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

Why is the Medicaid comparison limited to New Hampshire 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. New Hampshire (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.

Josy Mathew (NPI 1174715247)

Field	Value
Entity Type	Individual
Organization	Josy Mathew
Address	250 Pleasant St
City	Concord
State	NH
ZIP	03301
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	August 13, 2007

Payer Source	Total Paid
Medicare	$452.4K
Medicaid	$0

Key Findings

This provider’s Medicare footprint is small-to-moderate in scale with lifetime Medicare revenue of $452.4K and no Medicaid billing on file; the absence of any Medicaid billing ("none below — this provider has no Medicaid billing on file") means the practice is effectively single-payer (Medicare) as recorded in claims data, which concentrates payer exposure and should be considered in network-coverage or reimbursement assessments.

Revenue is highly concentrated into a very small set of codes: the precomputed top three Medicare codes account for 87.3% of this provider’s total Medicare revenue, with J9271 alone representing the largest share at 71.2% of Medicare revenue. This degree of concentration implies that changes in reimbursement or utilization for a single biologic/immunotherapy product could materially affect the provider’s Medicare revenue.

Procedure mix and code descriptions indicate a clinical operation centered on oncology infusion services combined with office-based management: the highest-revenue code is J9271 (injection, pembrolizumab), supported by chemotherapy administration codes such as 96413 and add-on infusion codes like 96417, plus high-volume E/M codes 99214 and 99215. Together these codes suggest an outpatient oncology practice that both administers systemic anti-cancer therapies and provides ongoing complex evaluation and management for established patients.

J9271 detail: the provider reported 10K claims for J9271 with $32 avg paid/claim and $320K revenue; that activity is described in the source as "typical, unremarkable volume" and the provider ranks #1186 of 1841 nationally (35th percentile). Despite J9271 driving the bulk of revenue, the national rank and the accompanying plain-English label indicate this provider is not a top national outlier for pembrolizumab administration.

Office visit activity is a meaningful secondary revenue source: 99214 accounts for $50.6K (568 claims, $89 avg paid/claim) and 99215 for $21.7K (181 claims, $120 avg paid/claim), together representing 11.2% and 4.8% of Medicare revenue respectively. Both 99214 and 99215 are reported with the plain-English label "typical, unremarkable volume" (99214 ranks #39274 of 479517, 92th percentile; 99215 ranks #13676 of 145531, 91th percentile), which aligns with an outpatient oncology practice that maintains steady, ongoing E/M encounters rather than unusually high or low visit volumes.

Several chemotherapy/infusion administration codes (96413, 96417, 96367 and related J-codes like J9045 and J2469) appear on the top-25 list and are also labeled "typical, unremarkable volume," with ranks clustering around median national positions (for example, 96413 ranks #3718 of 7514, 50th percentile). This pattern reinforces the interpretation of an oncology infusion clinic with routine chemotherapy and supportive-care administration rather than a high-volume infusion center dominating nationally.

There are operational items that warrant follow-up in audit or payer review: 920 claims for J1100 (injection, dexamethasone sodium phosphate) are recorded with $0 revenue on file, and several low-dollar antiemetic/supportive care J-codes (e.g., J0185, J2469) appear with very low average payments. These $0 or near-$0 paid lines can reflect bundled billing, pass-through arrangements, or administrative coding practices and should be checked with payer-specific adjudication data if accurate reimbursement allocation is important for contracting or utilization review.

Provider tenure is long-standing: the NPI was enumerated on 2007-08-13 (~19 years ago), indicating an established provider presence. Combined with the concentrated Medicare revenue profile and the code mix dominated by high-cost biologic administration and routine E/M visits, this suggests a steady oncology practice with a narrow revenue base that is stable in provider tenure but relatively exposed to shifts in Medicare drug coverage or utilization patterns.

Medicare: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	10,000	$30	$320K
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…	570	$90	$50.6K
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…	180	$120	$21.7K
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…	150	$110	$16K
99205	The provider sees a new 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 provider…	90	$150	$12.8K
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…	160	$60	$9.5K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	50	$60	$2.9K
J0185	Injection, aprepitant, 1 mg	2,600	$1	$2.6K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	30	$100	$2.5K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	20	$140	$2.4K

Showing 1–10 of 19

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New Hampshire Distribution

Josy Mathew — 1 of 18 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Hampshire

Full comparison — all codes billed, vs. state median

19 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	4	10	10,000	$40	$440.2K
96413	11	20	140	$100	$15.8K
99214	150	3,150	110	$80	$13.2K
99233	473	600	70	$90	$10.9K
99232	609	990	70	$60	$9.8K
99223	514	700	30	$130	$7.2K
99213	735	2,900	70	$50	$6.9K
99215	69	1,080	40	$110	$6.8K
99205	25	440	20	$140	$4.9K
J0185	2	10	2,600	$1	$4.7K

Showing 1–10 of 19

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fairview Health Services	MN	General Acute Care Hospital	$0	$90.4M
Fairview Health Services	MN	Emergency Medicine Physician	$0	$26.6M
Fairview Health Services	MN	General Acute Care Hospital	$0	$17.2M
Elliot Professional Services	NH	Internal Medicine Physician	$0	$12.8M
Fairview Express Care	MN	General Practice Physician	$0	$11.4M
Healtheast Medical Research Institute	MN	Clinic/Center	$0	$11.4M
Fairview Clinics	MN	Primary Care Clinic/Center	$0	$9.4M
Healtheast Medical Research Institute	MN	Clinic/Center	$0	$8.7M
Healtheast Medical Research Institute	MN	Internal Medicine Physician	$0	$8.3M
Healtheast Medical Research Institute	MN	Clinic/Center	$0	$7.4M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Bridges	NH	Case Management Agency	$0	$265.5M
Riverbend Community Mental Health, Inc.	NH	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$118.4M
Granite State Independent Living	NH	In Home Supportive Care Agency	$0	$74.7M
Ascentria Community Services, Inc	NH	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$52.6M
Ascentria Community Care, Inc	NH	Voluntary or Charitable Agency	$0	$50.3M
Concord Hospital, Inc.	NH	General Acute Care Hospital	$0	$28.8M
Concord Pediatric Dentistry	NH	Pediatric Dentistry	$0	$13.6M
New England Life Care, Inc.	NH	Home Infusion Therapy Pharmacy	$0	$11.4M
New Hampshire Home Care Providers LLC	NH	In Home Supportive Care Agency	$0	$11M
Brain Injury Association Of Nh	NH	Case Management Agency	$0	$11M

Josy Mathew — 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