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

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

Derek Middleton (NPI 1346602679)

Field	Value
Entity Type	Individual
Organization	Derek Middleton
Address	8901 Carti Way
City	Little Rock
State	AR
ZIP	72205
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	March 25, 2016

Payer Source	Total Paid
Medicare	$2.5M
Medicaid	$0

Key Findings

This provider is effectively single-payer in the dataset: total Medicare revenue is $2.5M and there is no Medicaid billing on file, so all observed public-payer activity is Medicare-only. Analysts should treat Medicare as the primary source of volume and revenue when assessing this provider's footprint and contracting risk.

Revenue is highly concentrated in a few high-cost infusion drugs: the precomputed top 3 Medicare codes account for 73.9% of the provider's Medicare revenue, driven by J9271, J9299, and J1437. That concentration indicates the practice’s financial performance is dependent on a small set of drug administrations rather than broad office-based E/M or lab services.

The code mix is consistent with an infusion-focused hematology/oncology practice: J9271 (29K claims, $1.2M revenue) and J9299 (16.1K claims, $385.4K revenue) are immune checkpoint inhibitors, while J1437 (9.9K claims, $168.3K revenue) and multiple chemotherapy administration add-on codes (96413, 96417, 96375) point to regular in-office infusions and chemotherapy delivery. Supportive-care products (J2506, J1569, J0885) and frequent basic labs (80053, 85025, 36415) further reflect integrated infusion plus supportive services rather than a purely consultative practice.

Competitive standing is uneven across specific drugs: for pembrolizumab (J9271) the provider ranks #135 of 1841 nationally (93th percentile) and is a notably above-typical high-volume user, while for nivolumab (J9299) the provider ranks #223 of 505 (56th percentile) which is a typical, unremarkable volume. Ferric derisomaltose (J1437) also shows strong national presence at #30 of 581 (95th percentile), signaling the provider is a major user of certain infusion therapies but only a routine user for some other oncology agents.

Several activity markers are statistical outliers that imply elevated clinical throughput: 96413 (chemotherapy administration) ranks #254 of 7514 (97th percentile) and 96375 ranks #148 of 5191 (97th percentile), both described as notably above typical national volume; additionally, 99215 (established outpatient E/M) is an extreme outlier at #2771 of 145531 (98th percentile). These high-percentile positions suggest both high infusion throughput and a larger-than-typical share of complex outpatient visits.

At the same time, the provider is not a top national user across every supportive drug: J2506 (pegfilgrastim) ranks #452 of 586 (20th percentile) and Q5126 (bevacizumab biosimilar) ranks #26 of 29 (11th percentile), both characterized in the file as typical or unremarkable volume. This mixed profile implies specialization in a subset of high-cost immunotherapies and infusions rather than uniformly high utilization across the full range of oncology drugs.

The presence and rank of inpatient/observation E/M codes show involvement beyond the clinic: 99233 (343 claims, $29.8K revenue) and 99223 (87 claims, $11K revenue) are present and rank at reasonable percentiles, indicating the provider performs subsequent and initial hospital inpatient/observation care in addition to outpatient infusions. Combined with high chemotherapy administration ranks, this suggests a practice that manages both ambulatory infusion and some inpatient oncology workflows.

Tenure data show the NPI was enumerated on 2016-03-25 (~10 years ago), so observed high volumes have been developed by a clinician with nearly a decade of Medicare enrollment. For payers and competitors evaluating market entry or competitive risk, the combination of sustained enrollment and concentrated, high-volume use of checkpoint inhibitors (notably J9271 at $1.2M and 51.2% of Medicare revenue) signals an established infusion-focused oncology presence in Little Rock, AR.

Medicare: Complete Services Breakdown

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

90 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	29,000	$40	$1.2M
J9299	Injection, nivolumab, 1 mg	16,060	$20	$385.4K
J1437	Injection, ferric derisomaltose, 10 mg	9,900	$20	$168.3K
J0897	Injection, denosumab, 1 mg	5,580	$20	$100.4K
Q5126	Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg	1,620	$60	$90.7K
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…	710	$90	$61.5K
J9264	Injection, paclitaxel protein-bound particles, 1 mg	5,800	$10	$58K
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…	430	$120	$53.3K
J1569	Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg	1,350	$40	$48.6K
J0885	Injection, epoetin alfa, (for non-esrd use), 1000 units	6,500	$10	$39K

Showing 1–10 of 90

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 90 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Arkansas Distribution

Derek Middleton — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arkansas

Full comparison — all codes billed, vs. state median

90 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	7	40	20,700	$40	$896.3K
J9299	14	30	15,660	$20	$432.9K
Q5126	6	10	3,210	$60	$174.1K
J1569	9	10	2,560	$40	$120.3K
J1437	4	20	6,450	$20	$107.8K
J9264	11	10	9,300	$10	$96.2K
J0897	48	160	2,580	$20	$89.7K
J2506	5	10	580	$80	$40.4K
J0885	16	40	4,070	$10	$38K
96413	17	80	380	$90	$36.6K

Showing 1–10 of 90

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Central Arkansas Radiation Therapy Institute Inc	AR	Hematology & Oncology Physician	$0	$11M
Central Arkansas Radiation Therapy Institute Inc	AR	Radiation Oncology Physician	$6.7M	$3.6M
Kamal Patel	AR	Hematology & Oncology Physician	$5.7M	$0
Ryan Hall	AR	Hematology & Oncology Physician	$4.6M	$0
Balagopalan Nair	AR	Hematology & Oncology Physician	$4.1M	$0
Lawrence Mendelsohn	AR	Hematology & Oncology Physician	$3.4M	$0
Jamie Burton	AR	Hematology & Oncology Physician	$2.8M	$0
Kewen Jauss	AR	Hematology & Oncology Physician	$2.8M	$0
Mariann Harrington	AR	Hematology & Oncology Physician	$2.7M	$0
Appalanaidu Sasapu	AR	Hematology & Oncology Physician	$2.6M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of Arkansas For Medical Sciences	AR	General Acute Care Hospital	$0	$87.2M
University Of Arkansas For Medical Sciences	AR	Internal Medicine Physician	$0	$28.6M
University Of Arkansas For Medical Sciences	AR	Pediatrics Physician	$0	$27.6M
Arkansas Department Of Health Immunizations	AR	Public Health or Welfare Agency	$0	$19.3M
Baptist Health	AR	General Acute Care Hospital	$0	$16.4M
Arkansas Department Of Health Family Planning Clinic	AR	Public Health or Welfare Agency	$0	$15.6M
Pediatrix Medical Group Of Arkansas PA	AR	Neonatal-Perinatal Medicine Physician	$0	$14.6M
Chenal Family Therapy, Plc	AR	Mental Health Counselor	$0	$12.2M
Francis A. Allen School For Exceptional Children, Inc.	AR	Developmentally Disabled Services Day Training Agency	$0	$11.9M
Arkansas Department Of Health Std	AR	Public Health or Welfare Agency	$0	$8.4M

Derek Middleton — 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