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

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

Robert Ali (NPI 1629414768)

Field	Value
Entity Type	Individual
Organization	Robert Ali
Address	101 S Canal St
City	Carlsbad
State	NM
ZIP	88220
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	May 16, 2013

Payer Source	Total Paid
Medicare	$634.6K
Medicaid	$0

Key Findings

Specialty and code mix align with a hematology/oncology outpatient infusion practice: the top revenue code is J0897 (10.6K claims, $18 avg paid/claim, $190.1K revenue; 31.4% of Medicare revenue), and the profile includes chemotherapy administration codes such as 96413 (347 claims, $91 avg paid/claim, $31.6K revenue) as well as supportive injectable therapies like J0885 (7.1K claims, $6 avg paid/claim, $42.5K revenue) and J1439 (39.8K claims, $1 avg paid/claim, $39.8K revenue). This mix indicates frequent provision of infused and injected cancer-related therapies alongside office-based management. The presence of imaging codes (78815) and routine lab codes further supports a full-service oncology workflow.

Revenue is concentrated in a small set of services: the precomputed top 3 Medicare codes account for 54.6% of this provider's total Medicare revenue. With total Medicare revenue reported as $634.6K, a majority of billings are concentrated in a few high-revenue items rather than being widely distributed across many low-value codes. That concentration suggests business sensitivity to utilization patterns or pricing changes in those leading codes.

This provider is effectively single-payer on file: Medicare revenue is $634.6K while Medicaid shows none on file. The absence of Medicaid billing indicates the provider either does not participate in Medicaid or has not submitted Medicaid claims, making Medicare the dominant (and sole documented) public payer exposure for analyst consideration. Payer-risk or access analyses should treat this as a Medicare-centric profile unless additional commercial or state billing data are available.

Competitive standing varies by code: J0897 ranks #1047 of 10057 providers nationally (90th percentile) and is described as typical, unremarkable volume for that code, indicating a strong but not exceptional national position for denosumab injections. By contrast, 99213 (929 claims, $60 avg paid/claim, $55.7K revenue) ranks #7686 of 457151 providers nationally (98th percentile) and is labeled an extreme outlier, far above typical national volume, which points to unusually high routine office-visit activity relative to peers. Other codes such as 78815 (75 claims, $1126 avg paid/claim, $84.5K revenue) sit near median volumes (rank #2668 of 6566, 59th percentile) and are therefore unremarkable competitively.

There are notable statistical outliers in utilization labels that should guide benchmarking: 99213 is marked an "extreme outlier, far above typical national volume," and 96372 is characterized as "notably above typical" (527 claims, $10 avg paid/claim, $5.3K revenue; 97th percentile). Several lab and common procedural codes (85025, 80053, 36415) are reported at very high national percentiles (95th–98th percentiles) yet labeled as typical for their respective codes, suggesting this provider bills high counts of routine monitoring and access procedures consistent with active oncology practice. Analysts should treat those flagged labels as indicators of unusually large patient-contact volume for certain CPTs rather than evidence of coding anomalies.

Imaging and diagnostics contribute meaningfully to revenue mix and suggest referral or onsite access to advanced imaging: 78815 (PET/CT) generated $84.5K (75 claims) and A9552 (71 claims, $154 avg paid/claim, $10.9K revenue) also appears on the list, indicating reliance on PET-related imaging for staging or monitoring. Additional CT codes (74178, 71270) appear further down the list, supporting a pattern of regular imaging use in clinical decision-making for oncology patients. This profile implies either coordinated imaging ordering or in-practice imaging referrals as part of care pathways.

Operational footprint is consistent with high-throughput outpatient oncology support: routine lab panels and venipuncture show large claim counts—85025 (1.4K claims, $8 avg paid/claim, $11.2K revenue), 80053 (1K claims, $10 avg paid/claim, $10.2K revenue), and 36415 (1.2K claims, $7 avg paid/claim, $8.5K revenue)—indicating frequent lab monitoring and blood draws. Those volumes, together with infusion-related codes (96413, 96401, 96415), point to sustained session-based treatment capacity and regular patient monitoring workflows typical of oncology practices. Staffing and supply planning should reflect recurring, high-frequency outpatient encounters.

Tenure and stability: the NPI was enumerated on 2013-05-16 (~13 years ago), indicating over a decade of participation in Medicare billing. That length of enrollment provides a multi-year footprint for trend analysis and suggests established payer relationships and operational continuity. Combined with the absence of Medicaid billing, the long tenure reinforces that historical Medicare activity is a reliable starting point for assessing this provider's competitive and operational profile.

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
J0897	Injection, denosumab, 1 mg	10,560	$20	$190.1K
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.…	80	$1,130	$84.5K
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…	930	$60	$55.7K
J0885	Injection, epoetin alfa, (for non-esrd use), 1000 units	7,080	$10	$42.5K
J1439	Injection, ferric carboxymaltose, 1 mg	39,750	$1	$39.8K
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…	410	$90	$37.7K
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…	350	$90	$31.6K
J9217	Leuprolide acetate (for depot suspension), 7.5 mg	160	$130	$21.5K
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…	100	$110	$11.4K
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…	1,400	$10	$11.2K

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. New Mexico Distribution

Robert Ali — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. state median

73 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0897	6	50	3,150	$20	$113.2K
78815	15	30	70	$600	$62.8K
J0885	2	10	7,080	$10	$35.8K
J9217	16	20	180	$130	$23.4K
J1439	2	10	25,500	$1	$23.1K
96413	5	40	170	$90	$17.7K
82306	25	30	110	$30	$17K
J3490	7	20	40	$150	$16.7K
A9552	12	20	100	$160	$15.1K
84443	31	60	110	$20	$13.3K

Showing 1–10 of 73

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Vincent Hospital	NM	General Acute Care Hospital	$0	$46.5M
Mercy Health System Corporation	WI	Multi-Specialty Clinic/Center	$0	$13.2M
Masoud Khorsand- Sahbaie Md P A	NM	Hematology & Oncology Physician	$0	$8.1M
St. Vincent Hospital	NM	Pediatrics Physician	$0	$4.7M
St. Vincent Hospital	NM	Pediatrics Physician	$0	$4.4M
St. Vincent Hospital	NM	Urgent Care Clinic/Center	$0	$3.2M
St. Vincent Hospital	NM	Hospitalist Physician	$0	$2M
Masoud Khorsand-sahbaie	NM	Hematology & Oncology Physician	$1.3M	$0
Ahmad Ramahi	NM	Rheumatology Physician	$407.5K	$0
Jessica Hildebrand	NC	Hematology & Oncology Physician	$348.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Carlsbad Medical Center LLC	NM	General Acute Care Hospital	$0	$26.4M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$9.2M
Pecos Valley Of New Mexico, LLC	NM	General Practice Physician	$0	$6.4M
Carlsbad Lifehouse Inc	NM	Community/Behavioral Health Agency	$0	$4.5M
Carc, Inc.	NM	Community/Behavioral Health Agency	$0	$4.3M
Caring Angels, LLC	NM	Home Infusion Agency	$0	$3.9M
Raney Pediatrics	NM	Pediatrics Physician	$0	$3.4M
Familia Dental Carlsbad LLC	NM	General Practice Dentistry	$0	$2.5M
City Of Carlsbad	NM	Land Ambulance	$390.4K	$1.3M
Michael Lim	NM	Ophthalmology Physician	$75K	$1.6M

Robert Ali — 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