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NPI 1760469407 · Hot Springs, AR · Hematology & Oncology Physician
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Stephen Divers is a hematology & oncology physician provider located in Hot Springs, Arkansas. This profile covers 86 Medicare and 2 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Stephen Divers |
| Address | 133 Harmony Park |
| City | Hot Springs |
| State | AR |
| ZIP | 71913 |
| Taxonomy | Hematology & Oncology Physician |
| NPI Enumerated | December 23, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.9M |
| Medicaid | $1.5K |
Practice profile and service mix: STEPHEN DIVERS is a Hematology & Oncology Physician whose Medicare billing is dominated by high-cost immunotherapies and advanced imaging, with J9271 (pembrolizumab), J9299 (nivolumab), and 78815 (PET/CT) appearing as the largest Medicare revenue contributors. The code mix also includes supportive oncology medications (e.g., J0897 denosumab, J1437 ferric derisomaltose) and chemotherapy administration codes (96413, 96417), consistent with an infusion-focused oncology practice that couples systemic therapy with staging/response imaging.
Medicare revenue concentration: the top 3 Medicare codes (J9271, J9299, 78815) account for 57.0% of this provider's total Medicare revenue, with J9271 at $1.1M (29.6% of Medicare revenue), J9299 at $624K (16.9%), and 78815 at $389.3K (10.5%). This concentration indicates the practice derives a majority of Medicare income from a small set of high-cost oncology services and drugs.
Payer mix and scale: Medicare is effectively the dominant payer for this provider — total Medicare revenue is $3.9M versus total Medicaid revenue of $1.5K — making the operation functionally single-payer (Medicare) in scale. The precomputed Medicaid concentration note that the top 3 Medicaid codes account for 100.0% of Medicaid revenue underscores how small and concentrated the provider's Medicaid footprint is.
Medicaid billing detail and in-state standing: Medicaid activity is minimal and concentrated in office visits, with 99214 representing $1.5K (100.0% of Medicaid revenue) from 28 claims and ranking #1363 of 1523 providers in-state (10th percentile; typical, unremarkable volume). There are additional Medicaid claims for 85025 (CBC) that show claims but $0 revenue, indicating either zero paid amount on those lab claims in the dataset or payer-specific reimbursement patterns.
National competitive standing on key Medicare codes: utilization rankings show mixed positioning — J9271 ranks #222 of 1841 (88th percentile; typical, unremarkable volume) and J9299 ranks #98 of 505 (81th percentile; typical, unremarkable volume), while imaging code 78815 ranks #366 of 6566 (94th percentile; notably above typical national volume). Several supportive or programmatic codes also show high standing, for example J0897 ranks #318 of 10057 (97th percentile; notably above typical national volume) and M0010 ranks #7 of 544 (99th percentile; notably above typical national volume), signaling strong relative participation in some oncology service lines and enhanced oncology model payments.
Statistical outliers in utilization: several encounter and administration codes are flagged as extreme outliers relative to national peers, notably 99214 (1.2K claims; $102.1K; ranks #7354 of 479517 providers nationally, 98th percentile; extreme outlier), 99213 (1.5K claims; $89.6K; ranks #2065 of 457151, 100th percentile; extreme outlier), 96413 (1K claims; $89.3K; ranks #70 of 7514, 99th percentile; extreme outlier), and 96372 (1.5K claims; $15.2K; ranks #133 of 58224, 100th percentile; extreme outlier). These labels indicate unusually high visit and injection/admin volumes versus national peers and suggest high patient throughput for office visits, injections, and chemotherapy administrations.
Operational implications from unit-based drug billing: very large claim counts on unit-priced drugs (for example J1442 with 29.4K claims, J0885 with 13.8K claims, J9271 with 25.4K claims and J9299 with 26K claims) imply substantial on-site drug administration and buy-and-bill activity, supporting an infusion-centric workflow and inventory management needs. The presence and high rank of biosimilar and growth-factor codes (Q5119 rank #17 of 335, Q5122 rank #69 of 239) further reflect adoption of biosimilars and supportive care agents within that infusion model.
Tenure and continuity: the provider's NPI was enumerated on 2005-12-23 (~21 years ago), indicating long-standing enrollment and continuity in Medicare/Medicaid billing which supports interpretation of these utilization patterns as established rather than newly emergent.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
86 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 25,400 | $40 | $1.1M |
| J9299 | Injection, nivolumab, 1 mg | 26,000 | $20 | $624K |
| 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.… | 390 | $990 | $389.3K |
| J0897 | Injection, denosumab, 1 mg | 19,140 | $20 | $344.5K |
| A9595 | Piflufolastat f-18, diagnostic, 1 millicurie | 220 | $730 | $161.6K |
| J1437 | Injection, ferric derisomaltose, 10 mg | 8,200 | $20 | $139.4K |
| J1569 | Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg | 3,180 | $40 | $114.5K |
| 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… | 1,190 | $90 | $102.1K |
| Q5119 | Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg | 4,270 | $20 | $93.8K |
| 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… | 1,520 | $60 | $89.6K |
Showing 1–10 of 86
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 86 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
86 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J9271 | 12 | 40 | 20,700 | $40 | $896.3K |
| J9299 | 6 | 30 | 15,660 | $20 | $432.9K |
| J1569 | 5 | 10 | 2,560 | $40 | $120.3K |
| J1437 | 8 | 20 | 6,450 | $20 | $107.8K |
| A9595 | 3 | 10 | 110 | $570 | $90.9K |
| J0897 | 4 | 160 | 2,580 | $20 | $89.7K |
| 78815 | 9 | 100 | 90 | $550 | $83.7K |
| Q5119 | 1 | 10 | 3,280 | $20 | $73.2K |
| J0885 | 6 | 40 | 4,070 | $10 | $38K |
| 96413 | 6 | 80 | 380 | $90 | $36.6K |
Showing 1–10 of 86
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 30 | $60 | $1.5K |
| 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… | 20 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Arkansas providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Arkansas median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 1,363 | 1,520 | 550 | $40 | $128.7K |
| 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… | 310 | 330 | 680 | $10 | $48.3K |
Other providers in the same ZIP code as Stephen Divers, ranked by combined Medicare and Medicaid revenue.
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