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

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

David Smith (NPI 1386641082)

Field	Value
Entity Type	Individual
Organization	David Smith
Address	8221 Teal Dr
City	Easton
State	MD
ZIP	21601
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	July 7, 2005

Payer Source	Total Paid
Medicare	$6.4M
Medicaid	$0

Key Findings

This provider has $6.4M in total Medicare revenue on file and no Medicaid billing, making its public payer footprint effectively single‑payer (Medicare only). The NPI was enumerated on 2005-07-07 (~21 years ago), indicating a long tenure in the Medicare program that supports an established outpatient practice profile.

Revenue is highly concentrated in a small set of therapeutics: J9271 ($2.3M, 35.6%), J9299 ($1.3M, 19.7%), and J9144 ($1.2M, 19.4%) together account for 74.6% of the provider’s Medicare revenue. That precomputed concentration implies the business is driven by a few high-revenue oncology drugs rather than a broad mix of low‑revenue services.

The CPT/HCPCS mix identifies this operation as an infusion‑based hematology/oncology practice: top codes are J9271 (pembrolizumab), J9299 (nivolumab), and J9144 (daratumumab), all high‑use monoclonal antibody/immunotherapy injections, supplemented by chemotherapy administration codes like 96413 and 96401. Supportive care and ancillary oncology medications also appear frequently (for example, J0897 denosumab, J2506 pegfilgrastim, J0881 darbepoetin alfa, and J1439 ferric carboxymaltose), which is consistent with an in‑office infusion suite that manages both oncologic and supportive infusions.

On competitive standing the provider ranks as a major national outlier for its top biologic drugs: J9271 ranks #15 of 1841 (99th percentile; extreme outlier), J9299 ranks #9 of 505 (98th percentile; notably above typical national volume), and J9144 ranks #10 of 615 (99th percentile; extreme outlier). Those ranks indicate this clinician is operating at volumes far above the typical national peer for these specific oncology agents, suggesting either a high patient throughput for immunotherapy or a regional referral concentration.

Operationally, several procedure and infusion‑support codes show atypically high volume, pointing to a high‑throughput infusion infrastructure: 96523 (irrigation/flush of venous access) ranks #5 of 1643 (100th percentile; extreme outlier), and 96372 (therapeutic/prophylactic injection) ranks #541 of 58224 (99th percentile; extreme outlier). High counts of administration codes such as 96365 and 96375 further support the presence of sustained infusion activity and ongoing device maintenance needs.

Evaluation-and-management activity is also elevated relative to national peers, indicating substantial ongoing patient management: 99214 shows 1.4K claims and $143.9K revenue and ranks #4362 of 479517 (99th percentile; extreme outlier), while 99213 and 99215 appear with notable volumes and percentiles as well. This mix suggests the practice not only administers high volumes of infusions but also provides regular follow-up visits and care coordination for a complex oncology patient panel.

The provider’s reliance on a handful of expensive oncology drugs and on Medicare as the sole public payer creates specific revenue sensitivity: with 74.6% of Medicare revenue concentrated in the top three codes and no Medicaid billing on record, changes in utilization, drug reimbursement, or Medicare policy affecting these agents would disproportionately affect overall revenue. Analysts and payers should view this profile as high concentration risk tied to specific biologics and to Medicare policy dynamics.

Beyond the top three drugs, other codes flagged as unusually high volume (for example, J1439 ferric carboxymaltose at 172.5K claims and $172.5K revenue, rank #11 of 1209, 99th percentile; and 96523 at the 100th percentile) indicate the practice also delivers high throughput for supportive infusion services and device maintenance. Together, these patterns paint a consistent picture of an established, infusion‑centric hematology/oncology provider with specialized throughput and a narrow set of revenue drivers.

Medicare: Complete Services Breakdown

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

40 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	52,800	$40	$2.3M
J9299	Injection, nivolumab, 1 mg	52,380	$20	$1.3M
J9144	Injection, daratumumab, 10 mg and hyaluronidase‑fihj	32,580	$40	$1.2M
J0897	Injection, denosumab, 1 mg	25,980	$20	$467.6K
J2353	Injection, octreotide, depot form for intramuscular injection, 1 mg	2,050	$160	$330.1K
J1439	Injection, ferric carboxymaltose, 1 mg	172,500	$1	$172.5K
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…	1,410	$100	$143.9K
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…	980	$110	$105.3K
J0881	Injection, darbepoetin alfa, 1 microgram (non-esrd use)	44,250	$1	$88.5K
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…	870	$70	$59.9K

Showing 1–10 of 40

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 40 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Maryland Distribution

David Smith — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. state median

40 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	3	60	15,000	$40	$787.6K
J9299	2	20	24,080	$20	$660.6K
J9144	1	30	11,970	$40	$493.5K
J2353	1	10	2,050	$160	$330.8K
J0897	11	340	3,600	$20	$114.4K
J0881	17	60	30,420	$1	$76.4K
J3490	9	100	70	$450	$62.1K
J2506	11	30	590	$80	$55.2K
J1439	1	40	30,750	$1	$36.2K
96413	5	230	200	$110	$29.6K

Showing 1–10 of 40

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Wilfredo Blasini	FL	Clinical Pathology Physician	$16.9M	$307.9K
Ryan Olson	FL	Anatomic Pathology & Clinical Pathology Physician	$12.8M	$80
American Oncology Partners PA	OH	Hematology & Oncology Physician	$0	$11.8M
Robert Mcdonald	AZ	Diagnostic Radiology Physician	$7.5M	$0
Stephen Divers	AR	Hematology & Oncology Physician	$3.9M	$1.5K
Robert Muldoon	AR	Hematology & Oncology Physician	$3.2M	$0
Bradley Sumrall	GA	Medical Oncology Physician	$3.1M	$0
Linda Hendricks	GA	Specialist	$3.1M	$0
Sue Tsuda	AR	Medical Oncology Physician	$3.1M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
For All Seasons, Inc	MD	Clinical Social Worker	$0	$11.4M
Bay Pediatric Center	MD	Pediatrics Physician	$0	$10.8M
Ydiprmc LLC	MD	Urgent Care Clinic/Center	$0	$8.7M
Elizabeth Clayton	MD	Rheumatology Physician	$7.1M	$0
Bnj Health Services LLC Easton	MD	Substance Use Disorder Rehabilitation Clinic/Center	$0	$6.7M
Eastern Shore Psychological Services LLC	MD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.3M
Shore Health System, Inc	MD	General Acute Care Hospital	$0	$5.3M
Chesapeake Treatment Services LLC	MD	Methadone Clinic	$0	$5.2M
Building Bridges Therapy Services	MD	Occupational Therapist	$0	$4.9M
Channel Marker, Inc.	MD	Rehabilitation Clinic/Center	$0	$4.3M

David Smith — 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