy administration codes such as 96413 and G0498 appear in the top codes, alongside drug injections like J1437 (ferric derisomaltose) and J0897 (denosumab). This mix implies on‑site infusion capability, regular chemotherapy administration workflows, and ancillary supportive infusions rather than primarily procedure‑based or surgical oncology.

Competitive standing for the top revenue driver J9271 is modest at the national level: J9271 is $765.4K (46.1% of Medicare revenue) and the provider ranks #509 of 1841 with a statistical label of “typical, unremarkable volume,” suggesting the practice is not a national leader in pembrolizumab administration despite the drug’s outsized contribution to its revenue.

Office visit volume is an outlier relative to national peers: 99214 accounts for $159.5K (9.6% of Medicare revenue) and is labeled an “extreme outlier” (rank #1931 of 479517). This indicates unusually high E/M visit throughput for established outpatient visits compared with broad national benchmarks and suggests a high outpatient caseload or repeated follow‑ups tied to ongoing oncology management.

Several supportive and infusion‑adjacent codes show above‑typical activity, reinforcing the infusion practice profile: 96413 ($52.5K) is labeled “notably above typical national volume,” G0498 ($15.4K) is “notably above typical national volume,” and J0185 ($24.8K) is also “notably above typical national volume.” Together these codes point to substantial chemotherapy/infusion ancillary services beyond the single large drug line.

High volumes of basic lab testing and phlebotomy are observed in Medicare claims, consistent with in‑office monitoring: 36415 (2.6K claims, $21K) appears at the 99th percentile (labeled “typical, unremarkable volume” in the dataset), and a cluster of chemistry/hematology panels such as 84132, 82435, and 84295 each appear at very high national percentiles with material claim counts and combined lab revenue. This pattern supports ongoing laboratory monitoring associated with infusion and oncology care.

The provider has an established presence: the NPI was enumerated on 2007-02-05 (~19 years ago), and over that tenure the provider has generated $1.8M in Medicare revenue. For payers and competitors, this signals a long‑standing local oncology practice with a modest Medicare revenue footprint and concentrated dependence on drug administration and high outpatient visit volumes.

Medicare: Complete Services Breakdown

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

73 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	17,800	$40	$765.4K
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…	1,810	$90	$159.5K
J1437	Injection, ferric derisomaltose, 10 mg	7,800	$20	$132.6K
J0897	Injection, denosumab, 1 mg	7,260	$20	$130.7K
J1449	Injection, eflapegrastim-xnst, 0.1 mg	3,300	$30	$82.5K
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…	560	$90	$52.5K
Q5122	Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg	470	$100	$47.3K
J2506	Injection, pegfilgrastim, excludes biosimilar, 0.5 mg	520	$80	$40.8K
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…	430	$60	$26.4K
J0185	Injection, aprepitant, 1 mg	24,830	$1	$24.8K

Showing 1–10 of 73

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 73 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Indiana Distribution

Peter Tothy — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. state median

73 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	7	20	11,200	$40	$631.7K
J1449	3	10	3,300	$30	$95.5K
J0897	32	220	2,730	$20	$74.9K
J1437	2	20	2,050	$20	$60.3K
Q5122	3	10	430	$100	$46.9K
J2506	3	10	370	$80	$33.1K
96413	7	120	140	$90	$19.1K
99214	23	10,540	110	$80	$15.5K
88185	6	10	530	$20	$13.5K
99233	560	2,720	80	$90	$13.4K

Showing 1–10 of 73

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Advanced Dermatology PC	NY	Dermatology Physician	$0	$43.9M
Community Care Network Inc	IN	Family Medicine Physician	$0	$33.9M
Schweiger Dermatology, PC	NJ	Dermatology Physician	$0	$17.2M
Franciscan Health Crown Point	IN	General Acute Care Hospital	$0	$11.4M
David Cohen	NY	Dermatology Physician	$352K	$8.4M
Mohamad Kassar	IN	Hematology & Oncology Physician	$4.7M	$0
Ramon Lee	IL	Retina Specialist (Ophthalmology) Physician	$4M	$8.5K
Sohail Hasan	IL	Retina Specialist (Ophthalmology) Physician	$3.4M	$34.2K
Neel Shah	IN	Hematology & Oncology Physician	$3.2M	$0
Raja Devanathan	IN	Pulmonary Disease Physician	$3M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Neurology And Pain Management Associates PC	IN	Internal Medicine Physician	$0	$11.7M
Elite Diagnostics LLC	IN	Clinical Medical Laboratory	$0	$9.6M
Lincare Inc.	IN	Durable Medical Equipment & Medical Supplies	$0	$6.7M
Infinity Counseling & Wellness Center LLC	IN	Professional Counselor	$0	$4.8M
Crown Counseling, LLC	IN	Community/Behavioral Health Agency	$0	$3.7M
City Of Crown Point	IN	Land Ambulance	$442.8K	$733K
Apac Surgical Center Ii, LLC	IN	Ambulatory Surgical Clinic/Center	$917.5K	$52K
Novamed Surgery Center Of Merrillville, LLC	IN	Ambulatory Surgical Clinic/Center	$873.1K	$59.5K
Douglas Williams Md	IN	Ophthalmology Physician	$492.1K	$0
Tahir Khokher	IN	Cardiovascular Disease Physician	$262.8K	$206.9K

Peter Tothy — 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