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

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

Mark Fleming (NPI 1457383663)

Field	Value
Entity Type	Individual
Organization	Mark Fleming
Address	3000 Coliseum Dr
City	Hampton
State	VA
ZIP	23666
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	July 7, 2006

Payer Source	Total Paid
Medicare	$3.9M
Medicaid	$0

Key Findings

This provider is effectively single‑payer: Total Medicare revenue is $3.9M while Total Medicaid revenue is none (no Medicaid billing on file), so Medicare entirely dominates reported public‑program activity. Analyses of utilization and financial exposure should therefore focus on Medicare fee‑for‑service patterns rather than a dual‑payer mix.

Revenue is highly concentrated in a small set of immunotherapy and oncology drug codes — the precomputed top 3 Medicare codes account for 82.5% of this provider's total Medicare revenue. In particular, J9271 accounts for $2.4M (62.9% of Medicare revenue) and J9299 contributes $628.3K (16.7%); this concentration implies that a few high‑cost drug lines drive the majority of income.

The code mix indicates an infusion‑centric oncology practice: J9271 (pembrolizumab) and J9299 (nivolumab) are the primary revenue drivers, supported by chemotherapy administration codes such as 96413 ($75.3K) and add‑on/infusion codes like 96417 ($7.3K) and 96375 ($12.2K). Additional supportive biologics and growth‑factor billing (J2506 pegfilgrastim $71.6K; Q5122 biosimilar $45.8K) further support an active chemotherapy/immunotherapy service line with in‑office infusion capability.

Competitive standing is uneven across products: for J9271 the provider ranks #10 of 1841 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code), marking them as a national outlier and a major deliverer of pembrolizumab. By contrast, J9299 ranks #88 of 505 providers nationally (83th percentile; typical, unremarkable volume for this code), indicating more ordinary participation in nivolumab relative to peers.

Several additional oncology codes show unusually high relative volume, reinforcing specialization: 99214 (1.1K claims, $107.6K) ranks #8079 of 479517 providers nationally (98th percentile; extreme outlier, far above typical national volume for this code), J9217 (578 claims, $77.5K) ranks #43 of 3683 (99th percentile; extreme outlier, far above typical national volume for this code), and J9171 (11.1K claims, $11.1K) ranks #5 of 207 providers nationally (98th percentile; extreme outlier, far above typical national volume for this code). These ranks point to both high clinical throughput and deep engagement with multiple oncology therapeutics compared with national peers.

The provider maintains a steady stream of evaluation‑and‑management visits consistent with active longitudinal oncology care: 99214 (1.1K claims, $107.6K), 99213 (690 claims, $44.9K), and 99215 (263 claims, $35K) all appear in the top codes list and hold high percentile ranks. High E/M volumes alongside large injectable volumes suggest the practice manages follow‑up, toxicity management, and treatment planning in‑clinic rather than exclusively referring infusions elsewhere.

This NPI has long tenure in the billing file: NPI enumerated (registered) 2006-07-07 (~20 years ago), indicating an established practice presence in Hampton, VA. Longevity paired with the current code mix may reflect sustained oncology service delivery and an embedded referral base.

Because a substantial share of Medicare dollars here is tied to a few high‑cost immunotherapies, the practice faces concentration risk: changes in utilization patterns, clinical guidelines, or reimbursement for J9271 and J9299 could materially affect revenue. Operationally, this profile favors monitoring drug‑specific utilization and payer edits, and evaluating whether infusion capacity, buy‑and‑bill exposure, or contracting leverage is aligned with this narrow revenue base.

Medicare: Complete Services Breakdown

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

80 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	56,400	$40	$2.4M
J9299	Injection, nivolumab, 1 mg	28,560	$20	$628.3K
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…	1,150	$90	$107.6K
J0897	Injection, denosumab, 1 mg	4,800	$20	$86.4K
J9217	Leuprolide acetate (for depot suspension), 7.5 mg	580	$130	$77.5K
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…	760	$100	$75.3K
J2506	Injection, pegfilgrastim, excludes biosimilar, 0.5 mg	850	$80	$71.6K
Q5122	Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg	550	$80	$45.8K
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…	690	$70	$44.9K
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…	260	$130	$35K

Showing 1–10 of 80

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 80 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Virginia Distribution

Mark Fleming — 14 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. state median

80 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	1	110	12,800	$40	$610.9K
J9299	2	30	12,920	$20	$335.4K
J0897	101	340	2,820	$20	$89.3K
J0881	19	80	10,200	$1	$34.5K
88185	40	60	620	$20	$34.3K
Q5122	3	40	270	$90	$32.5K
J2506	2	40	360	$80	$31.2K
96413	9	230	250	$100	$28.5K
J9217	4	130	140	$130	$23.9K
99214	308	12,890	140	$80	$21K

Showing 1–10 of 80

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Virginia Oncology Associates	VA	Hematology & Oncology Physician	$0	$6.2M
Maryland Oncology Hematology P.A.	MD	Hematology & Oncology Physician	$0	$4.6M
Victor Archie	VA	Radiation Oncology Physician	$4M	$0
Julia Schaefer-cutillo	NC	Hematology & Oncology Physician	$4M	$0
Thomas Alberico	VA	Hematology & Oncology Physician	$3.5M	$0
David Kobulnicky	VA	Hematology & Oncology Physician	$3M	$0
Celesteann Bremer	VA	Hematology & Oncology Physician	$2.8M	$0
Bo Zhao	VA	Hematology & Oncology Physician	$2.6M	$0
Michael Lee	VA	Specialist	$2.3M	$0
Ligeng Tian	VA	Hematology & Oncology Physician	$2.2M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hampton Newport News Community Services Board	VA	Community/Behavioral Health Agency	$0	$123.8M
Sentara Hospitals	VA	General Acute Care Hospital	$0	$78.5M
Serenity C & C Inc.	VA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$74.2M
Agape Counseling & Therapeutic Services, Inc	VA	Community/Behavioral Health Agency	$0	$18.5M
Alliance Behavioral Counseling	VA	Community/Behavioral Health Agency	$0	$16.9M
Hampton Mental Health Associates, Inc	VA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$12M
United And Empowered Care, Inc	VA	Developmentally Disabled Services Day Training Agency	$0	$11.8M
Better Life Services, Inc.	VA	Community/Behavioral Health Agency	$0	$9.2M
Creating Scholars Through Therapy, LLC	VA	Community/Behavioral Health Agency	$0	$7.6M
Key Elements Care, LLC	VA	In Home Supportive Care Agency	$0	$6.8M

Mark Fleming — 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