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NPI 1871767152 · Hot Springs, AR · Hematology & Oncology Physician
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Amy Cleveland is a hematology & oncology physician provider located in Hot Springs, Arkansas. This profile covers 50 Medicare and 3 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 | Amy Cleveland |
| Address | 1455 Higdon Ferry Rd |
| City | Hot Springs |
| State | AR |
| ZIP | 71913 |
| Taxonomy | Hematology & Oncology Physician |
| NPI Enumerated | April 17, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.1M |
| Medicaid | $990 |
This provider’s volume is overwhelmingly Medicare-driven: reported total Medicare revenue is $2.1M while total Medicaid revenue is $986, making the practice effectively Medicare-dominant rather than balanced across both public payers. The contrast in scale suggests limited Medicaid participation or a patient mix weighted toward Medicare beneficiaries.
Revenue concentration on Medicare is extreme: precomputed data show the top 3 Medicare codes by revenue account for 83.3% of Medicare revenue, and those three codes are led by J9271 at $1.5M (74.6% of this provider's total Medicare revenue). Such concentration indicates that a single high-cost oncology drug is the primary revenue driver for this clinician.
Code-level business implications point to an infusion-focused hematology/oncology practice: dominant use of J9271 (pembrolizumab) plus measurable claims for chemotherapy administration codes like 96413, infusion codes 96365/96375, and supportive-care agents such as J0897 (denosumab) and J0885 (epoetin alfa). The presence of PET/CT imaging (78815) and oncology model payment code M0010 further supports an outpatient oncology infusion and care-management operation.
Competitive standing for immunotherapy is strong: J9271 ranks #56 of 1841 providers nationally (97th percentile; notably above typical national volume for this code), indicating this provider is a high-volume national administrator of pembrolizumab. By contrast, J0897 (denosumab) appears at a mid-level position (#2469 of 10057, 75th percentile; typical, unremarkable volume) suggesting the pembrolizumab program is the distinctive service line.
Office visit and management activity is higher-than-typical for an oncology clinician: 99214 generated $77.9K from 906 claims and ranks #14603 of 479517 providers nationally (97th percentile; notably above typical national volume), while 99213 ranks in the 98th percentile nationally. This pattern of elevated E&M volume alongside infusion billing suggests frequent follow-up and ongoing care management associated with active systemic therapy.
Medicaid footprint is minimal and concentrated: precomputed results note the top 3 Medicaid codes by revenue account for 100.0% of Medicaid revenue, and all reported Medicaid revenue ($986) is attributed to 99213 (33 claims, $30 avg paid/claim), which ranks #1521 of 1735 in-state (12th percentile; typical, unremarkable volume). Payers should view this provider as functionally single-payer (Medicare) from a public-program perspective.
Tenure and operational stability are consistent with an established practice: the NPI was enumerated on 2008-04-17 (~18 years ago), and the combination of long tenure with $2.1M of Medicare revenue and high-volume J9271 administration points to an experienced oncology infusion operation rather than a recently launched clinic.
From a payer-management perspective, concentrated reliance on a single high-cost biologic (J9271) plus related infusion and supportive-care codes (96413, 96365, J0897, J0885) creates clear opportunities and risk areas for utilization management, site-of-care strategies, and contracting. Given that the top 3 Medicare codes account for 83.3% of Medicare revenue, review of pembrolizumab utilization patterns and adherence to oncology pathways would be high-yield for cost and quality oversight.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
50 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 35,600 | $40 | $1.5M |
| J0897 | Injection, denosumab, 1 mg | 5,640 | $20 | $101.5K |
| 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… | 910 | $90 | $77.9K |
| 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… | 820 | $60 | $48.3K |
| 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.… | 40 | $1,000 | $42.8K |
| 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… | 470 | $90 | $40.3K |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | 6,380 | $10 | $38.3K |
| J1437 | Injection, ferric derisomaltose, 10 mg | 1,400 | $20 | $22.4K |
| Q5122 | Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg | 250 | $90 | $21.9K |
| M0010 | Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services | 270 | $70 | $19.2K |
Showing 1–10 of 50
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 50 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
50 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J9271 | 2 | 40 | 20,700 | $40 | $896.3K |
| J1437 | 23 | 20 | 6,450 | $20 | $107.8K |
| J0897 | 47 | 160 | 2,580 | $20 | $89.7K |
| 78815 | 66 | 100 | 90 | $550 | $83.7K |
| J0885 | 17 | 40 | 4,070 | $10 | $38K |
| 96413 | 35 | 80 | 380 | $90 | $36.6K |
| A9552 | 30 | 40 | 180 | $150 | $28.9K |
| Q5122 | 3 | 10 | 250 | $90 | $24.9K |
| J9217 | 31 | 50 | 100 | $130 | $20K |
| 99214 | 235 | 4,300 | 130 | $70 | $18.8K |
Showing 1–10 of 50
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.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 30 | $30 | $990 |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 20 | $0 | $0 |
| 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… | 40 | $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
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 1,521 | 1,740 | 550 | $30 | $88.8K |
| 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… | 279 | 330 | 680 | $10 | $48.3K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 504 | 550 | 330 | $1 | $10K |
Other providers in the same ZIP code as Amy Cleveland, ranked by combined Medicare and Medicaid revenue.
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