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NPI 1376552745 · Las Vegas, NV · Hematology & Oncology Physician
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Anuradha Thummala is a hematology & oncology physician provider located in Las Vegas, Nevada. This profile covers 100 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 | Anuradha Thummala |
| Address | 7445 Peak Dr |
| City | Las Vegas |
| State | NV |
| ZIP | 89128 |
| Taxonomy | Hematology & Oncology Physician |
| NPI Enumerated | August 5, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.7M |
| Medicaid | $38.5K |
This provider’s revenue is overwhelmingly Medicare-driven: total Medicare revenue is $2.7M versus total Medicaid revenue of $38.5K, indicating Medicare is the dominant payer in dollar terms and the practice is effectively single‑payer in scale. Medicaid activity exists but is a small fraction of overall billing, so payer-strategy and contract negotiations will be largely about Medicare exposure.
Medicare revenue is highly concentrated in a small set of oncology biologics and infusion services — the top three Medicare codes (J9271, J1930, J9144) account for 54.7% of the provider’s Medicare revenue. Those codes correspond to pembrolizumab, lanreotide, and daratumumab, which together point to a practice focused on high-cost immunotherapy/oncologic biologic administration rather than primarily office-only management.
Medicaid billing is even more concentrated: the top three Medicaid codes (99213, 99214, 96413) account for 80.5% of Medicaid revenue, with the Medicaid mix dominated by office evaluation & management (99213/99214) and some chemotherapy administration (96413). This pattern suggests the provider’s Medicaid population generates mostly E/M visits and a smaller proportion of procedural infusion revenue, consistent with limited Medicaid infusion volume relative to Medicare.
Competitive standing by code shows a mixed picture nationally: for Medicare, the largest single revenue driver J9271 ($834.3K, 33.8% of Medicare revenue) ranks #428 of 1841 providers nationally (77th percentile; typical, unremarkable volume for this code), and J1930 ($263.2K, 10.7%) ranks #23 of 56 (60th percentile; typical, unremarkable volume). At the same time, office E/M code 99214 on Medicare is an outlier: it accounts for $136.6K (5.5% of Medicare revenue) and ranks #3972 of 479,517 providers nationally (99th percentile; extreme outlier, far above typical national volume), indicating unusually high E/M volume compared with peers.
Within Medicare service lines the provider shows operational capacity for infusion and related monitoring: multiple high-revenue J‑codes (J9271, J9144, J1930, J1568) plus chemotherapy administration codes (96413, 96417, 96365) and labs (85025, 80053, 82728) appear in the top CPT list. The presence of PET/CT imaging codes 78815 and 78816 among top revenue items further indicates active diagnostic/staging activity either on-site or tightly coordinated with imaging partners, consistent with a full-service oncology practice model.
Several utilization signals stand out as notably above typical: J0881 (55.5K claims, $110.9K Medicare revenue) ranks in the 96th percentile and is labeled "notably above typical national volume for this code," and infusion/injection support code 96372 (902 claims, $9.9K Medicare revenue) ranks in the 99th percentile and is labeled an "extreme outlier, far above typical national volume for this code." These high-volume administration codes suggest substantial throughput of injectable therapies and procedural activity relative to national peers.
On the Medicaid side the provider’s market position appears modest in-state: 99213 ($13.2K, 34.1% of Medicaid revenue) ranks #1463 of 2476 providers in-state (41th percentile; typical, unremarkable volume) and 99214 ($13K, 33.7%) ranks #1444 of 2254 in-state (36th percentile; typical, unremarkable volume). The in-state rankings indicate the provider is not a dominant Medicaid oncology/E/M provider in Nevada, with most Medicaid activity clustered in routine E/M visits rather than high-volume specialty infusion.
The provider has long tenure in Medicare/Medicaid billing, with NPI enumeration on 2006-08-05 (~20 years ago), indicating sustained participation in federal programs and an established billing history that supports the observed specialization in oncology infusion services and related diagnostic and lab monitoring activity.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
100 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 19,400 | $40 | $834.3K |
| J1930 | Injection, lanreotide, 1 mg | 6,120 | $40 | $263.2K |
| J9144 | Injection, daratumumab, 10 mg and hyaluronidase‑fihj | 7,200 | $40 | $252K |
| J0897 | Injection, denosumab, 1 mg | 10,320 | $20 | $196.1K |
| 78815 | PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.… | 150 | $1,270 | $184.7K |
| 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… | 1,450 | $90 | $136.6K |
| J1568 | Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg | 3,420 | $30 | $116.3K |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | 55,460 | $1 | $110.9K |
| 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… | 620 | $100 | $64.1K |
| Q5122 | Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg | 600 | $90 | $54K |
Showing 1–10 of 100
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 100 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
100 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J9271 | 9 | 40 | 13,000 | $40 | $625.8K |
| J9144 | 11 | 10 | 9,180 | $40 | $445.4K |
| J1930 | 1 | 10 | 5,820 | $40 | $255K |
| J1568 | 10 | 10 | 4,470 | $30 | $164.2K |
| J0897 | 8 | 70 | 3,630 | $20 | $94.6K |
| 78815 | 12 | 60 | 60 | $930 | $80.4K |
| J0881 | 1 | 30 | 17,400 | $1 | $49.5K |
| 82306 | 16 | 30 | 80 | $30 | $41.9K |
| Q5122 | 2 | 10 | 350 | $90 | $37.7K |
| J1439 | 3 | 10 | 24,000 | $1 | $27.7K |
Showing 1–10 of 100
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… | 210 | $60 | $13.2K |
| 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… | 140 | $90 | $13K |
| 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… | 40 | $120 | $4.9K |
| 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… | 70 | $40 | $2.5K |
| 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… | 300 | $10 | $2.1K |
| 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. | 120 | $10 | $1.2K |
| 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… | 40 | $20 | $820 |
| 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. | 10 | $60 | $770 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 60 | $1 | $120 |
| 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… | 10 | $10 | $80 |
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… | 15 | 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… | 1,444 | 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… | 61 | 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… | 1,463 | 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. | 59 | 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. | 97 | 130 | 1,600 | $1 | $74.9K |
| 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… | 100 | 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… | 275 | 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… | 26 | 30 | 220 | $1 | $6.4K |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 102 | 150 | 180 | $1 | $1.4K |
Other providers in the same ZIP code as Anuradha Thummala, ranked by combined Medicare and Medicaid revenue.
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