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

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

Sonam Patel (NPI 1306230230)

Field	Value
Entity Type	Individual
Organization	Sonam Patel
Address	1111 Duff Ave
City	Ames
State	IA
ZIP	50010
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	March 28, 2015

Payer Source	Total Paid
Medicare	$1.8M
Medicaid	$0

Key Findings

This provider is effectively single-payer: reported lifetime Medicare revenue is $1.8M and there is no Medicaid billing on file, so all documented public-payer activity is Medicare-based. That concentration means analyses of utilization and financial performance should be interpreted in the context of Medicare-only reimbursement and patient mix.

Revenue is highly concentrated in a small set of Medicare codes: the precomputed top 3 Medicare codes account for 69.4% of this provider's total Medicare revenue. The three are J9271 ($842.8K, 49.2%), J0897 ($181.3K, 10.6%), and 99214 ($165.1K, 9.6%), indicating heavy dependence on these services for overall revenue.

The code mix signals an infusion-centered oncology practice with substantial outpatient management work. J9271 (pembrolizumab) is the single largest revenue driver at $842.8K and, together with infusion/chemotherapy administration codes such as 96413 and 96365 and supportive drugs like J0897 (denosumab) and J1561 (immune globulin), the pattern is consistent with a practice delivering immunotherapy/chemotherapy infusions plus associated supportive care.

Competitive standing is mixed across the top therapies: J9271 (rank #417 of 1841, 77th percentile) and J0897 (rank #1243 of 10057, 88th percentile) are described as typical, unremarkable volumes for those codes despite generating the largest shares of this provider's Medicare revenue. In contrast, the E/M code 99214 (2K claims, $82 avg paid/claim, $165.1K) ranks #1277 of 479517 providers nationally and is labeled an extreme outlier (100th percentile), indicating unusually high office/clinic visit volume relative to national peers.

Several administration and infusion codes are statistically elevated versus peers, suggesting above-typical chemo and injection throughput. Specifically, 96413 (648 claims, $84 avg paid/claim, $54.4K) is flagged as notably above typical national volume (96th percentile), J9070 (575 claims, $9.2K) ranks #8 of 135 providers (95th percentile; notably above typical national volume), and 96372 (668 claims, $6K) is in the 98th percentile and also described as notably above typical national volume. These entries support the characterization of heavier-than-average infusion activity.

Some supportive and lab services are frequently billed and rank high among peers, consistent with in-office monitoring tied to infusion oncology. Codes such as 80053 (1.9K claims, $18.7K; 97th percentile), 85025 (2.1K claims, $17K; 97th percentile), and 36415 (1.6K claims, $13.2K; 99th percentile) appear at high national percentiles while being described as typical, unremarkable volumes, indicating routine but consistently high-volume lab and phlebotomy work accompanying treatment.

The provider's NPI tenure is established but not long-standing relative to some peers: enumerated on 2015-03-28 (~11 years ago). That ~11-year enrollment window combined with the billing profile suggests an established outpatient oncology practice that has built a sustained Medicare patient base and drug/infusion throughput over a multi-year period.

Given the concentration of revenue in a few high-cost oncology drugs and an extreme outlier status for 99214 visits, payers and analysts should prioritize monitoring utilization and reimbursement around high-impact items—J9271, J0897, and 99214—when assessing financial risk, contract negotiations, or network placement for this provider.

Medicare: Complete Services Breakdown

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

81 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	19,600	$40	$842.8K
J0897	Injection, denosumab, 1 mg	9,540	$20	$181.3K
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…	2,010	$80	$165.1K
J1561	Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg	3,810	$40	$148.6K
J0881	Injection, darbepoetin alfa, 1 microgram (non-esrd use)	32,320	$1	$64.6K
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…	650	$80	$54.4K
J2506	Injection, pegfilgrastim, excludes biosimilar, 0.5 mg	530	$90	$47.5K
J1439	Injection, ferric carboxymaltose, 1 mg	39,000	$1	$39K
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…	400	$60	$22.6K
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.	1,870	$10	$18.6K

Showing 1–10 of 81

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 81 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Iowa Distribution

Sonam Patel — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. state median

81 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	10	30	17,200	$40	$902.3K
J1561	3	10	4,150	$40	$170.9K
J0897	19	190	1,920	$20	$74.1K
J0881	2	10	15,520	$1	$43.2K
J1439	8	10	41,250	$1	$39.7K
J2506	6	20	440	$80	$38.9K
96413	5	80	210	$90	$24K
J9217	47	50	140	$130	$23.4K
91322	512	580	80	$140	$15.2K
99214	4	4,690	100	$70	$14.4K

Showing 1–10 of 81

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mcfarland Clinic PC	IA	Multi-Specialty Clinic/Center	$0	$26.7M
Thomas Buroker	IA	Medical Oncology Physician	$9.4M	$0
Kyle Alliman	IA	Ophthalmology Physician	$8.7M	$0
Alex Kartvelishvili	IA	Ophthalmology Physician	$8.1M	$0
Paul Boeke	IA	Ophthalmology Physician	$7.1M	$0
Austin Strohbehn	IA	Retina Specialist (Ophthalmology) Physician	$5.8M	$0
Jeremy Deutsch	KS	Hematology & Oncology Physician	$5.7M	$0
Robert Behrens	IA	Medical Oncology Physician	$5.2M	$0
Matthew Mcknight	IA	Foot & Ankle Surgery Podiatrist	$4.7M	$23.5K
James Singer	IA	Retina Specialist (Ophthalmology) Physician	$4.1M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mainstream Living, Inc.	IA	Social Worker	$0	$134.3M
Youth And Shelter Services, Inc.	IA	Counselor	$0	$11.4M
Mary Greeley Medical Center	IA	General Acute Care Hospital	$0	$9.1M
Mary Greeley Medical Center	IA	Land Ambulance	$0	$4.4M
Venkatesh Rudrapatna	IA	Hematology & Oncology Physician	$3.4M	$0
Sreenath Kodali	IA	Hematology & Oncology Physician	$3.2M	$0
The Richmond Center	IA	Mental Health Counselor	$0	$2.4M
Joseph Merchant	IA	Hematology & Oncology Physician	$1.8M	$0
Tracy Kangas	IA	Ophthalmology Physician	$1.1M	$0
Steven Anderson	IA	Ophthalmology Physician	$755.9K	$0

Sonam Patel — 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