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

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

Pamela Smith (NPI 1780771824)

Field	Value
Entity Type	Individual
Organization	Pamela Smith
Address	803 Poplar St
City	Murray
State	KY
ZIP	42071
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	October 9, 2006

Payer Source	Total Paid
Medicare	$1.8M
Medicaid	$0

Key Findings

This provider is overwhelmingly Medicare-focused: Total Medicare revenue is $1.8M while Total Medicaid revenue is none (no Medicaid billing on file), so the practice effectively operates as a single‑payer (Medicare) billing entity for the datasets provided. That payer concentration should be treated as a core characteristic for network, reimbursement, or competitive analyses.

Revenue is heavily concentrated in a small set of drug/infusion codes: the precomputed top three Medicare codes account for 84.5% of this provider's total Medicare revenue, indicating a drug‑centric revenue profile rather than clinic visit or procedure‑driven income. Specifically, J9271 accounts for $1.1M (63.0% of Medicare revenue), J0897 accounts for $320.8K (18.4%), and 96413 accounts for $54.3K (3.1%), so drug administration dominates the financial picture.

The code mix and dollar amounts point to an oncology infusion practice model: J9271 (pembrolizumab) shows 25.6K claims with $43 avg paid/claim and $1.1M revenue, and J0897 (denosumab) shows 17.8K claims with $18 avg paid/claim and $320.8K revenue. Coupled with chemotherapy administration codes such as 96413 and add‑ons like 96417/96411, the payer profile is consistent with routine in‑office biologic and chemotherapy administration rather than primarily billed inpatient or surgical services.

Competitive standing on key drugs is mixed: for J9271 the provider ranks #213 of 1841 providers nationally (88th percentile; typical, unremarkable volume for this code), which indicates above‑average national activity but not a dominant outlier. By contrast, J0897 ranks #367 of 10057 providers nationally (96th percentile; notably above typical national volume for this code), signaling unusually high denosumab utilization relative to national peers and suggesting a competitive strength or specialization in bone‑targeted therapy administration.

Chemotherapy administration volumes are elevated versus national peers: 96413 (chemotherapy infusion) records 603 claims, $90 avg paid/claim, $54.3K revenue and ranks #410 of 7514 providers nationally (95th percentile; notably above typical national volume for this code). This high percentile for 96413 supports the interpretation that active therapeutic chemotherapy infusions are a meaningful component of clinical activity beyond monoclonal antibody or supportive drug administration.

Several supportive and infusion‑related codes are also statistically high, reflecting high throughput of injections and IV procedures: 96372 (639 claims, $10 avg paid/claim, $6.4K; 98th percentile; notably above typical national volume) and 96375 (613 claims, $11 avg paid/claim, $6.7K; 92nd percentile) are elevated nationally. These outlier labels indicate the practice frequently administers injections and sequential IV medications, consistent with an infusion suite or clinic workflow that delivers multiple agents per encounter.

Clinical visit revenue is a relatively small portion of the profile, reinforcing the infusion focus: E/M codes 99214 (410 claims, $89 avg paid/claim, $36.5K; 86th percentile) and 99213 (288 claims, $58 avg paid/claim, $16.7K; 86th percentile) contribute modestly to total Medicare revenue. The disparity between high drug revenue (J9271/J0897) and lower office E/M revenue suggests the operation prioritizes drug administration services over prolonged office‑based management visits.

The provider has long tenure in the NPI file (NPI enumerated 2006-10-09 (~20 years ago)), which may reflect established referral relationships and an enduring local practice presence in Murray, KY. For contracting or network planning, combine this longevity with the single‑payer Medicare revenue concentration and the high percentiles on infusion codes to assess the provider’s role as a specialized outpatient oncology/infusion resource in the market.

Medicare: Complete Services Breakdown

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

71 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	25,600	$40	$1.1M
J0897	Injection, denosumab, 1 mg	17,820	$20	$320.8K
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…	600	$90	$54.3K
J0885	Injection, epoetin alfa, (for non-esrd use), 1000 units	8,450	$10	$50.7K
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…	410	$90	$36.5K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	110	$220	$23.4K
Q5106	Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units	3,640	$10	$21.8K
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…	290	$60	$16.7K
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.	1,670	$10	$16.7K
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…	2,000	$10	$16K

Showing 1–10 of 71

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 71 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Kentucky Distribution

Pamela Smith — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. state median

71 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	1	10	20,900	$40	$847.8K
J0897	2	80	2,280	$20	$59.6K
J3490	2	10	50	$370	$27.2K
J0885	1	10	2,560	$10	$20.8K
Q5106	2	10	3,560	$10	$19.7K
96413	3	50	100	$90	$16.7K
96401	16	20	200	$50	$14.3K
99214	896	7,230	110	$70	$14.1K
Q0138	4	10	31,110	$1	$13.1K
99232	1,614	2,860	100	$60	$11.6K

Showing 1–10 of 71

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Billings Clinic	MT	General Practice Physician	$0	$53.8M
Murray-calloway County Public Hospital Corporation	KY	General Acute Care Hospital	$0	$29.5M
Covenant Medical Group, Inc.	TN	Family Medicine Physician	$0	$17.9M
Billings Clinic	MT	Emergency Care Clinic/Center	$0	$15.7M
Murray-calloway County Public Hospital Corporation	KY	Multi-Specialty Clinic/Center	$0	$3.3M
Billings Clinic	MT	General Acute Care Hospital	$0	$3.1M
Omar Ahmed	NY	Neurology Physician	$1M	$1.8M
Billings Clinic	MT	Durable Medical Equipment & Medical Supplies	$0	$2.4M
Ryan Grover	TN	Radiation Oncology Physician	$2.2M	$0
Applied Health Services Incorporated	MT	Durable Medical Equipment & Medical Supplies	$0	$2.2M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Living In Kentucky, LLC	KY	Community/Behavioral Health Agency	$0	$21.3M
Behavior Support Services, LLC	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$9.2M
Vmd Primary Providers Central Kentucky	KY	Internal Medicine Physician	$0	$4.4M
Watch, Inc.	KY	Developmentally Disabled Services Day Training Agency	$0	$3.8M
Primary Care Medical Center Inc	KY	Family Medicine Physician	$0	$3.7M
Murray Calloway County Emergency	KY	Land Ambulance	$538.6K	$581.8K
Jesse Williams	KY	Optometrist	$44.4K	$352.5K
James Jaco	KY	Optometrist	$69K	$304.6K
James Outland	KY	Dermatology Physician	$348.8K	$0
Jacques Youssef	KY	Nephrology Physician	$322.1K	$0

Pamela Smith — 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