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

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

Joni Tilford (NPI 1114006988)

Field	Value
Entity Type	Individual
Organization	Joni Tilford
Address	4101 Tiger Lily Rd Ste 100
City	Lincoln
State	NE
ZIP	68516
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	November 3, 2006

Payer Source	Total Paid
Medicare	$1M
Medicaid	$0

Key Findings

Practice is effectively a Medicare-focused oncology infusion practice: total Medicare revenue is $1M while Medicaid billing is none, and the top revenue-driving codes are high-cost biologic and infusion agents such as J9271 ($335.4K, 33.0%), J0897 ($156.6K, 15.4%) and J1576 ($123.2K, 12.1%), which together account for 60.6% of Medicare revenue. The code mix (pembrolizumab, denosumab, IV immune globulin and multiple chemotherapy administration CPTs like 96413 and G0498) indicates a service line centered on outpatient oncology/infusion treatments rather than primary care or inpatient procedures.

Revenue is highly concentrated in a few drugs: the precomputed top-3 share is 60.6%, with J9271 alone responsible for $335.4K (33.0%) of Medicare revenue. This concentration means the practice’s financial performance is sensitive to usage and reimbursement of a small set of high-cost injectables rather than broad E/M volume.

Payer mix is effectively single-payer Medicare: the profile shows $1M in lifetime Medicare revenue and none for Medicaid, signaling the provider operates without measurable Medicaid participation on file. That asymmetry suggests contracting, referral patterns, or patient mix that favors Medicare beneficiaries and oncology care billed to Medicare.

Competitive standing by code is mixed and generally within typical peer ranges: J0897 ranks #1401 of 10057 providers nationally (86th percentile; typical, unremarkable volume), indicating relatively higher-than-average national activity for denosumab, while J9271 ranks #1430 of 1841 (21th percentile; typical, unremarkable volume) showing modest national volume for pembrolizumab. Other services such as office E/M care (99214 ranks #47085 of 479517, 90th percentile; typical, unremarkable volume) and lab testing (85025 ranks #1112 of 32833, 97th percentile; typical, unremarkable volume) show the practice performs strongly on routine visit and on-site lab volumes compared with peers.

Several procedural codes point to an on-site infusion and phlebotomy workflow: 36415 (venipuncture) has 1.4K claims with $10.8K revenue and ranks #1789 of 86467 (98th percentile; typical, unremarkable volume), and 85025 (CBC) has 1.8K claims with $14.7K revenue and ranks #1112 of 32833 (97th percentile; typical, unremarkable volume). High percentile placement on these lab and specimen codes supports a steady throughput of infusion patients requiring blood monitoring and same-site specimen collection.

There are high-count, low-unit-payment items in the mix that contribute measurable revenue through volume: J1439 shows 19.5K claims at $1 avg paid/claim for $19.5K revenue (1.9% of Medicare revenue) and ranks #852 of 1209 (28th percentile; typical, unremarkable volume). This pattern is consistent with frequent use of low-dollar injectable items alongside fewer, high-dollar biologic infusions.

Chemo administration and add-on infusion codes show routine chemotherapy activity but not dominant national share: 96413 appears with 369 claims, $35.1K revenue and ranks #1316 of 7514 (82th percentile; typical, unremarkable volume), while add-on codes like 96417 and 96415 appear at lower revenue and mid-to-lower percentiles. These entries support characterization of the practice as regularly delivering multi-drug infusion sessions rather than being a major national hub for chemotherapy administration.

Provider tenure is long-standing: the NPI enumerated on 2006-11-03 (~20 years ago), indicating roughly two decades of billing history under this NPI and suggesting established referral relationships and operational experience in hematology/oncology care. This longevity combined with concentrated Medicare billing provides context for evaluating historical utilization trends and contracting leverage.

Medicare: Complete Services Breakdown

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

58 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	7,800	$40	$335.4K
J0897	Injection, denosumab, 1 mg	8,700	$20	$156.6K
J1576	Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg	2,370	$50	$123.2K
J1449	Injection, eflapegrastim-xnst, 0.1 mg	4,220	$30	$105.6K
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…	510	$90	$44.5K
J2506	Injection, pegfilgrastim, excludes biosimilar, 0.5 mg	480	$80	$39.4K
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…	370	$100	$35.1K
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…	220	$130	$28.3K
J1439	Injection, ferric carboxymaltose, 1 mg	19,500	$1	$19.5K
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…	280	$60	$16.2K

Showing 1–10 of 58

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 58 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Nebraska Distribution

Joni Tilford — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. state median

58 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	24	30	14,400	$40	$671.6K
J1576	1	10	2,370	$50	$122.1K
J1449	2	10	3,700	$30	$92.4K
J0897	19	200	2,040	$20	$62.7K
J2506	7	20	460	$90	$40.5K
J1439	23	30	25,880	$1	$26.4K
J0885	12	10	3,180	$10	$19.2K
96413	17	80	60	$90	$18.2K
74177	144	160	170	$80	$15.3K
99214	321	3,210	110	$70	$14.9K

Showing 1–10 of 58

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bryan Medical Center	NE	General Acute Care Hospital	$0	$56.9M
Alegent Creighton Clinic	NE	Family Medicine Physician	$0	$43.2M
The Physician Network	NE	Family Medicine Physician	$0	$3.1M
Eric Avery	NE	Hematology & Oncology Physician	$3.1M	$0
Kailash Mosalpuria	NE	Hematology & Oncology Physician	$2.9M	$0
Chi Health Clinic Specialty, LLC	NE	Hospitalist Physician	$0	$2.6M
Madhu Midathada	NE	Hematology & Oncology Physician	$2.3M	$0
Scott Mcham	NE	Hematology & Oncology Physician	$1.9M	$0
Sakeer Hussain	IA	Hematology & Oncology Physician	$1.9M	$0
Kearney Regional Medical Center LLC	NE	General Acute Care Hospital	$0	$1.8M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Melvin Churchill	NE	Rheumatology Physician	$4.8M	$0
Lincoln Radiology Group PC	NE	Diagnostic Radiology Physician	$0	$4.5M
Elite Professionals Home Care LLC	NE	Home Health Agency	$0	$4.2M
Rick Chatwell	NE	Rheumatology Physician	$3.5M	$0
Lincoln Pediatric Group LLC	NE	Pediatrics Physician	$0	$2.3M
Nebraska House Call Physicians, P.C.	NE	Internal Medicine Physician	$0	$1.7M
Steven Dunder	NE	Hematology & Oncology Physician	$1.7M	$0
Urology Surgical Center LLC	NE	Ambulatory Surgical Clinic/Center	$1.4M	$190.5K
Wallace Peterson	NE	Hematology & Oncology Physician	$1.5M	$0
Irfan Vaziri	NE	Medical Oncology Physician	$1.4M	$0

Joni Tilford — 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