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

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

Victor Aviles (NPI 1275501645)

Field	Value
Entity Type	Individual
Organization	Victor Aviles
Address	26 Edgerton Dr
City	North Falmouth
State	MA
ZIP	02556
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	March 10, 2006

Payer Source	Total Paid
Medicare	$1.8M
Medicaid	$0

Key Findings

VICTOR AVILES is enumerated as an NPI on 2006-03-10 (~20 years ago) and is credentialed as a Hematology & Oncology Physician; the provider reports a total Medicare revenue of $1.8M and has no Medicaid billing on file, making Medicare the effectively sole public payer in the dataset. This tenure and single-payer footprint suggest an established outpatient oncology practice predominantly serving Medicare beneficiaries.

Revenue is highly concentrated: the precomputed top-3 Medicare codes account for 77.0% of this provider's total Medicare revenue, with J9271 alone representing $1M or 61.6% of Medicare revenue. The top three revenue contributors are J9271, J0897, and 99214, pointing to a small number of drugs and visits driving the bulk of income.

The code mix and top revenue drivers signal an infusion-focused oncology operation: J9271 (pembrolizumab) and J0897 (denosumab) are the two largest drug revenues and supportive medications such as J2506 (pegfilgrastim) and J0885 (epoetin alfa) also appear in the top codes. Presence of chemotherapy administration codes (96413, G0498) alongside drug codes indicates on-site administration of systemic anticancer therapies and related supportive care rather than a strictly consult-only practice.

Competitive standing for the largest drug, J9271, places the provider at rank #244 of 1841 providers nationally (87th percentile; typical, unremarkable volume for this code), and J0897 ranks #1355 of 10057 providers nationally (86th percentile; typical, unremarkable volume for this code). These percentiles indicate above-average national activity for these infusible oncology agents but do not suggest a market-dominant national role.

Office evaluation-and-management activity is elevated relative to national peers: 99214 shows 916 claims for $90.7K (5.4% of Medicare revenue) and ranks #14238 of 479517 providers nationally (97th percentile; notably above typical national volume for this code), while 99213 also ranks in the 97th percentile. High E/M percentiles combined with the infusion codes point to a busy outpatient clinic with substantial follow-up and established-patient visit volume.

Several procedure codes reflect frequent infusion and injection workflows and are statistical outliers in national comparisons: 96372 (675 claims) ranks #944 of 58224 providers (98th percentile; notably above typical national volume) and 96360 (235 claims) ranks #58 of 2672 providers (98th percentile; notably above typical national volume). These "notably above typical" labels align with an operational profile that routinely performs injections, IV pushes, and infusion setup in-office.

Ancillary in-office services support the infusion model: routine lab and access codes such as 85025 (1.5K claims, $11.9K), 36415 (1.1K claims, $8.7K) and 36591 (127 claims, $2.8K) indicate on-site blood draws and port/line management tied to chemotherapy delivery. The combination of these low-revenue, high-count diagnostic and access codes with high-cost drug codes is consistent with an integrated infusion clinic workflow.

Payer concentration risk is notable because the provider reports no Medicaid billing on file; with $1.8M in Medicare revenue and no recorded Medicaid revenue, reimbursement exposure and negotiating leverage will be driven almost entirely by Medicare payment dynamics and commercial arrangements not visible in this dataset. Analysts should treat this profile as a Medicare-centric practice when considering network contracting or utilization benchmarking.

Medicare: Complete Services Breakdown

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

43 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	24,200	$40	$1M
J0897	Injection, denosumab, 1 mg	8,940	$20	$169.9K
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…	920	$100	$90.7K
J2506	Injection, pegfilgrastim, excludes biosimilar, 0.5 mg	900	$80	$73.8K
J0885	Injection, epoetin alfa, (for non-esrd use), 1000 units	11,460	$10	$68.8K
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…	720	$70	$49K
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…	410	$110	$45.4K
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…	200	$150	$29K
J9217	Leuprolide acetate (for depot suspension), 7.5 mg	110	$130	$14.1K
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.	250	$50	$13.6K

Showing 1–10 of 43

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 43 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Massachusetts Distribution

Victor Aviles — 13 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. state median

43 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	1	10	6,400	$40	$471K
J0897	12	110	2,880	$20	$81.9K
J2506	1	10	900	$80	$73.7K
J0885	2	10	10,240	$10	$39.8K
J9217	35	60	120	$130	$18.1K
96413	3	60	120	$110	$17.6K
99214	264	15,410	110	$80	$15.6K
96401	19	20	140	$60	$15.2K
Q0138	1	20	14,280	$1	$11.7K
G0498	1	10	50	$220	$11.3K

Showing 1–10 of 43

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Falmouth Hospital Association Inc	MA	General Acute Care Hospital	$0	$25.4M
Glen Gejerman	NJ	Radiation Oncology Physician	$6.5M	$0
Bhavesh Balar	NJ	Hematology & Oncology Physician	$4.2M	$0
Richard Lim	RI	Internal Medicine Physician	$52.2K	$3.4M
Kenneth Nahum	NJ	Hematology & Oncology Physician	$3.2M	$0
Frederick Smith	MD	Medical Oncology Physician	$2.7M	$0
May Abdo-matkiwsky	NJ	Hematology & Oncology Physician	$2.6M	$0
Denis Fitzgerald	NJ	Hematology & Oncology Physician	$2.3M	$0
Gurpreet Lamba	VT	Hematology & Oncology Physician	$2.2M	$0
Jeffrey Silberberg	NJ	Hematology & Oncology Physician	$2M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kavitha Reddy	MA	Dermatology Physician	$868K	$0
Mark Liska	MA	Dermatology Physician	$357.6K	$0
Kerri Liska	MA	Physician Assistant	$265.8K	$0
James Wrede	MA	Neuromusculoskeletal Medicine & OMM Physician	$204.3K	$0
Michael Leahy	MA	Neurology Physician	$57.4K	$11.8K

Victor Aviles — Billing Profile & Reimbursement Data

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Victor Aviles — 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