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

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

Amanda Fowler (NPI 1215224886)

Field	Value
Entity Type	Individual
Organization	Amanda Fowler
Address	2500 N State St
City	Jackson
State	MS
ZIP	39216
Taxonomy	Rheumatology Physician
NPI Enumerated	July 5, 2011

Payer Source	Total Paid
Medicare	$3.4M
Medicaid	$0

Key Findings

Scale and payer mix: This provider’s lifetime billing is concentrated in Medicare with Total Medicare revenue of $3.4M and Total Medicaid revenue of none, so the practice is effectively single‑payer (Medicare) in the available data. The absence of any Medicaid billing on file means state Medicaid patterns and in‑state competitive dynamics cannot be assessed from claims.

Revenue concentration at the code level: The precomputed top‑3 share shows that the top three Medicare codes account for 61.4% of this provider’s Medicare revenue. Those top drivers are J3262 ($823.6K, 23.8%), J1602 ($814K, 23.5%), and J0129 ($486.2K, 14.1%), indicating very strong revenue concentration in a small set of drug administration codes.

Service‑line and operational profile: The dominant codes (J3262, J1602, J0129, and J1745) are injectable biologic agents and the presence of high‑volume infusion/administration CPTs (96413, 96401, 96415) and injection administration codes (96372, 96375) indicate the practice operates an infusion/infusion‑support service line rather than only outpatient office visits. This mix is consistent with a rheumatology practice that both prescribes and administers parenteral biologic therapies on‑site.

Competitive standing on key biologics: The provider is a national high‑volume outlier for multiple biologic drug codes — J3262 ranks #13 of 618 (98th percentile; extreme outlier) and J1602 ranks #12 of 1041 (99th percentile; extreme outlier) — signaling market activity far above typical national volumes for those specific drugs. By contrast, J0129 ranks #274 of 1221 (78th percentile; typical, unremarkable volume), so not all biologic lines are outsized relative to peers.

Infusion and visit volume signal a procedure‑heavy practice: Chemotherapy/infusion administration code 96413 is also an extreme outlier (rank #26 of 7514, 100th percentile) and the E/M code 99214 is an extreme outlier as well (rank #6409 of 479517, 99th percentile), which together suggest high throughput of extended office encounters paired with IV-/infusion‑based drug delivery. These patterns point to a workflow and staffing model oriented around infusion sessions and moderately complex outpatient management.

Additional notable high volumes: J1745 (infliximab) ranks #28 of 1352 (98th percentile; notably above typical national volume) and several lab and diagnostic codes (e.g., 36415, 85025, 80076) appear at elevated percentile ranks for their code sets, consistent with on‑site phlebotomy and routine monitoring tied to biologic therapy. Those complementary services support the core infusion business rather than representing independent revenue centers.

Business implications of concentration: With 61.4% of Medicare revenue coming from three injectable biologic codes, the practice’s revenue profile is highly concentrated and therefore tied closely to utilization and payer coverage of those specific drugs. From a payer/contracting perspective, this concentration implies that negotiated drug reimbursement, buy‑and‑bill arrangements, and infusion reimbursement policies will materially affect the provider’s revenue stream.

Tenure and market presence: The NPI was enumerated 2011‑07‑05 (~15 years ago), indicating an established billing history in Medicare; combined with the extreme outlier ranks on multiple infusion/drug codes, this suggests the provider has built a sustained, high‑volume infusion practice over time rather than exhibiting a short‑term spike.

Medicare: Complete Services Breakdown

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

41 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J3262	Injection, tocilizumab, 1 mg	164,720	$10	$823.6K
J1602	Injection, golimumab, 1 mg, for intravenous use	74,000	$10	$814K
J0129	Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	14,300	$30	$486.2K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	15,220	$30	$395.7K
J0717	Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	77,200	$1	$308.8K
J0897	Injection, denosumab, 1 mg	8,520	$20	$153.4K
J3111	Injection, romosozumab-aqqg, 1 mg	14,070	$10	$112.6K
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…	1,250	$90	$112.1K
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…	1,270	$90	$110.1K
99204	The provider sees a new 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 provider…	180	$120	$20.4K

Showing 1–10 of 41

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 41 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Mississippi Distribution

Amanda Fowler — 16 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Mississippi

Full comparison — all codes billed, vs. state median

41 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	4	10	8,840	$30	$367.2K
J3262	1	10	55,080	$1	$299.4K
J1602	1	10	18,250	$10	$265.7K
J0717	1	10	36,000	$1	$144.1K
J3111	3	10	11,130	$10	$101.3K
J0897	27	110	3,030	$20	$95.7K
J1745	1	20	2,470	$30	$87.5K
96413	2	70	100	$80	$22.6K
99214	138	4,110	170	$70	$21.9K
99213	3,201	4,000	100	$50	$10.3K

Showing 1–10 of 41

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
State Of Mississippi - University Of Mississippi Medical Center	MS	General Acute Care Hospital	$0	$507.2M
Anderson Regional Medical Center	MS	General Acute Care Hospital	$0	$32.5M
Anderson Regional Medical Center	MS	Rural Health Clinic/Center	$0	$5.4M
Anderson Regional Medical Center	MS	General Acute Care Hospital	$0	$4.1M
Anderson Physician Alliance, Inc.	MS	Multi-Specialty Clinic/Center	$0	$2.7M
Mitchell Gruich	MS	Pediatrics Physician	$0	$2.3M
Sahdev Saharan	CA	Rheumatology Physician	$1.5M	$674K
State Of Mississippi-university Of Mississippi Medical Center	MS	Family Medicine Physician	$0	$2M
Molly Sullivan	MS	Family Nurse Practitioner	$1.9M	$0
Elizabeth Herrington	MS	Medical Oncology Physician	$1.9M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Central Ms. Planning & Dev. District, Inc.	MS	Case Management Agency	$0	$47.2M
St Dominic-jackson Memorial Hospital	MS	General Acute Care Hospital	$0	$37.1M
Afnb Home Care LLC	MS	In Home Supportive Care Agency	$0	$25.6M
Ms Children's Home Society	MS	Community/Behavioral Health Agency	$0	$19.4M
Mississippi State Department Of Health	MS	Community/Behavioral Health Agency	$0	$14.9M
Ms State Department Of Health	MS	Community/Behavioral Health Agency	$0	$14.5M
Guangzhi Qu	MS	Hematology & Oncology Physician	$9.1M	$0
Mississippi Asthma & Allergy Clinic PA	MS	Allergy & Immunology Physician	$0	$8.2M
Mississippi Methodist Hospital & Rehabilitation Center, Inc.	MS	General Acute Care Hospital	$0	$5.7M
Jerrick Rose	MS	Pediatric Dentistry	$0	$4.6M

Amanda Fowler — 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