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

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

Thomas Alberico (NPI 1922001064)

Field	Value
Entity Type	Individual
Organization	Thomas Alberico
Address	5900 Lake Wright Dr
City	Norfolk
State	VA
ZIP	23502
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	May 23, 2005

Payer Source	Total Paid
Medicare	$3.5M
Medicaid	$0

Key Findings

THOMAS ALBERICO is a hematology & oncology physician enumerated on 2005-05-23 (~21 years ago) with Total Medicare revenue of $3.5M and no Medicaid billing on file, making his practice effectively single-payer (Medicare) in the available claims data. The NPI tenure and concentrated payer exposure suggest a well-established Medicare-facing oncology practice in Norfolk, VA.

Revenue is highly concentrated in a narrow set of oncology infusions: the precomputed top three Medicare codes account for 69.1% of this provider's Medicare revenue. Those top drivers are J9271 ($1.2M, 35.6%), J9299 ($752.2K, 22.4%), and J9358 ($372K, 11.1%), indicating most revenue flows from a small number of high-cost drug administrations.

The code mix indicates an infusion-centered oncology practice delivering advanced immunotherapies and antibody–drug conjugates: J9271 (pembrolizumab), J9299 (nivolumab) and J9358 (fam-trastuzumab deruxtecan) dominate revenue. Ancillary chemotherapy administration and infusion codes such as 96413 (825 claims, $80.9K) and G0498 (91 claims, $16K) further support that the operation is structured around on-site drug administration rather than primarily clinic consults.

Competitive standing varies by drug: J9358 is a standout — the provider ranks #1 of 6 nationally (100th percentile; notably above typical national volume) for that code, signaling a rare high-volume position in fam-trastuzumab deruxtecan administration. By contrast, J9271 ($1.2M) ranks #160 of 1841 (91th percentile; typical, unremarkable volume) and J9299 ($752.2K) ranks #69 of 505 (87th percentile; typical, unremarkable volume), so the provider is a dominant national outlier for a specific ADC while holding typical to above-typical positions on checkpoint inhibitors.

Several non-top-3 items also register as statistical high-volume signals for this provider: 99213 (2K claims, $127.6K) is labeled an "extreme outlier" at the 100th percentile nationally, 96375 (1.5K claims, $17.4K) is a 99th percentile extreme outlier, and J0881 (53.5K claims, $107.1K) is at the 95th percentile and described as notably above typical national volume. These patterns point to unusually high counts of both evaluation/management encounters and supportive or procedural infusion services compared with national peers.

The absence of any Medicaid billing (none below) contrasts with substantial Medicare activity ($3.5M) and implies limited Medicaid exposure in this provider’s payer mix. That single-payer concentration could mean greater sensitivity to Medicare policy and reimbursement shifts and limits visibility into care patterns for Medicaid beneficiaries.

Operationally, the practice appears to perform high volumes of on-site diagnostics and specimen handling to support infusion care: 80053 (4K claims, $40.1K) and 85025 (4.5K claims, $36.2K) are both at the 99th percentile nationally for claim counts, and 36415 (2.7K claims, $21.9K) is also at the 99th percentile. These lab and venipuncture volumes align with a clinic infrastructure that provides frequent bloodwork and infusion monitoring as part of systemic cancer therapy.

Taken together, the longevity of the NPI (2005-05-23, ~21 years) plus concentrated Medicare revenue driven by high-cost oncology infusions and several 95–100th percentile code volumes suggest an established, infusion-focused oncology practice with a national leadership position for at least one emerging ADC (J9358) while remaining a typical or above-typical participant for common immunotherapy agents.

Medicare: Complete Services Breakdown

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	27,800	$40	$1.2M
J9299	Injection, nivolumab, 1 mg	31,340	$20	$752.2K
J9358	Injection, fam-trastuzumab deruxtecan-nxki, 1 mg	18,600	$20	$372K
J0897	Injection, denosumab, 1 mg	9,480	$20	$170.6K
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…	2,030	$60	$127.6K
J9264	Injection, paclitaxel protein-bound particles, 1 mg	11,500	$10	$115K
J0881	Injection, darbepoetin alfa, 1 microgram (non-esrd use)	53,540	$1	$107.1K
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…	830	$100	$80.8K
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…	740	$90	$68.5K
J2506	Injection, pegfilgrastim, excludes biosimilar, 0.5 mg	580	$80	$46.7K

Showing 1–10 of 86

Medicare: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Thomas Alberico — 14 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. state median

86 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	8	110	12,800	$40	$610.9K
J9358	1	10	18,600	$20	$380.8K
J9299	1	30	12,920	$20	$335.4K
J0897	43	340	2,820	$20	$89.3K
J9264	2	10	6,800	$10	$86.1K
J0881	2	80	10,200	$1	$34.5K
88185	49	60	620	$20	$34.3K
Q5122	15	40	270	$90	$32.5K
J2506	4	40	360	$80	$31.2K
96413	5	230	250	$100	$28.5K

Showing 1–10 of 86

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Virginia Oncology Associates	VA	Hematology & Oncology Physician	$0	$6.2M
Maryland Oncology Hematology P.A.	MD	Hematology & Oncology Physician	$0	$4.6M
Victor Archie	VA	Radiation Oncology Physician	$4M	$0
Julia Schaefer-cutillo	NC	Hematology & Oncology Physician	$4M	$0
Mark Fleming	VA	Hematology & Oncology Physician	$3.9M	$0
David Kobulnicky	VA	Hematology & Oncology Physician	$3M	$0
Celesteann Bremer	VA	Hematology & Oncology Physician	$2.8M	$0
Bo Zhao	VA	Hematology & Oncology Physician	$2.6M	$0
Michael Lee	VA	Specialist	$2.3M	$0
Ligeng Tian	VA	Hematology & Oncology Physician	$2.2M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sentara Hospitals	VA	General Acute Care Hospital	$0	$79.7M
Tremont Road Dental Super, P.C.	VA	General Practice Dentistry	$0	$63.5M
Sentara Medical Group	VA	Family Medicine Physician	$0	$48.7M
Emergency Physicians Of Tidewater	VA	Emergency Medicine Physician	$0	$47.9M
Community Alternative Inc	VA	Community/Behavioral Health Agency	$0	$44.3M
Life's Journey	VA	Adult Mental Health Clinic/Center	$0	$24.4M
Keys To Success Family & Developmental Services	VA	Community/Behavioral Health Agency	$0	$16.1M
Advantage Home Care, LLC	VA	Home Health Agency	$0	$15.7M
National Counseling Group, Inc	VA	Mental Health Counselor	$0	$14.5M
Childrens Medical Group Inc	VA	Pediatrics Physician	$0	$9.1M

Thomas Alberico — 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