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

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

Benjamin Jones (NPI 1134447980)

Field	Value
Entity Type	Individual
Organization	Benjamin Jones
Address	3686 Grandview Pkwy
City	Birmingham
State	AL
ZIP	35243
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	May 4, 2010

Payer Source	Total Paid
Medicare	$2.4M
Medicaid	$0

Key Findings

This provider’s revenue profile is effectively single‑payer: Total Medicare revenue is $2.4M and there is no Medicaid billing on file, so Medicare drives the entire recorded public‑payer footprint. The top 3 Medicare codes account for 57.3% of this provider's total Medicare revenue, indicating a high concentration of income in a small set of drug/infusion codes.

Revenue is heavily concentrated in pembrolizumab administration: J9271 (pembrolizumab) alone accounts for $877.2K in Medicare revenue and 37.1% of the provider’s Medicare total, with 20.4K claims at an average paid/claim of $43. This makes oncology immunotherapy the single largest revenue driver and signals that checkpoint inhibitor infusions are a core service line for the practice, even though national rank for J9271 (#375 of 1841, 79th percentile) is described as typical.

The practice also shows substantial use of intravenous immune‑globulin products across multiple HCPCS entries: J1569 ($274.7K, 11.6% of Medicare revenue), J1556 ($201.8K, 8.5%), and J1568 ($190.7K, 8.1%). These code-level revenues and high claim counts (e.g., 7.6K claims for J1569) indicate a mixed therapeutics portfolio beyond cytotoxic or checkpoint agents, consistent with hematology activity that includes immune modulation; national ranks vary from relatively high (J1569 at the 84th percentile) to modest (J1556 at the 27th percentile), showing product‑specific variation in market position.

Infusion and chemotherapy administration activity is prominent in the procedure mix: codes such as 96413 ($58.1K; 660 claims), 96365 ($22K; 523 claims) and the add‑on 96417 ($14.7K; 334 claims) reflect frequent in‑office intravenous drug delivery. Notably, 96417 is an extreme outlier nationally (#37 of 3014, 99th percentile), and 96413 is described as notably above typical national volume (96th percentile), which together suggest above‑average throughput for multi‑drug infusion encounters relative to peers.

Clinic visit volume is also elevated, supporting a high outpatient caseload: 99213 generated $50K (807 claims) and ranks in the 98th percentile nationally, labeled as notably above typical volume, while 99214 produced $35.6K and ranks in the 86th percentile. This mix of high E/M volumes alongside infusion codes is consistent with an established office‑based hematology/oncology practice managing ongoing systemic therapy and routine follow‑up visits.

Several specific codes are statistical outliers or notably above typical national volumes in ways that point to specialized service lines: J1454 (fosnetupitant/palonosetron) is an extreme outlier (#5 of 422, 99th percentile) with $70.3K in revenue, and J1439 (ferric carboxymaltose) is notably above typical national volume (96th percentile) with $111.8K in revenue. These concentrated, above‑typical usages suggest the practice has unusually high utilization of certain antiemetic and IV iron therapies relative to national peers.

Competitive standing is mixed across codes: the provider is a strong outlier on several procedure and drug administration entries (e.g., 96417 and J1454 at the 99th percentile), yet its largest revenue drug, J9271, sits at a typical national level (79th percentile). In aggregate this profile indicates an established, specialized infusion practice with pockets of national‑level intensity but not uniformly dominant share across all top revenue drivers.

The provider has long tenure on file — NPI enumerated 2010-05-04 (~16 years ago) — which, combined with the concentrated drug/infusion revenue mix and elevated E/M volumes, is consistent with an established hematology & oncology practice operating a sustained in‑office infusion service line. Given the heavy concentration of Medicare revenue in a few high‑revenue drug codes, future shifts in utilization patterns or reimbursement for those specific agents could materially affect reported Medicare income.

Medicare: Complete Services Breakdown

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

52 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	20,400	$40	$877.2K
J1569	Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg	7,630	$40	$274.7K
J1556	Injection, immune globulin (bivigam), 500 mg	3,540	$60	$201.8K
J1568	Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg	6,150	$30	$190.7K
J9264	Injection, paclitaxel protein-bound particles, 1 mg	15,600	$10	$156K
J1439	Injection, ferric carboxymaltose, 1 mg	111,750	$1	$111.8K
J0897	Injection, denosumab, 1 mg	5,820	$20	$104.8K
J1454	Injection, fosnetupitant 235 mg and palonosetron 0.25 mg	210	$330	$70.3K
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…	660	$90	$58.1K
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…	810	$60	$50K

Showing 1–10 of 52

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 52 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Alabama Distribution

Benjamin Jones — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. state median

52 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	15	30	19,900	$40	$827.2K
J1556	4	10	5,820	$60	$339.8K
J1568	13	30	5,180	$30	$316.2K
J1569	1	10	5,120	$40	$179.3K
J9264	2	10	17,400	$10	$167.5K
J0897	59	200	3,120	$20	$97.7K
J1437	21	40	3,000	$20	$59.1K
J1439	1	10	41,250	$1	$39K
J1454	1	20	90	$340	$33.7K
J2506	3	10	340	$70	$25.1K

Showing 1–10 of 52

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Matthew Tucker	AL	Hematology & Oncology Physician	$1.3M	$0
Birmingham Hematology Oncology Assoc LLC	AL	Hematology & Oncology Physician	$0	$1.1M
Cara Bondly	AL	Hematology & Oncology Physician	$986.3K	$0
Joanne Rossman	AL	Hematology & Oncology Physician	$874.6K	$0
John Piede	AL	Hematology & Oncology Physician	$774.1K	$0
Christopher Wang	AL	Hematology & Oncology Physician	$760.3K	$0
Carter Capra	AL	Hematology & Oncology Physician	$741.9K	$0
Racquel Innis-shelton	AL	Hematology & Oncology Physician	$422.5K	$0
Daniel Allendorf	AL	Student in an Organized Health Care Education/Training Program	$375.7K	$0
Ashley Fry	AL	Hematology & Oncology Physician	$358.2K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Taustin Laboratories	AL	Clinical Medical Laboratory	$54.1K	$37M
The Children's Hospital Of Alabama	AL	Pediatric Otolaryngology Physician	$0	$15.8M
Wiregrass Hospice, LLC	AL	Community Based Hospice Care Agency	$0	$3.5M
Compassus Op Of Alabama LLC	AL	Community Based Hospice Care Agency	$0	$3.5M
Vuepoint Diagnostics, LLC	AL	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$1.3M	$181.3K
Continuumrx, Inc.	AL	Home Infusion Therapy Pharmacy	$0	$1.3M
Agape Care Alabama LLC	AL	Community Based Hospice Care Agency	$0	$1.1M
Affinity Hospital LLC	AL	General Acute Care Hospital	$0	$904.8K
Journey Hospice Of Alabama,llc	AL	Community Based Hospice Care Agency	$0	$896.8K
Puzzle Piece LLC	AL	Pediatric Occupational Therapist	$0	$867.1K

Benjamin Jones — 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