Loading...
NPI 1053337295 · Kingston, PA · Hematology & Oncology Physician
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Bruce Saidman is a hematology & oncology physician provider located in Kingston, Pennsylvania. This profile covers 73 Medicare and 1 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 | Bruce Saidman |
| Address | 382 Pierce St |
| City | Kingston |
| State | PA |
| ZIP | 18704 |
| Taxonomy | Hematology & Oncology Physician |
| NPI Enumerated | July 14, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.4M |
| Medicaid | $1 |
This provider is effectively single‑payer Medicare by revenue: lifetime Medicare revenue is $3.4M while Medicaid revenue is $4, so Medicare accounts for virtually all billed dollars and the provider’s commercial or state Medicaid exposure is negligible. Analysts should treat this as a Medicare-centric billing profile when evaluating revenue risk and network leverage.
Revenue concentration is high: the precomputed top‑3 Medicare codes (J9271, J9299, J0897) account for 74.5% of the provider’s total Medicare revenue, with J9271 contributing $1.6M (48.7%), J9299 $521.3K (15.5%), and J0897 $351K (10.4%). That level of dependence on a small set of high-dollar injectable therapies creates material sensitivity to utilization or reimbursement changes for those agents.
The code mix strongly indicates an oncology infusion practice centered on high-cost immunotherapy and supportive biologics: J9271 (pembrolizumab), J9299 (nivolumab), and J0897 (denosumab) are the largest revenue drivers, supported by chemotherapy administration codes such as 96413, 96417, 96416, and infusion/IV codes like 96365 and 96367. Routine lab and phlebotomy codes (80053, 85025, 36415) and frequent E/M codes (99213, 99214, ) further point to an office-based infusion workflow with on-site monitoring and ancillary testing.
Competitive standing for key immunotherapy volumes is outsized: J9271 ranks #36 of 1841 providers nationally (98th percentile) and is described as notably above typical national volume, marking this provider as a major national participant for pembrolizumab administration. By contrast, J9299 ranks #142 of 505 (72th percentile) and is characterized as typical/unremarkable volume, indicating stronger relative specialization in pembrolizumab than in nivolumab.
Multiple administration and visit codes are statistical outliers, implying very high infusion throughput compared with peers: J1439 is an extreme outlier, far above typical national volume, with 263.3K claims and $263.3K revenue (7.8%); 96413 is labeled an extreme outlier with 904 claims and $87.7K revenue (2.6%); and 96417 and 99211 are also called extreme outliers. These outlier labels suggest this practice bills infusion and related services at volumes well beyond typical peer operations.
A few billing entries are operationally unique or lack peer comparison: 96379 ranks #1 of 1 providers nationally with no national peer volume comparison available, which may reflect a uniquely used billing pathway or a coding pattern uncommon among peers and should be reviewed when benchmarking utilization. Similarly, J0640 (rank #15 of 822, 98th percentile) and other high‑rank codes are flagged as extreme outliers and warrant targeted review for coding and operational benchmarking.
The raw claim counts signal substantial throughput demands: 38.2K claims for J9271 and 263.3K claims for J1439 indicate large volumes of infusion encounters and inventory turnover that have implications for scheduling, drug acquisition and waste management, and payer contracting. Analysts evaluating network capacity or partner integration should account for the practice’s heavy infusion operations when modeling referral flows or authorizations.
Provider tenure is long and suggests an established specialty practice: the NPI was enumerated on 2006-07-14 (~20 years ago), consistent with an experienced hematology/oncology physician managing a high-volume infusion practice. Combined with the concentrated revenue profile, this tenure implies institutional stability but also concentrated exposure to reimbursement or utilization shifts in the small number of dominant therapeutics.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
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 | 38,200 | $40 | $1.6M |
| J9299 | Injection, nivolumab, 1 mg | 21,720 | $20 | $521.3K |
| J0897 | Injection, denosumab, 1 mg | 19,500 | $20 | $351K |
| J1439 | Injection, ferric carboxymaltose, 1 mg | 263,250 | $1 | $263.3K |
| 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… | 1,810 | $60 | $114K |
| 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… | 900 | $100 | $87.7K |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | 24,510 | $1 | $49K |
| Q5111 | Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg | 440 | $110 | $48.4K |
| 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… | 470 | $90 | $43.2K |
| 96379 | Use 96379 to report therapeutic, prophylactic, or diagnostic intravenous or intraarterial injection or infusion procedures that do not have a specific code. | 390 | $100 | $39.7K |
Showing 1–10 of 73
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
Full comparison — all codes billed, vs. state median
73 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J9271 | 1 | 40 | 13,000 | $40 | $604.4K |
| J9299 | 2 | 10 | 9,330 | $20 | $291K |
| J0897 | 19 | 530 | 2,460 | $20 | $89.6K |
| J0881 | 24 | 50 | 24,690 | $1 | $72.7K |
| Q5111 | 2 | 10 | 320 | $110 | $40.6K |
| 96379 | 1 | 10 | 390 | $100 | $39.9K |
| J1439 | 1 | 60 | 27,000 | $1 | $36K |
| J3490 | 30 | 110 | 60 | $70 | $27.9K |
| 80053 | 23 | 220 | 110 | $10 | $21.6K |
| J9217 | 36 | 130 | 130 | $130 | $21.3K |
Showing 1–10 of 73
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.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 30 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Pennsylvania median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 406 | 450 | 1,220 | $1 | $48K |
Other providers in the same ZIP code as Bruce Saidman, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Beyond Behavior Consulting | PA | Behavior Analyst | $0 | $10.3M |
| Keystone Behavior Services, LLC | PA | Community/Behavioral Health Agency | $0 | $6.1M |
| Luzerne Intermediate Unit #18 | PA | Community/Behavioral Health Agency | $0 | $5.7M |
| Erik Kruger | PA | Ophthalmology Physician | $2.4M | $11.8K |
| Surgical Specialty Center Of Northeastern Pennsylvania, LLC | PA | Ambulatory Surgical Clinic/Center | $1.5M | $124.1K |
| Anthony Andrews | PA | Ophthalmology Physician | $1.3M | $100 |
| Radu Pacurariu | PA | Ophthalmology Physician | $1M | $0 |
| Mark Grohol | PA | Optometrist | $221.5K | $697.4K |
| Gateway Surgery Center LLC | PA | Ambulatory Surgical Clinic/Center | $756.7K | $11.8K |
| Dhirendra Kumar | PA | Family Medicine Physician | $638.2K | $0 |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.