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

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

Joseph Jones (NPI 1316092109)

Field	Value
Entity Type	Individual
Organization	Joseph Jones
Address	29653 Anchor Cross Blvd
City	Daphne
State	AL
ZIP	36526
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	January 24, 2007

Payer Source	Total Paid
Medicare	$1.6M
Medicaid	$0

Key Findings

This provider is effectively a single-payer Medicare practice with Total Medicare revenue of $1.6M and no Medicaid billing on file; analysts should treat Medicaid as absent when assessing local payer mix and network leverage. The absence of Medicaid activity indicates patient population and contracting are largely Medicare-focused rather than dual-covered.

Revenue concentration is highly focused: the precomputed top 3 Medicare codes account for 81.0% of the provider's total Medicare revenue, indicating a narrow set of high-value services drive the practice's income. That concentration suggests the business is dependent on a few infused or injectable oncology agents rather than a broad mix of outpatient E/M or ancillary services.

The dominant revenue driver is J9271 (pembrolizumab) with $920.2K revenue, representing 60.6% of Medicare revenue; this single biologic accounts for the majority of billings and positions the practice as an infusion-centric oncology provider. J0897 (denosumab) and Q5119 (rituximab biosimilar) provide the next-largest shares ($250.6K and $58.6K respectively) and together with J9271 make up the precomputed top-three share, reinforcing a drug/infusion-heavy revenue model.

Clinical mix and service-line inference: the prevalence of high-volume injectable oncology codes (J9271, J0897, Q5119) alongside chemotherapy administration codes (96413, 96401, 96365, 96367, 96417) and office E/M visits (99213, 99214) indicates the provider operates an outpatient oncology infusion clinic that delivers systemic cancer therapies and associated clinic visits and monitoring. The presence of lab codes (85025, 80053, , ) and frequent venipuncture () supports on-site lab monitoring typical of medical oncology practice.

Competitive standing for core drugs is mixed: for J9271 the provider ranks #328 of 1841 (82th percentile) which is characterized in the file as "typical, unremarkable volume," indicating the provider is a modest but not dominant national participant for pembrolizumab. For J0897 the provider ranks #616 of 10057 (94th percentile) which is high relative volume nationally for denosumab; the data label is still "typical, unremarkable volume," but the percentile indicates comparatively strong activity for that agent versus peers. Q5119 ranks #71 of 335 (78th percentile), a solid but not leading position for that biosimilar.

Procedure-level outliers and notable volumes: several common support services show elevated national position labels — 99213 ranks in the 96th percentile and is described as "notably above typical national volume," and both 36415 and 85025 blood-draw/CBC codes rank in the high 90s percentile range with labels of "typical, unremarkable volume," suggesting high throughput of basic clinic monitoring consistent with frequent infusions. Additionally, codes for subcutaneous/hormonal chemotherapy administration (96402) and injection services (96372) are described as "notably above typical national volume," indicating above-average utilization of these specific administration routes relative to peers.

Tenure and credentialing stability: the provider's NPI was enumerated on 2007-01-24 (approximately 19 years ago), indicating long-standing credentialing in the Medicare program which supports continuity of relationships with payers and referral sources. This longevity, combined with a concentrated infusion-based revenue stream, suggests an established clinical practice rather than a recent start-up.

Operational risk considerations for payers: given the high concentration of revenue in a few expensive injectable oncology agents (J9271 at 60.6% and top-three concentration of 81.0%), reimbursement policy changes, biosimilar uptake, or shifts in drug utilization could materially affect the provider's revenue. Payers should monitor utilization trends for pembrolizumab, denosumab, and rituximab biosimilars in this clinician's claims to anticipate financial or network impacts.

Medicare: Complete Services Breakdown

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

59 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	21,400	$40	$920.2K
J0897	Injection, denosumab, 1 mg	13,920	$20	$250.6K
Q5119	Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg	2,930	$20	$58.6K
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…	480	$90	$41.4K
Q5106	Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units	6,730	$10	$40.4K
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…	430	$90	$36.2K
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…	590	$60	$33.7K
J9217	Leuprolide acetate (for depot suspension), 7.5 mg	120	$130	$16.1K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	1,590	$10	$12.7K
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…	1,510	$10	$12.1K

Showing 1–10 of 59

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 59 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Alabama Distribution

Joseph Jones — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. state median

59 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	11	30	19,900	$40	$827.2K
J0897	15	200	3,120	$20	$97.7K
Q5119	2	10	2,280	$20	$55.9K
83521	3	10	40	$20	$26K
Q5106	2	10	2,650	$10	$23.6K
J9217	30	50	130	$130	$22.4K
96413	22	150	150	$90	$20.2K
99214	1,049	7,330	120	$80	$16.8K
80053	41	670	140	$10	$13.1K
82784	14	40	230	$10	$12.9K

Showing 1–10 of 59

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Cookeville Regional Medical Center	TN	General Acute Care Hospital	$0	$17.1M
Ali Hachem	AL	Hematology & Oncology Physician	$2.3M	$0
Brian Heller	AL	Hematology & Oncology Physician	$2.3M	$0
William Mcevoy	AL	Hematology & Oncology Physician	$1.7M	$0
The Cookeville Surgery Center	TN	Ambulatory Surgical Clinic/Center	$24.7K	$1.6M
Michael Meshad	AL	Hematology & Oncology Physician	$1.1M	$0
Jeffrey George	AL	Hematology & Oncology Physician	$1.1M	$0
Rachel Kruspe	AL	Hematology & Oncology Physician	$1M	$0
Nicole Angel	AL	Medical Oncology Physician	$985.3K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eastern Shore Developmental Clinic	AL	Nurse Practitioner	$0	$4M
Daphne Pediatric Dentistry Inc	AL	Pediatric Dentistry	$0	$2M
Kids Kount Therapy Services, LLC	AL	Early Intervention Provider Agency	$0	$1.5M
Autism Behavior And Cognitive Development LLC	AL	Community/Behavioral Health Agency	$0	$1.2M
American Autism & Rehabilitation Center Inc	AL	Occupational Therapist	$0	$862.3K
Rachael Harmon	AL	Radiation Oncology Physician	$729.3K	$0
Brittany Case	AL	Medical Oncology Physician	$727.3K	$0
David Thomason	AL	Physical Medicine & Rehabilitation Physician	$536.1K	$0
Jonathan Rainer	AL	Physical Medicine & Rehabilitation Physician	$418.9K	$0
Alan Stanford	AL	Dermatology Physician	$198K	$0

Joseph Jones — Billing Profile & Reimbursement Data

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Joseph Jones — 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