Jay Robinow — Billing Profile & Reimbursement Data

This provider’s Medicare volume is the sole payer-facing footprint in the record: Total Medicare revenue is $1.2M and there is no Medicaid billing on file, indicating an effectively single-payer (Medicare) billing profile for payers to consider when assessing network contracting or population coverage. The precomputed concentration metric shows the top three Medicare codes account for 55.2% of this provider’s total Medicare revenue, underscoring heavy dependence on a small set of services.

The revenue mix and code descriptions point to a combined diagnostic radiopharmacy and therapeutic radiation practice: the top three revenue drivers are 78815 ($335K revenue, 27.7% of this provider's total Medicare revenue), A9596 ($168.7K revenue, 13.9% of this provider's total Medicare revenue), and G6015 ($164.1K revenue, 13.6% of this provider's total Medicare revenue). 78815 and A9596 are PET/CT and radiopharmaceutical diagnostic codes while G6015 is an intensity‑modulated treatment delivery code, indicating the provider bills both advanced molecular imaging and active radiation treatment delivery.

Revenue concentration is high: the single code 78815 represents $335K (27.7% of Medicare revenue) and the precomputed top-three share is 55.2%, implying that changes in utilization or reimbursement for PET/CT and IMRT delivery could materially affect the provider’s Medicare revenue. Analysts should flag sensitivity to pricing or utilization shifts for PET/CT imaging and radiopharmaceutical supplies when modeling future revenue.

Competitive standing on major codes is modest to regionally notable rather than dominant nationally. For 78815 the provider ranks #534 of 6566 providers nationally (92th percentile; typical, unremarkable volume), for A9596 the provider ranks #52 of 168 providers nationally (69th percentile; typical, unremarkable volume), and for G6015 the provider ranks #625 of 1429 providers nationally (56th percentile; typical, unremarkable volume); these rankings reflect above‑average placement on 78815 but generally typical volumes across the other top codes.

The provider shows a notable emphasis on radiopharmaceutical diagnostics beyond standard FDG PET: A9596 (Gallium ga-68 gozetotide) produced $168.7K and A9552 (Fluorodeoxyglucose f-18 fdg) produced $61.7K with A9552 ranked #148 of 2411 providers nationally (94th percentile; typical, unremarkable volume). This pattern suggests operational capability for specialty nuclear medicine agents and potential exposure to supply- or reimbursement-driven variation in those specific tracer codes.

Therapeutic planning and delivery services form a clear secondary revenue stream: IMRT planning and delivery codes such as G6015 ($164.1K), 77301 ($43.4K), 77373 ($35.9K), and 77427 ($34.4K) appear across the top codes, indicating ongoing radiation oncology case management from simulation/planning through delivery. The mix of high-revenue diagnostic PET/CT plus these radiation therapy codes is consistent with an integrated imaging-to-treatment workflow rather than a pure diagnostic or pure therapy operation.

The absence of any Medicaid claims ("none below — this provider has no Medicaid billing on file") means payer mix risk is concentrated in Medicare; this has operational and contracting implications for Medicaid-directed programs, dual-eligible populations, and state-level reimbursement negotiations. Analysts should treat this provider as effectively single‑payer when projecting payer-specific utilization or assessing market access for Medicaid populations.

Tenure in the dataset is long-standing: NPI enumerated 2006-04-06 (~20 years ago), which indicates roughly two decades of Medicare enrollment and suggests stability of participation in the Medicare program; this longevity can be factored into credentialing and historical utilization trend analysis.