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

Why is the Medicaid comparison limited to New Hampshire 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. New Hampshire (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.

Jonathan Proulx (NPI 1518320837)

Field	Value
Entity Type	Individual
Organization	Jonathan Proulx
Address	789 Central Ave
City	Dover
State	NH
ZIP	03820
Taxonomy	Hematology (Internal Medicine) Physician
NPI Enumerated	April 4, 2016

Payer Source	Total Paid
Medicare	$725.4K
Medicaid	$0

Key Findings

This provider’s billing footprint is concentrated in Medicare only: total Medicare revenue is $725.4K and there is no Medicaid billing on file, so the practice is effectively single‑payer (Medicare) from a claims perspective. That payer concentration may shape contracting and referral dynamics since Medicaid is not represented in the dataset.

Revenue concentration is very high: the precomputed top three Medicare codes account for 79.0% of the provider’s total Medicare revenue, driven by J9271 ($378.4K, 52.3%), J0897 ($115.6K, 16.0%), and J1439 ($77.3K, 10.7%). This indicates a heavy dependence on a small number of high‑cost injectable therapies for the bulk of reimbursement.

The code mix and taxonomy (Hematology (Internal Medicine) Physician) point to an infusion‑center and oncology/hematology service model: J9271 (pembrolizumab) is an oncologic immunotherapy, J0897 (denosumab) is used for bone‑related indications often in oncology, and J1439 (ferric carboxymaltose) is an IV iron preparation. Presence of chemotherapy/infusion administration codes such as 96413, 96365 and multiple add‑on infusion codes supports an operational workflow centered on IV drug administration rather than purely office‑based consults.

Competitive standing on the largest revenue driver is modest: J9271 ranks #1323 of 1841 providers nationally (28th percentile; typical, unremarkable volume for this code), so although J9271 generates the largest share of this provider’s revenue, that volume is not high relative to national peers. This suggests the practice captures meaningful revenue from pembrolizumab locally but is not a major national infusion center for that agent.

By contrast, the provider shows above‑typical national standing on two other injectables important to their revenue mix: J0897 ranks #2106 of 10057 providers (79th percentile; typical, unremarkable volume for this code) and J1439 ranks #107 of 1209 providers (91th percentile; typical, unremarkable volume for this code). The very high rank on J1439 indicates unusually strong use of ferric carboxymaltose relative to peers, consistent with a practice that delivers frequent IV iron treatments.

Several procedural codes tied to infusion workflows are also concentrated at high percentiles: 96360 (IV catheter placement) shows 188 claims and ranks #91 of 2672 providers (97th percentile; typical, unremarkable volume), and 96365 (initial IV infusion) shows 284 claims and ranks #1080 of 8873 providers (88th percentile; typical, unremarkable volume). These high percentile placements corroborate that IV access and infusion throughput are core operational activities.

Evaluation-and-management activity is present but secondary to infusion services: the provider billed 276 claims for 99214 ($25.9K revenue, 77th percentile) and 113 claims for 99215 ($15.6K revenue, 82th percentile), indicating regular outpatient follow‑up and management visits to support infusion care. The relative revenue split between infusion drugs and E/M services suggests the business model monetizes drug administration more than face‑to‑face visit volume.

The provider’s NPI enumeration date is 2016-04-04 (~10 years ago), indicating about a decade of recorded Medicare activity; combined with the concentrated drug revenue and high infusion‑procedure percentiles, this tenure supports a stable, infusion‑focused hematology practice that participates in Medicare but does not bill Medicaid.

Medicare: Complete Services Breakdown

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

48 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	8,800	$40	$378.4K
J0897	Injection, denosumab, 1 mg	6,420	$20	$115.6K
J1439	Injection, ferric carboxymaltose, 1 mg	77,250	$1	$77.3K
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…	290	$100	$29.7K
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	$25.9K
J1454	Injection, fosnetupitant 235 mg and palonosetron 0.25 mg	50	$330	$16K
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…	110	$140	$15.6K
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.	280	$50	$13.9K
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…	100	$120	$11.7K
96360	The provider introduces a catheter intravenously for supplementation of fluid and electrolytes for 31 minutes to one hour to treat severe cases of dehydration.	190	$30	$4.9K

Showing 1–10 of 48

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 48 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New Hampshire Distribution

Jonathan Proulx — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Hampshire

Full comparison — all codes billed, vs. state median

48 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	5	10	10,000	$40	$440.2K
J0897	4	20	2,760	$20	$75.4K
J1439	1	10	77,250	$1	$67.5K
J1454	2	10	60	$330	$18.1K
96413	5	20	140	$100	$15.8K
99214	626	3,150	110	$80	$13.2K
99213	1,560	2,900	70	$50	$6.9K
99215	145	1,080	40	$110	$6.8K
96401	4	10	70	$50	$5.1K
99205	289	440	20	$140	$4.9K

Showing 1–10 of 48

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Physicians Of Indiana Inc	IN	Family Medicine Physician	$0	$185M
Massachusetts General Physicians Organization Inc	MA	Dermatology Physician	$0	$60.2M
Boston Emergency Physician Foundation, Inc.	MA	Emergency Medicine Physician	$0	$24.3M
Colorado Permanente Medical Group, P.C.	CO	Internal Medicine Physician	$0	$23.2M
Babak Jian Seyedahmadi	MA	Ophthalmology Physician	$4.4M	$0
Can Ilyas	ME	Hematology & Oncology Physician	$3.2M	$0
Wentworth Douglass Physician Corporation	NH	Magnetic Resonance Imaging Radiologic Technologist	$0	$2.7M
David Benton	ME	Hematology & Oncology Physician	$2.6M	$0
Matthew Dugan	ME	Hematology & Oncology Physician	$1.8M	$0
Adam Feldman	MA	Urology Physician	$1.6M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Behavioral Health And Developmental Services Of Strafford County, Inc	NH	Case Management Agency	$0	$169.8M
Living Innovations Support Services, LLC	NH	Developmentally Disabled Services Day Training Agency	$0	$147.3M
Living Innovations Support Services, LLC	NH	Developmentally Disabled Services Day Training Agency	$0	$129.3M
Wentworth Douglass Hospital	NH	General Acute Care Hospital	$0	$30.6M
Work Opportunities Unlimited Contracts, Inc.	NH	Developmentally Disabled Services Day Training Agency	$0	$17.9M
Living Innovations Support Services, LLC	NH	Community/Behavioral Health Agency	$0	$11.2M
Work Opportunities Unlimited Contracts, Inc.	NH	Developmentally Disabled Services Day Training Agency	$0	$8.4M
Behavioral Health And Developmental Services Of Strafford County, Inc	NH	Early Intervention Provider Agency	$0	$5M
Seacoast Emergency Physicians, PC	NH	Emergency Medical Services (Emergency Medicine) Physician	$0	$4.5M
Southeastern New Hampshire Alcohol And Drug Abuse Services	NH	Substance Use Disorder Rehabilitation Clinic/Center	$0	$3.7M

Jonathan Proulx — Billing Profile & Reimbursement Data

Sign up for Jonathan Proulx — Billing Profile & Reimbursement Data policy alerts

Jonathan Proulx — Billing Profile & Reimbursement Data

Sign up for Jonathan Proulx — Billing Profile & Reimbursement Data policy alerts

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