NPI 1548266844 — Billing Profile & Reimbursement Data
NPI 1548266844 · XX · healthcare
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NPI 1548266844 is a healthcare provider located in Unspecified Location. This profile covers 30 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services. Note: "XX" is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; claims coded under it are grouped and benchmarked here the same way a traditional state would be.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | NPI 1548266844 |
| Address | |
| City | |
| State | XX (Unspecified Location) |
| ZIP | |
| Taxonomy | N/A |
| NPI Enumerated | |
| NPI Deactivated | August 30, 2025 |
(source: CMS Medicare & Medicaid claims data)
Key Findings
This provider is effectively a Medicare-only biller at the time of the file: total Medicare revenue is $1.2M while Medicaid revenue is listed as none, so the operation appears to rely almost entirely on Medicare patients and has no Medicaid billing on file. That single‑payer footprint limits insight into state Medicaid market position and suggests payer-concentration exposure on Medicare reimbursement dynamics.
Revenue is extremely concentrated in a small number of high-cost drugs and imaging procedures: the precomputed top 3 codes by revenue account for 83.9% of this provider's total Medicare revenue. In particular, J9271 drives the largest share with $774K revenue (64.8% of this provider's total Medicare revenue), indicating the provider’s finances are highly dependent on a single therapy.
The code mix and descriptions indicate this practice operates primarily as an oncology infusion and diagnostic center. High revenue from J9271 (pembrolizumab) and J0897 (denosumab) alongside infusion and chemotherapy administration codes such as 96413 and add-on infusion codes (, ) and PET/CT imaging () point to integrated cancer treatment and imaging services rather than a general primary‑care practice.
Medicare: Total Revenue Breakdown by CPT/HCPCS Code
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
Medicare: Complete Services Breakdown
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
30 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 18,000 | $40 | $774K |
| J0897 | Injection, denosumab, 1 mg | 8,160 | $20 | $138.7K |
| 78815 | PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.… | 90 | $1,010 | $89.9K |
| 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… | 330 | $130 | $41.7K |
| 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… | 350 | $80 | $28.1K |
| 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… | 270 | $90 | $24.8K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 400 | $40 | $16.2K |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | 2,640 | $10 | $15.8K |
| 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… | 1,230 | $10 | $9.8K |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 90 | $100 | $9K |
Showing 1–10 of 30
Medicare: Competitive Analysis & Benchmarks
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 30 CPT/HCPCS codes. Note: this provider's state, "XX," is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; the State panel below benchmarks against other providers coded under the same designation.
View: State1 / 2
Full comparison — all codes billed, vs. state median
30 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J9271 | 3 | 10 | 17,200 | $40 | $743.5K |
| 78815 | 36 | 10 | 200 | $1,090 | $220.7K |
| A9552 | 5 | 10 | 220 | $400 | $87.4K |
| 96413 | 12 | 10 | 350 | $100 | $34.2K |
| J0897 | 7 | 10 | 1,440 | $20 | $26.6K |
| 99213 | 2,479 | 10 | 140 | $60 | $18.8K |
| 99214 | 1,155 | 10 | 80 | $90 | $15.8K |
| 99215 | 24 | 10 | 60 | $110 | $13.3K |
| 96367 | 9 | 10 | 350 | $20 | $7.6K |
| 85025 | 16 | 10 | 820 | $10 | $6.2K |
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Frequently Asked Questions
References
- 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
- 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.
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