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

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

Grace Raja (NPI 1558561126)

Field	Value
Entity Type	Individual
Organization	Grace Raja
Address	8901 Carti Way
City	Little Rock
State	AR
ZIP	72205
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	July 23, 2007

Payer Source	Total Paid
Medicare	$1.5M
Medicaid	$0

Key Findings

This provider is a Hematology & Oncology physician whose Medicare billing mix is dominated by high-cost oncology drug administration, consistent with an infusion-based cancer practice. The single largest code is J9271 (pembrolizumab) with $877.2K revenue and 20.4K claims (62.8% of the provider's Medicare revenue), supported by chemotherapy administration codes such as 96413 and infusion codes like 96365/96375, which together point to ongoing systemic therapy delivery and follow-up management.

Revenue is highly concentrated: the precomputed top-3 Medicare codes (J9271, 99214, J0897) account for 74.8% of this provider's total Medicare revenue. Those three codes include J9271 at $877.2K (62.8%), 99214 at $102.7K (7.3%), and J0897 at $65.9K (4.7%), indicating that a handful of services drive most of the provider's Medicare receipts.

This provider is effectively single-payer from an active-billing perspective: lifetime Medicare revenue is $1.5M while there is no Medicaid billing on file. That concentration creates dependence on Medicare volumes and reimbursement for the practice's financial performance and payer negotiations.

Competitive standing varies by service line: for J9271 the provider ranks #375 of 1841 nationally (79th percentile) and is characterized as typical/unremarkable volume for that oncology drug, so they are a solid but not dominant national participant in pembrolizumab administration. By contrast, the E/M code 99214 ranks #7030 of 479517 nationally (99th percentile) and is labeled an extreme outlier, signaling unusually high office-visit volume for established patients compared with national peers.

Operational metrics point to a high-throughput infusion and monitoring workflow: the provider submitted 20.4K claims for J9271 and substantial claim counts for supportive drugs and infusions such as J0885 (5.2K claims), J1437 (3.7K claims), and 96375 (943 claims). These volumes, together with chemotherapy administration 96413 (545 claims), imply frequent outpatient infusion encounters and repeat dosing schedules that require infusion nursing and drug handling capacity.

Laboratory and monitoring services are also prominent and concentrated in high percentiles, consistent with active oncology management. High-claim lab codes include 85025 at 2.2K claims (rank #900 of 32833, 97th percentile), 80053 at 1.9K claims (rank #648 of 26416, 98th percentile), and 36415 at 1.9K claims (rank #1020 of 86467, 99th percentile), indicating routine in-office phlebotomy and panel testing to support chemotherapy and biologic therapy.

Several codes are flagged as statistically notable relative to peers and underscore intensity of outpatient cancer care: 99214 is an extreme outlier for office visits, while 96413 (chemotherapy administration) is described as notably above typical (rank #556 of 7514, 93rd percentile), 99215 is notably above typical (95th percentile), and 96375 is notably above typical (96th percentile). Together, these labels point to both high visit complexity and above-typical chemotherapy/infusion throughput compared with national peers.

The provider has long tenure in the Medicare program, with NPI enumerated on 2007-07-23 (~19 years ago), and the lifetime Medicare revenue on file is $1.5M. That combination of sustained enrollment and the current revenue mix suggests a stable, established oncology practice focused on infusion therapies and outpatient management rather than broad-based multispecialty ambulatory care.

Medicare: Complete Services Breakdown

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

78 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	20,400	$40	$877.2K
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…	1,210	$90	$102.7K
J0897	Injection, denosumab, 1 mg	3,660	$20	$65.9K
J1437	Injection, ferric derisomaltose, 10 mg	3,670	$20	$62.4K
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…	550	$90	$46.9K
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…	270	$130	$33.1K
J0885	Injection, epoetin alfa, (for non-esrd use), 1000 units	5,230	$10	$31.4K
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.	1,930	$10	$19.3K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	210	$90	$18.1K
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…	2,150	$10	$17.2K

Showing 1–10 of 78

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 78 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Arkansas Distribution

Grace Raja — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arkansas

Full comparison — all codes billed, vs. state median

78 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	21	40	20,700	$40	$896.3K
J1437	18	20	6,450	$20	$107.8K
J0897	65	160	2,580	$20	$89.7K
J0885	19	40	4,070	$10	$38K
96413	30	80	380	$90	$36.6K
99214	111	4,300	130	$70	$18.8K
88185	6	20	780	$20	$18.5K
99233	315	960	130	$90	$18.2K
99232	845	1,450	130	$60	$14.7K
J0185	20	20	7,540	$1	$12K

Showing 1–10 of 78

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Health System Of Texas	TX	Children's Hospital	$0	$263.9M
University Of Texas Southwestern Medical Center At Dallas	TX	Pediatrics Physician	$0	$66.3M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
University Of Texas Southwestern Medical Center At Dallas	TX	Obstetrics & Gynecology Physician	$0	$31.7M
Central Arkansas Radiation Therapy Institute Inc	AR	Hematology & Oncology Physician	$0	$11M
Central Arkansas Radiation Therapy Institute Inc	AR	Radiation Oncology Physician	$6.7M	$3.6M
Kamal Patel	AR	Hematology & Oncology Physician	$5.7M	$0
Ryan Hall	AR	Hematology & Oncology Physician	$4.6M	$0
Balagopalan Nair	AR	Hematology & Oncology Physician	$4.1M	$0
Lawrence Mendelsohn	AR	Hematology & Oncology Physician	$3.4M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of Arkansas For Medical Sciences	AR	General Acute Care Hospital	$0	$87.2M
University Of Arkansas For Medical Sciences	AR	Internal Medicine Physician	$0	$28.6M
University Of Arkansas For Medical Sciences	AR	Pediatrics Physician	$0	$27.6M
Arkansas Department Of Health Immunizations	AR	Public Health or Welfare Agency	$0	$19.3M
Baptist Health	AR	General Acute Care Hospital	$0	$16.4M
Arkansas Department Of Health Family Planning Clinic	AR	Public Health or Welfare Agency	$0	$15.6M
Pediatrix Medical Group Of Arkansas PA	AR	Neonatal-Perinatal Medicine Physician	$0	$14.6M
Chenal Family Therapy, Plc	AR	Mental Health Counselor	$0	$12.2M
Francis A. Allen School For Exceptional Children, Inc.	AR	Developmentally Disabled Services Day Training Agency	$0	$11.9M
Arkansas Department Of Health Std	AR	Public Health or Welfare Agency	$0	$8.4M

Grace Raja — Billing Profile & Reimbursement Data

Sign up for Grace Raja — Billing Profile & Reimbursement Data policy alerts

Grace Raja — Billing Profile & Reimbursement Data

Sign up for Grace Raja — 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