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

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

Resty Tibayan (NPI 1508029208)

Field	Value
Entity Type	Individual
Organization	Resty Tibayan
Address	2460 W Horizon Ridge Pkwy
City	Henderson
State	NV
ZIP	89052
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	July 3, 2008

Payer Source	Total Paid
Medicare	$1.2M
Medicaid	$0

Key Findings

This provider is effectively single‑payer: reported Total Medicare revenue is $1.2M while there is no Medicaid billing on file, so Medicaid does not appear in this provider’s payer mix and Medicare drives the entire reported public‑payer revenue stream. Analysts should treat Medicare trends as the primary lens for financial and service‑line insights.

Revenue is highly concentrated in a handful of drug codes: the precomputed top three Medicare codes account for 70.6% of the provider’s Medicare revenue, with J9271 alone representing 49.1% of Medicare revenue ($533.2K from 12.4K claims). This concentration means changes in utilization, pricing, or payer policy for pembrolizumab could materially affect the provider’s Medicare revenue.

The code mix and volumes indicate an infusion‑centric hematology/oncology practice: J9271 (pembrolizumab) at 12.4K claims, J1568 (immune globulin, octagam) at 3.8K claims, and J0897 (denosumab) at 6.1K claims together drive the majority of drug revenue and point to routine in‑office administration of immunotherapy and supportive biologics. Presence of chemotherapy administration codes such as 96413 (310 claims) and infusion initiation code G0498 (74 claims) further supports a sustained outpatient infusion operation rather than only consultative care.

Support services and point‑of‑care monitoring are prominent: the provider bills high volumes of lab and phlebotomy codes — 85025 (1.7K claims), 36415 (1.6K claims), 80053 (1.4K claims) and multiple chemistry and iron studies (for example, 82746 at 631 claims and 82728 at 625 claims). Many of these lab codes rank at or above the 90th national percentile (e.g., 80053 at the 96th percentile, 85025 at the 96th, 36415 at the 98th), suggesting substantial in‑office diagnostic throughput to support infusion and oncology care.

The outpatient evaluation and management footprint is meaningful: 99213 (725 claims, $47.1K; 4.3% of Medicare revenue) and 99214 (624 claims, $61.2K; 5.6% of Medicare revenue) together show routine established‑patient office work, with 99213 described as notably above typical national volume (97th percentile) and 99214 at the 93rd percentile. New‑patient visits are also substantial (99204: 150 claims, $17.6K; 1.6% of revenue, 95th percentile), indicating the practice maintains both intake of new oncology patients and ongoing follow‑up.

On competitive standing for top drugs, this provider is a modest/typical national participant rather than a clear market leader: J9271 ranks #910 of 1841 (50th percentile; typical, unremarkable volume), J1568 ranks #144 of 381 (62th percentile; typical, unremarkable volume), and J0897 ranks #2243 of 10057 (77th percentile; typical, unremarkable volume). These ranks signal neither unusually high nor exceptionally low national presence for the highest‑revenue medications, though the absolute revenue concentration in J9271 remains material to the practice.

Operational intensity is suggested by the combination of high claim counts for specific drugs and frequent administration codes: examples include 12.4K claims for J9271, 6.1K claims for J0897, and supporting administration codes such as 96413 (310 claims), 96365 (176 claims), and 96375 (474 claims). This mix implies regular, repeated in‑office dosing cycles and workflow investments in infusion nursing, scheduling, and monitoring rather than a low‑throughput consultative model.

The provider has been enumerated for a sustained period (NPI enumerated 2008-07-03 (~18 years ago)), which, combined with the entrenched infusion, lab, and E/M billing patterns, indicates an established hematology/oncology outpatient practice with mature operational processes for delivering and documenting biologic and chemotherapeutic services.

Medicare: Complete Services Breakdown

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

73 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	12,400	$40	$533.2K
J1568	Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg	3,750	$30	$123.8K
J0897	Injection, denosumab, 1 mg	6,120	$20	$110.2K
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…	620	$100	$61.2K
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…	730	$70	$47.1K
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…	310	$100	$31.3K
J0881	Injection, darbepoetin alfa, 1 microgram (non-esrd use)	9,740	$1	$19.5K
99204	The provider sees a new 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 provider…	150	$120	$17.6K
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.	1,420	$10	$14.2K
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…	1,730	$10	$13.9K

Showing 1–10 of 73

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 73 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Nevada Distribution

Resty Tibayan — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nevada

Full comparison — all codes billed, vs. state median

73 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	21	40	13,000	$40	$625.8K
J1568	8	10	4,470	$30	$164.2K
J0897	17	70	3,630	$20	$94.6K
J0881	21	30	17,400	$1	$49.5K
82306	6	30	80	$30	$41.9K
99233	802	1,150	150	$90	$26.8K
96413	22	70	210	$100	$23.7K
99232	894	1,340	140	$60	$23.7K
84443	25	80	50	$20	$22.7K
80053	11	100	160	$10	$22.2K

Showing 1–10 of 73

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Allison Curtis Kingsley Meoz Michael & Sanchez PC	NV	Hematology & Oncology Physician	$0	$13.4M
Clark Jean	NV	Hematology & Oncology Physician	$4.2M	$21.8K
Imran Ahmed	NV	Hematology & Oncology Physician	$4M	$7.6K
Rupesh Parikh	NV	Hematology & Oncology Physician	$3.1M	$9.6K
Anuradha Thummala	NV	Hematology & Oncology Physician	$2.7M	$38.5K
Wolfram Samlowski	NV	Hematology & Oncology Physician	$2.4M	$8.1K
Ghulam Kashef	NV	Medical Oncology Physician	$2.1M	$17.1K
Anthony Nguyen	NV	Hematology & Oncology Physician	$1.8M	$0
Brian Vicuna	NV	Medical Oncology Physician	$1.8M	$35.9K
Fadi Braiteh	NV	Medical Oncology Physician	$1.5M	$30.1K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Platinum Hospitalists LLP	NV	Hospitalist Physician	$0	$38.8M
Urgent Care Nevada, LLC	NV	Urgent Care Clinic/Center	$0	$34.9M
Dignity Health	NV	General Acute Care Hospital	$0	$18.7M
Behavioral Health Solutions LLC	NV	Community/Behavioral Health Agency	$0	$11.4M
Lamotte Pediatrics, LLP	NV	Pediatrics Physician	$0	$9.4M
Minghsun Liu Md PC	NV	Infectious Disease Physician	$0	$5.1M
Optimized Management LLC	NV	Clinical Social Worker	$0	$5M
Misch/hyun/hodapp Healthcare, LLP	NV	Pediatrics Physician	$0	$4.5M
Ellsworth Cox Pediatric Dentistry LLC	NV	Pediatric Dentistry	$0	$3.7M
Total Infusion Care LLC	NV	Home Infusion Therapy Pharmacy	$0	$3.1M

Resty Tibayan — Billing Profile & Reimbursement Data

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Resty Tibayan — 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