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.

Matthew Dugan (NPI 1386614295)

Field	Value
Entity Type	Individual
Organization	Matthew Dugan
Address	11 Rock Row Ste 120
City	Westbrook
State	ME
ZIP	04092
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	January 24, 2006

Payer Source	Total Paid
Medicare	$1.8M
Medicaid	$0

Key Findings

MATTHEW DUGAN is a Hematology & Oncology Physician with total Medicare revenue of $1.8M and no Medicaid billing on file (none). His NPI was enumerated 2006-01-24 (~20 years ago), indicating long-standing enrollment in Medicare and an effectively single-payer Medicare practice footprint based on the available claims data.

Revenue is highly concentrated: the precomputed top 3 Medicare codes (J9299, J9271, J0897) account for 83.2% of this provider's total Medicare revenue. Those three codes individually are reported as $706.6K revenue (40.0%) for J9299, $640.7K revenue (36.3%) for J9271, and $123.1K revenue (7.0%) for J0897, signaling that a small set of high-cost injectable agents drives the bulk of billings.

The code mix points to an infusion-centered oncology practice focused on high-cost immunotherapies and supportive bone agents: J9299 (nivolumab) and J9271 (pembrolizumab) dominate revenue, while J0897 (denosumab) and other injectable/supportive codes such as J0881 and J1439 appear in the top line. Chemotherapy administration and add-on chemotherapy codes (for example 96413, 96417, 96411, 96415) are present as well, indicating active in-office chemotherapy and related infusion services alongside immunotherapy.

National competitive standing is mixed by code: J9299 is relatively prominent (ranks #76 of 505 nationally, 85th percentile; the dataset labels this as typical, unremarkable volume for this code), J9271 is a mid-tier volume (ranks #701 of 1841, 62th percentile; typical, unremarkable volume), and J0897 is high in national rank but still described as typical (ranks #1948 of 10057, 80th percentile; typical, unremarkable volume). In short, the practice shows above-average national activity on certain oncology injectables while otherwise matching expected volumes for many codes.

Evaluation-and-management and in-office testing volumes are notable relative to national peers: 99214 generates $66.2K (3.7% of Medicare revenue) and ranks #25885 of 479517 nationally (95th percentile; notably above typical national volume), while lab and phlebotomy codes such as 80053 ($9.3K revenue, ranks #1651 of 26416, 94th percentile), 85025 ($7.7K, ranks #2466 of 32833, 92th percentile), and 36415 ($5.1K, ranks #6535 of 86467, 92th percentile) are also high by percentile. These patterns suggest frequent office-based visits with onsite laboratory/phlebotomy capacity supporting the infusion practice.

Several high-claim but low-paid supply/drug lines appear in the top codes, which points to frequent, small-reimbursement dosing events: J0881 shows 21.5K claims at $2 avg paid/claim for $43K revenue (2.4% of Medicare revenue) and J1439 shows 23.3K claims at $1 avg paid/claim for $23.3K revenue (1.3%). This mix (many low-paid supply claims alongside a small number of very high-revenue immunotherapy claims) is consistent with infusion clinics that bill both high-cost biologics and routine supportive agents.

From a payer-mix and risk perspective, the absence of Medicaid billing (none) combined with $1.8M in Medicare revenue means the practice is effectively single-payer in the available public claims, concentrating reimbursement exposure in Medicare. That concentration could matter for contracting and reimbursement sensitivity assessments, since the dataset shows little to no Medicaid revenue to diversify public-payer exposure.

Tenure and operational implication: with an NPI enumerated 2006-01-24 (~20 years ago) and sustained billing for complex oncology injectables and infusion services, the provider appears to operate an established oncology infusion and outpatient management practice. The combination of long enrollment and concentrated immunotherapy revenue suggests a stable, specialized service line rather than a recent or transient billing pattern.

Medicare: Complete Services Breakdown

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

57 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9299	Injection, nivolumab, 1 mg	30,720	$20	$706.6K
J9271	Injection, pembrolizumab, 1 mg	14,900	$40	$640.7K
J0897	Injection, denosumab, 1 mg	6,840	$20	$123.1K
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…	700	$90	$66.2K
J0881	Injection, darbepoetin alfa, 1 microgram (non-esrd use)	21,500	$1	$43K
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…	400	$100	$40.1K
J1454	Injection, fosnetupitant 235 mg and palonosetron 0.25 mg	70	$350	$24.1K
J1439	Injection, ferric carboxymaltose, 1 mg	23,250	$1	$23.3K
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…	140	$140	$18.5K
G0498	Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community…	50	$210	$11.1K

Showing 1–10 of 57

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 57 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Maine Distribution

Matthew Dugan — 6 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

57 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	5	10	16,450	$40	$699.2K
J9299	2	10	30,720	$20	$671.3K
J0897	4	20	2,730	$20	$86.4K
J0881	2	10	15,200	$1	$47K
J1439	6	10	24,750	$1	$32.2K
J3490	2	10	70	$390	$29.1K
96413	3	30	170	$100	$20.6K
J1454	2	10	60	$340	$18.3K
G0498	2	10	60	$210	$11.6K
99214	14	2,500	70	$70	$7.2K

Showing 1–10 of 57

Related Providers

Other providers that share a Tax Identification Number (TIN) with Matthew Dugan, 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
John Winters	ME	Hematology & Oncology Physician	$1.5M	$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
Philip Russell	ME	Psychiatry Physician	$14.5K	$720.3K

Nearby Providers

Other providers in the same ZIP code as Matthew Dugan, 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

Matthew Dugan — 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