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NPI 1053348037 · Florence, AL · Hematology & Oncology Physician
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Clint Kingsley is a hematology & oncology physician provider located in Florence, Alabama. This profile covers 78 Medicare and 4 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 | Clint Kingsley |
| Address | 180 Cox Creek Pkwy S Ste B |
| City | Florence |
| State | AL |
| ZIP | 35630 |
| Taxonomy | Hematology & Oncology Physician |
| NPI Enumerated | June 27, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.6M |
| Medicaid | $22K |
This provider operates as a medical oncology practice focused on high-cost immunotherapy and supportive oncology agents: the single top Medicare revenue code is J9271 (pembrolizumab) with 18.8K claims and $808.4K revenue, and the Medicare code mix also includes supportive/adjunct agents such as Q5127 (pegfilgrastim-fpgk) and J0897 (denosumab). The presence of chemotherapy administration codes (96413, 96365, 96417) alongside multiple injectable biologics and iron preparations (J1437, J1750) is consistent with an infusion-based oncology service line that provides both anticancer therapy and frequent supportive care.
Medicare revenue is highly concentrated: the precomputed top 3 Medicare codes account for 69.8% of total Medicare revenue, and J9271 alone represents $808.4K (53.6% of the provider's Medicare revenue). That concentration indicates that pembrolizumab is the dominant revenue driver in the Medicare book of business and that changes in utilization or reimbursement for that agent would materially affect overall Medicare revenue.
Office E/M intensity on Medicare is unusually high: 99214 appears 1.3K times for $115.5K in revenue and is labeled an "extreme outlier, far above typical national volume" (rank #6087 of 479517, 99th percentile). This suggests heavy longitudinal management of established patients in the outpatient setting in addition to infusion services, implying substantial non-procedural patient follow-up and care coordination workload.
Payer mix is heavily skewed toward Medicare: lifetime Medicare revenue is $1.6M versus Medicaid revenue of $22K, so the provider is effectively Medicare-dominant. Medicaid billing is concentrated as well — the precomputed top 3 Medicaid codes account for 99.7% of Medicaid revenue — and those Medicaid dollars are driven mainly by office E/M codes 99214 ($12K, 54.9% of Medicaid revenue) and 99215 ($7.6K, 35.1% of Medicaid revenue), indicating that Medicaid encounters are primarily office visits rather than high-cost infusions.
Competitive standing on the high-cost drug lines is modest to typical rather than dominant: J9271 ranks #461 of 1841 nationally (74th percentile) which is a typical national volume for the code, Q5127 ranks #13 of 30 nationally (59th percentile) and J0897 ranks #2077 of 10057 (79th percentile). These ranks indicate the provider is a recognized but not leading national participant for these injectable therapies, with volume levels that are generally described as typical or unremarkable across most listed drug codes.
High-volume diagnostic and phlebotomy activity supports an in-office infusion model: lab and specimen codes such as 80053 (1.9K claims, $18.7K, 97th percentile), 85025 (2.1K claims, $16.6K, 97th percentile), and 36415 (2K claims, $16K, 99th percentile) all rank well above typical national volumes. The combination of frequent lab panels, CBCs, and venipunctures aligns with protocols for chemotherapy and biologic therapy monitoring and suggests substantial on-site or ordered lab work tied to infusion care.
Provider tenure is long-standing: the NPI was enumerated 2006-06-27 (~20 years ago), indicating an established presence in Florence, AL. That longevity, together with concentrated Medicare immunotherapy revenue and high E/M volume, points to a stable oncology practice with an established patient panel and a focus on outpatient infusion and ongoing management.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
78 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 18,800 | $40 | $808.4K |
| Q5127 | Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg | 470 | $270 | $127.8K |
| J0897 | Injection, denosumab, 1 mg | 6,480 | $20 | $116.6K |
| 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… | 1,270 | $90 | $115.5K |
| J1437 | Injection, ferric derisomaltose, 10 mg | 3,500 | $20 | $56K |
| 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… | 430 | $90 | $38.8K |
| J1454 | Injection, fosnetupitant 235 mg and palonosetron 0.25 mg | 100 | $340 | $34.9K |
| Q5108 | Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg | 340 | $100 | $33.9K |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | 13,240 | $1 | $26.5K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 1,870 | $10 | $18.7K |
Showing 1–10 of 78
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 78 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
78 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J9271 | 19 | 30 | 19,900 | $40 | $827.2K |
| Q5127 | 11 | 20 | 590 | $270 | $165.7K |
| J0897 | 51 | 200 | 3,120 | $20 | $97.7K |
| J1437 | 18 | 40 | 3,000 | $20 | $59.1K |
| Q5108 | 6 | 10 | 370 | $100 | $38.1K |
| J1454 | 10 | 20 | 90 | $340 | $33.7K |
| J0881 | 8 | 30 | 7,720 | $1 | $24.1K |
| 96413 | 29 | 150 | 150 | $90 | $20.2K |
| 99214 | 81 | 7,330 | 120 | $80 | $16.8K |
| 88185 | 4 | 30 | 490 | $20 | $15.4K |
Showing 1–10 of 78
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.
4 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… | 280 | $40 | $12K |
| 99215 | The provider sees an established 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… | 90 | $80 | $7.6K |
| 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… | 530 | $1 | $2.1K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 30 | $1 | $70 |
How this provider's Medicaid billing volume and revenue compare to other Alabama providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Alabama median
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 1,256 | 1,990 | 680 | $60 | $201.7K |
| 99215 | The provider sees an established 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… | 191 | 330 | 140 | $240 | $197.4K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 184 | 200 | 2,000 | $10 | $105.9K |
| 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… | 247 | 370 | 1,540 | $10 | $65K |
Other providers in the same ZIP code as Clint Kingsley, ranked by combined Medicare and Medicaid revenue.
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