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NPI 1275755670 · Las Vegas, NV · Medical Oncology Physician
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Brian Vicuna is a medical oncology physician provider located in Las Vegas, Nevada. This profile covers 70 Medicare and 10 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Brian Vicuna |
| Address | 653 N Town Center Dr Ste 402 |
| City | Las Vegas |
| State | NV |
| ZIP | 89144 |
| Taxonomy | Medical Oncology Physician |
| NPI Enumerated | May 3, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.8M |
| Medicaid | $35.9K |
Medicare-dominant revenue profile: this provider reports $1.8M in lifetime Medicare revenue versus $35.9K in Medicaid, indicating Medicare is the overwhelmingly larger payer relationship for the practice and that the business is effectively Medicare-driven rather than Medicaid-driven. The absolute dollar gap and the mix of high-cost drug codes on the Medicare side point to a payor mix where Medicaid is a minor contributor to total revenue.
High concentration in a few oncology drugs on Medicare: precomputed results show the top 3 Medicare codes account for 70.7% of Medicare revenue, and those codes are J9271, J9144, and J0897. The dollar amounts tied to those codes (J9271 $714K; J9144 $342K; J0897 $121K) signal that a small set of immunotherapy/biologic injectables is the primary revenue driver for this provider on Medicare.
Business and service-line implications — infusion oncology practice: the top Medicare codes are J9271 (pembrolizumab) and J9144 (daratumumab), both high-cost oncology infusions, supported by administration/infusion CPTs such as 96413, 96417, 96365, and G0498 appearing in the claim mix. This pattern indicates the provider operates an office-based infusion/oncology service that delivers immunotherapy and chemotherapy agents and associated in-office infusion care rather than a purely consult-only oncology role.
Medicaid billing skews to evaluation & management visits: Medicaid revenue is concentrated in outpatient E/M codes (99213 $11.8K, 99214 $9.3K, 99204 $3.8K) and the precomputed top-3 share is 69.5% of the provider’s Medicaid revenue. This suggests that Medicaid activity is focused on office visits and follow-up care rather than high-cost drug administration, with smaller Medicaid infusion volumes (e.g., 96365, 96375) contributing modestly.
Competitive standing on Medicare oncology drugs is modest: for the largest Medicare revenue code J9271 the provider ranks #553 of 1841 (69th percentile) and is characterized as "typical, unremarkable volume," while J9144 ranks at the 55th percentile and J0897 at the 80th percentile (both described as typical, unremarkable volume). These ranks indicate the provider is a regular, moderately active participant nationally in administering these agents but not a dominant national leader for any single drug.
High relative E/M intensity on Medicare but lower Medicaid penetration: Medicare E/M codes show elevated national standing for higher-intensity visits — 99214 is at the 94th percentile and labeled "notably above typical national volume," and 99215 is at the 96th percentile and also labeled "notably above typical national volume." By contrast, the same E/M codes on Medicaid are in lower in-state percentiles (99213 38th, 99214 30th) and described as typical, indicating the provider treats more Medicare patients with higher-acuity office visits than Medicaid patients.
Notable statistical outliers in service mix: a few non-drug codes are marked in the source data as "notably above typical" (for example Medicare 99214, 99215, and 96372), signaling heavier-than-typical volumes of moderate-to-high complexity outpatient visits and IV push procedures relative to national peers. These elevated E/M and procedure volumes reflect significant clinic throughput and repeat oncology follow-up activity on the Medicare panel.
Established tenure supports continuity of care: the provider’s NPI was enumerated on 2007-05-03 (~19 years ago), indicating long-standing presence in the market which aligns with a stable infusion and follow-up visit practice pattern reflected in the Medicare-heavy revenue and repeated administration of high-cost oncology agents.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
70 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 17,000 | $40 | $714K |
| J9144 | Injection, daratumumab, 10 mg and hyaluronidase‑fihj | 9,000 | $40 | $342K |
| J0897 | Injection, denosumab, 1 mg | 6,720 | $20 | $121K |
| J1568 | Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg | 1,980 | $30 | $67.3K |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | 32,180 | $1 | $64.4K |
| 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… | 670 | $90 | $61.8K |
| 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… | 420 | $100 | $42.7K |
| 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… | 290 | $140 | $39.2K |
| 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… | 500 | $60 | $30.2K |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 220 | $130 | $28.1K |
Showing 1–10 of 70
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 70 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
70 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J9271 | 12 | 40 | 13,000 | $40 | $625.8K |
| J9144 | 7 | 10 | 9,180 | $40 | $445.4K |
| J1568 | 12 | 10 | 4,470 | $30 | $164.2K |
| J0897 | 15 | 70 | 3,630 | $20 | $94.6K |
| J0881 | 8 | 30 | 17,400 | $1 | $49.5K |
| Q5122 | 8 | 10 | 350 | $90 | $37.7K |
| J2506 | 3 | 10 | 270 | $90 | $27.8K |
| 99233 | 1,114 | 1,150 | 150 | $90 | $26.8K |
| J9217 | 10 | 40 | 120 | $130 | $23.9K |
| 96413 | 10 | 70 | 210 | $100 | $23.7K |
Showing 1–10 of 70
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
10 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 190 | $60 | $11.8K |
| 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… | 100 | $90 | $9.3K |
| 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… | 30 | $150 | $3.8K |
| 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. | 60 | $60 | $3.7K |
| 96375 | Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the… | 80 | $30 | $2.5K |
| 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… | 20 | $120 | $1.8K |
| 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… | 230 | $10 | $1.6K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 90 | $10 | $880 |
| 96372 | A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician… | 20 | $20 | $340 |
| 83615 | The lab analyst measures the lactate dehydrogenase, typically in a serum sample. Lactate dehydrogenase is found in many body tissues, especially in the liver, kidney, and heart, and also in red blood… | 20 | $10 | $100 |
How this provider's Medicaid billing volume and revenue compare to other Nevada providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Nevada median
10 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 19 | 20 | 240 | $90 | $189.3K |
| 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… | 1,563 | 2,250 | 290 | $60 | $138K |
| 96375 | Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the… | 59 | 70 | 2,110 | $10 | $114.5K |
| 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… | 1,523 | 2,480 | 330 | $50 | $107.6K |
| 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. | 52 | 60 | 2,150 | $20 | $93.7K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 102 | 130 | 1,600 | $1 | $74.9K |
| 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… | 615 | 780 | 90 | $100 | $46.6K |
| 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… | 103 | 160 | 1,190 | $1 | $39.8K |
| 96372 | A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician… | 323 | 360 | 190 | $10 | $26.9K |
| 83615 | The lab analyst measures the lactate dehydrogenase, typically in a serum sample. Lactate dehydrogenase is found in many body tissues, especially in the liver, kidney, and heart, and also in red blood… | 24 | 30 | 220 | $1 | $6.4K |
Other providers in the same ZIP code as Brian Vicuna, ranked by combined Medicare and Medicaid revenue.
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