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

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

Ananda Walaliyadda (NPI 1497747703)

Field	Value
Entity Type	Individual
Organization	Ananda Walaliyadda
Address	1448 E Center St
City	Pocatello
State	ID
ZIP	83201
Taxonomy	Specialist
NPI Enumerated	August 22, 2005

Payer Source	Total Paid
Medicare	$3.9M
Medicaid	$0

Key Findings

This provider’s billing is effectively single‑payer: total Medicare revenue is $3.9M and there is no Medicaid billing on file, so Medicare dominates the revenue base and Medicaid does not appear in the payer mix. The provider’s NPI was enumerated 2005-08-22 (~21 years ago), indicating long-standing enrollment that aligns with an established clinical operation.

Revenue is highly concentrated in three biologic infusion codes: J0129 ($1.2M, 29.8%), J3262 ($958.7K, 24.5%), and J1602 ($921.3K, 23.6%), and the precomputed top-3 share is 77.9% of Medicare revenue. This concentration means a large majority of Medicare dollars come from a small set of high-cost injectable/infusion drugs rather than broad E/M or ancillary service lines.

The code mix and descriptions point to an infusion‑centric specialty practice: the top drugs are abatacept (J0129), tocilizumab (J3262), and golimumab (J1602), and the provider also bills high volumes of infusion administration codes such as 96365 (1.2K claims, $53.1K revenue) and chemotherapy/infusion codes like 96413 (518 claims, $48.7K revenue). Together these suggest the provider operates an outpatient infusion service or a specialty clinic that administers biologic/IV therapies rather than a primarily office‑visit based practice.

For competitive standing, the provider is a major national outlier on several top drug codes: J3262 ranks #6 of 618 providers nationally (99th percentile; extreme outlier) and J1602 ranks #6 of 1041 providers nationally (100th percentile; extreme outlier), while J0129 ranks #31 of 1221 (98th percentile; notably above typical national volume). These ranks indicate the provider is functioning at much higher volumes than most peers for specific biologic infusions and is a significant national-level participant for those drugs.

Visit-level and infusion service intensity is also notable: 99215 (448 claims, $54.7K revenue, 1.4%) ranks #2508 of 145531 providers nationally (98th percentile; extreme outlier) and 96365 ranks #72 of 8873 (99th percentile; extreme outlier). High percentile placement for both complex E/M visits and initial IV infusion administration supports the interpretation of frequent, high-acuity outpatient infusion encounters tied to the biologic drug mix.

Ancillary laboratory and routine procedural services are present but represent a small share of revenue: examples include 86481 (73 claims, $7.2K), 80053 (386 claims, $3.9K), and 36415 (462 claims, $3.7K), with most of these lab codes described as typical or unremarkable in national volume. This pattern reinforces that the core business driver is drug administration, with labs and phlebotomy serving a supportive role rather than driving revenue.

Operational and contracting implications follow from the heavy biologic dependence: with 77.9% of Medicare revenue coming from the top three infusion drugs and multiple codes labeled as extreme outliers or notably above typical national volume, the practice’s revenue and capacity are likely sensitive to drug acquisition, payer coverage policies for high‑cost biologics, and infusion throughput. Analysts should expect material exposure to changes in reimbursement or utilization management around these specific J‑codes.

Although the provider is based in POCATELLO, ID, the national‑level high ranks on several infusion drug codes suggest the practice may act as a regional referral or high‑volume infusion site rather than a low‑volume local office. Combined with ~21 years of enrollment, the pattern is consistent with an established specialty infusion operation that attracts a larger-than-typical Medicare infusion caseload relative to most peers.

Medicare: Complete Services Breakdown

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

33 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0129	Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	34,300	$30	$1.2M
J3262	Injection, tocilizumab, 1 mg	191,740	$10	$958.7K
J1602	Injection, golimumab, 1 mg, for intravenous use	92,130	$10	$921.3K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	12,190	$30	$317K
J0717	Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	56,400	$1	$225.6K
J0897	Injection, denosumab, 1 mg	5,280	$20	$95K
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…	450	$120	$54.7K
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.	1,150	$50	$53.1K
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…	520	$90	$48.7K
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…	280	$90	$24K

Showing 1–10 of 33

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 33 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Idaho Distribution

Ananda Walaliyadda — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. state median

33 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	1	10	9,950	$30	$369.8K
J3262	1	10	27,790	$1	$340.8K
J1602	1	10	15,030	$10	$266.6K
J1745	1	10	8,420	$30	$196.9K
J0717	1	10	50,200	$1	$196.2K
J0897	8	30	2,580	$20	$76.2K
96413	3	20	250	$90	$26K
99214	414	2,690	90	$70	$10.4K
83970	12	20	100	$40	$9.1K
96365	1	20	80	$40	$7.4K

Showing 1–10 of 33

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bmh Inc.	ID	Rural Health Clinic/Center	$0	$5.8M
Bmh Inc	ID	Critical Access Hospital	$0	$3.5M
Bmh Inc	ID	Rural Health Clinic/Center	$0	$2.6M
Bmh, Inc.	ID	Surgery Physician	$0	$2.3M
Arthritis Specialty Center,inc	ID	Specialist	$0	$1.4M
Bmh, Inc.	ID	Family Medicine Physician	$0	$864.1K
Bmh, Inc.	ID	Sports Medicine (Family Medicine) Physician	$0	$765.1K
Bmh Inc	ID	Family Medicine Physician	$0	$546.8K
William Nibley	UT	Medical Oncology Physician	$166K	$326K
Stephen Richins	ID	Medical Physician Assistant	$466.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Moonlight Mountain Recovery, Inc	ID	Substance Abuse Rehabilitation Facility	$0	$17.7M
Pocatello Children & Adolescent Clinic	ID	Pediatrics Physician	$0	$11M
Speech Therapy Services, LLC	ID	Speech-Language Pathologist	$0	$8.5M
Pocatello Chubbuck School District #25	ID	Local Education Agency (LEA)	$0	$7.9M
Facial & Oral Surgery Associates, Inc.	ID	Oral and Maxillofacial Surgery (Dentist)	$0	$6.3M
Health West, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$6.2M
Pocatello Hospital LLC	ID	General Acute Care Hospital	$0	$6.1M
Health West, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$5.9M
Rocky Mountain Physician Group LLC	ID	Emergency Medicine Physician	$0	$5.5M
Community Mental Health	ID	Community/Behavioral Health Agency	$0	$4.3M

Ananda Walaliyadda — 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