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.

Luigi Bertoli (NPI 1164514386)

Field	Value
Entity Type	Individual
Organization	Luigi Bertoli
Address	2022 Brookwood Medical Ctr Dr
City	Birmingham
State	AL
ZIP	35209
Taxonomy	Hematology (Internal Medicine) Physician
NPI Enumerated	September 28, 2006

Payer Source	Total Paid
Medicare	$2.8M
Medicaid	$0

Key Findings

This provider’s Medicare revenue is highly concentrated: total Medicare revenue is $2.8M and J1568 accounts for $2.6M revenue (93.1% of this provider's total Medicare revenue), while the precomputed top 3 Medicare codes together account for 95.9% of total Medicare revenue. That concentration indicates the practice’s financial performance is overwhelmingly driven by a single drug code and a very small set of infusion-related services.

The code mix identifies an infusion-centered hematology practice: J1568 (J1568 – Injection, immune globulin (octagam), intravenous) shows 79.6K claims at $33 avg paid/claim and $2.6M revenue, and the next-highest codes are infusion administration codes 96365 (1.1K claims, $45 avg paid/claim, $50.1K revenue) and 96366 (1.9K claims, $15 avg paid/claim, $29.1K revenue). Together these patterns are consistent with routine, high-volume IVIG and related infusion administration rather than a visit-heavy outpatient clinic.

On competitive standing, the provider is an outlier nationally for its top infusion/drug codes: J1568 ranks #1 of 381 providers nationally (100th percentile; extreme outlier), 96366 ranks #15 of 2976 providers nationally (100th percentile; extreme outlier), and 96365 ranks #76 of 8873 providers nationally (99th percentile; extreme outlier). These ranks indicate the provider is a dominant national-volume performer for those specific infusion and drug codes.

The payer mix is effectively single-payer Medicare: the record shows total Medicare revenue of $2.8M and no Medicaid billing on file. This means analyses of Medicaid exposure or state-level Medicaid competitiveness are not applicable for this provider.

Non-infusion evaluation-and-management activity appears modest relative to infusion services: 99214 shows 213 claims and $19.2K revenue, 99212 shows 417 claims and $17.1K revenue, and 99213 shows 82 claims and $5.2K revenue. These E/M volumes and revenues are small compared with the single-code drug revenue and suggest limited revenue contribution from routine office visits.

Supporting clinical and laboratory activity is present but not dominant: 85025 (CBC) has 1.5K claims and $11.7K revenue and 36415 (blood draw) has 1.3K claims and $10.4K revenue, both ranking in typical to above-typical national percentiles. These volumes are consistent with an infusion practice that performs routine lab monitoring and specimen collection for infusion patients.

Several supply/drug line items show high claim counts with no standalone Medicare payment recorded—examples include J2405 (1.2K claims, $0 avg paid/claim, $0 revenue) and J1100 (3.5K claims, $0 avg paid/claim, $0 revenue). These entries indicate line-item reporting of products or units that did not generate separate Medicare payments during the reporting window.

The provider’s NPI was enumerated on 2006-09-28 (~20 years ago), indicating long tenure. Combined with the concentrated, high-volume infusion billing pattern, this longevity supports the interpretation of an established infusion-focused hematology practice with sustained throughput over many years.

Medicare: Complete Services Breakdown

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

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J1568	Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg	79,620	$30	$2.6M
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	1,110	$50	$50.1K
96366	The provider administers an intravenous infusion or infusions of a medication for an additional hour or subsequent hours after the first hour to prevent, treat, or diagnose a condition or disease.	1,940	$20	$29.1K
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…	210	$90	$19.2K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	420	$40	$17.1K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	630	$30	$16.3K
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…	1,460	$10	$11.7K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	1,300	$10	$10.4K
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…	110	$90	$9.9K
96360	The provider introduces a catheter intravenously for supplementation of fluid and electrolytes for 31 minutes to one hour to treat severe cases of dehydration.	400	$20	$9.2K

Showing 1–10 of 23

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 23 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Alabama Distribution

Luigi Bertoli — 11 of 21 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

23 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J1568	1	30	5,180	$30	$316.2K
96413	83	150	150	$90	$20.2K
99214	2,404	7,330	120	$80	$16.8K
J1750	22	20	560	$10	$9.2K
99213	3,046	6,470	80	$50	$7.9K
96365	1	170	130	$40	$7.5K
85025	44	1,020	110	$10	$5.9K
99205	506	820	30	$140	$5K
36415	47	1,550	100	$10	$4.8K
96375	24	100	200	$10	$3.7K

Showing 1–10 of 23

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
James Barton	AL	Hematology & Oncology Physician	$1.2M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Core Diagnostic Laboratories LLC	AL	Clinical Medical Laboratory	$1.3M	$44.2M
Lab Works, LLC	AL	Clinical Medical Laboratory	$738.4K	$41.6M
Valentines Home Care, Inc.	AL	Durable Medical Equipment & Medical Supplies	$0	$13.6M
Devansh Lab Werks,inc	AL	Clinical Medical Laboratory	$1.9M	$5.9M
Grayson And Associates PC	AL	Psychiatry Physician	$0	$5M
Affinity Acquisitions, LLC	AL	Community Based Hospice Care Agency	$0	$4.8M
Metro Pediatrics PC	AL	Specialist	$0	$4.5M
Birmingham Radiological Group PC	AL	Diagnostic Radiology Physician	$0	$3.5M
Proteus Molecular And Clinical Lab LLC	AL	Clinical Medical Laboratory	$236.9K	$3.2M
Greg Eudy	AL	Rheumatology Physician	$3.3M	$0

Luigi Bertoli — 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