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

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

John Winters (NPI 1366648693)

Field	Value
Entity Type	Individual
Organization	John Winters
Address	11 Rock Row Ste 120
City	Westbrook
State	ME
ZIP	04092
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	June 24, 2007

Payer Source	Total Paid
Medicare	$1.5M
Medicaid	$0

Key Findings

This provider is a Hematology & Oncology Physician based in WESTBROOK, ME and has an NPI enumerated on 2007-06-24 (~19 years ago), indicating long-standing Medicare participation and stable tenure in clinical practice. The specialty designation and long enumeration window support interpretation of an established oncology-focused practice rather than a recent or transient billing pattern.

The provider’s payer mix is effectively single-payer Medicare: lifetime Medicare revenue is $1.5M while Medicaid revenue is none on file, so analysts should treat this profile as Medicare-dominated when modeling revenue exposure, payer negotiations, or access implications. The absence of Medicaid billing means limited state-program exposure and greater sensitivity to Medicare policy or commercial contract shifts.

Revenue is highly concentrated in a small set of services: the precomputed top 3 codes by revenue account for 75.1% of this provider’s total Medicare revenue. The three highest-revenue codes are J9144 ($731.9K, 48.4%), J1569 ($302.4K, 20.0%), and 99214 ($100.5K, 6.6%), showing the practice’s income is dominated by a few high-volume/high-value items.

The code mix indicates an infusion- and drug-administration–centric oncology practice: J9144 (daratumumab) and J1569 (immune globulin) are the two largest revenue drivers, consistent with routine administration of high-cost biologic infusions in-office or in an infusion suite. Supportive and adjunctive therapy codes such as J0881 (darbepoetin alfa, $86.6K, 5.7%) and J1439 (ferric carboxymaltose, $60K, 4.0%) further signal ongoing management of anemia and iron deficiency common in oncology care.

Competitive standing is mixed by service line: for drug administration the provider is a strong national participant—J9144 ranks #53 of 615 providers nationally (92th percentile; typical, unremarkable volume) and J1569 ranks #69 of 542 (87th percentile; typical, unremarkable volume)—indicating above-average but not dominant positioning for those biologics. By contrast, E/M volume is an outlier: 99214 ranks #8902 of 479517 providers nationally (98th percentile; extreme outlier, far above typical national volume), suggesting unusually high office-visit billing intensity compared with peer clinicians.

Utilization patterns extend beyond infusion drugs to frequent lab and administration services that support ongoing oncology care: key ancillary services include 36415 (venipuncture) with 1.7K claims and rank #1158 of 86467 (99th percentile; typical, unremarkable volume), 85025 (CBC) with 1.9K claims and rank #1096 of 32833 (97th percentile; typical, unremarkable volume), and infusion administration codes such as 96365 ($15.1K, rank #930 of 8873, 89th percentile; typical, unremarkable volume). These high-percentile ancillary codes are consistent with a high-throughput infusion and monitoring workflow.

From a business-risk perspective, the practice’s dependence on a handful of high-revenue injectable therapies creates revenue sensitivity to changes in utilization, drug pricing, or reimbursement for those specific J-codes. Coupled with no Medicaid billing on file, payers and analysts should note concentration risk on Medicare-covered infusion treatments and the provider’s operational reliance on in-office administration and frequent follow-up visits.

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
J9144	Injection, daratumumab, 10 mg and hyaluronidase‑fihj	19,260	$40	$731.9K
J1569	Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg	8,400	$40	$302.4K
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…	1,100	$90	$100.5K
J0881	Injection, darbepoetin alfa, 1 microgram (non-esrd use)	43,300	$1	$86.6K
J1439	Injection, ferric carboxymaltose, 1 mg	60,000	$1	$60K
J1568	Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg	1,330	$30	$43.9K
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…	340	$100	$34.2K
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…	230	$140	$31.3K
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.	310	$50	$15.1K
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…	1,850	$10	$14.8K

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. Maine Distribution

John Winters — 13 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. state median

59 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9144	2	10	21,420	$40	$813.5K
J1569	1	10	3,150	$40	$144.9K
J0881	1	10	15,200	$1	$47K
J1568	1	10	1,330	$30	$43.6K
J1439	2	10	24,750	$1	$32.2K
J3490	1	10	70	$390	$29.1K
96413	5	30	170	$100	$20.6K
99214	3	2,500	70	$70	$7.2K
96401	2	10	80	$50	$6.1K
96365	1	30	90	$50	$5.6K

Showing 1–10 of 59

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Hospital	ME	General Acute Care Hospital	$0	$35.5M
Can Ilyas	ME	Hematology & Oncology Physician	$3.2M	$0
David Benton	ME	Hematology & Oncology Physician	$2.6M	$0
Matthew Dugan	ME	Hematology & Oncology Physician	$1.8M	$0
Maine Center For Cancer Medicine & Blood Disorders, P.A.	ME	Hematology & Oncology Physician	$0	$1.5M
Christian Thomas	ME	Hematology & Oncology Physician	$1.5M	$0
Devon Evans	ME	Hematology & Oncology Physician	$1.5M	$0
Brian Haney	ME	Hematology & Oncology Physician	$1.2M	$0
Yoko Fukuda	NH	Hematology & Oncology Physician	$945K	$0
Jonathan Proulx	NH	Hematology (Internal Medicine) Physician	$725.4K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Creative Works	ME	Developmentally Disabled Services Day Training Agency	$0	$144.1M
Woodfords Family Services	ME	Community/Behavioral Health Agency	$0	$101.5M
Safe Residential Care, LLC	ME	Physical Disabilities Residential Treatment Facility	$0	$94.6M
3rivers, Inc.	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$78.6M
Woodfords Family Services	ME	Community/Behavioral Health Agency	$0	$46.3M
Alliance Case Management	ME	Case Management Agency	$0	$17.8M
Woodfords Family Services	ME	In Home Supportive Care Agency	$0	$11.3M
Woodfords Family Services	ME	Case Management Agency	$0	$9.4M
Mas Medical Staffing Corporation	ME	Home Health Agency	$0	$8.1M
Maine Community Homecare	ME	In Home Supportive Care Agency	$0	$8.1M

John Winters — 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