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NPI 1922330844 · Hot Springs, AR · Hematology & Oncology Physician
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Lingyi Chen is a hematology & oncology physician provider located in Hot Springs, Arkansas. This profile covers 51 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 | Lingyi Chen |
| Address | 1455 Higdon Ferry Rd |
| City | Hot Springs |
| State | AR |
| ZIP | 71913 |
| Taxonomy | Hematology & Oncology Physician |
| NPI Enumerated | February 2, 2010 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.3M |
| Medicaid | $1.4K |
This provider is an infusion-focused hematology/oncology practice: the Medicare revenue mix is dominated by high-cost infused and injectable oncology agents (J9271 pembrolizumab and J0897 denosumab) plus frequent chemotherapy administration codes (96413, 96401) and supportive care biologics (J0885, J1442, Q5122). Imaging (78815 PET/CT) and oncology-model payment M0010 also appear, consistent with a full-service oncology practice that provides diagnosis, systemic therapy, and treatment monitoring rather than solely clinic visits.
Revenue concentration is high on Medicare: precomputed data show the top 3 Medicare codes by revenue account for 74.9% of this provider's total Medicare revenue, with J9271 representing $593.4K (46.6%), J0897 $272.5K (21.4%), and 99213 $88.6K (6.9%). This concentration means changes in utilization, pricing, or patient mix for these specific products or visit types would materially affect overall Medicare revenue.
Payer mix is effectively single-payer at scale: this provider reported $1.3M in total Medicare revenue versus only $1.4K in total Medicaid revenue, indicating Medicare is the dominant source of billings and that Medicaid contributes a de minimis share of overall revenue. Operational and contracting focus should therefore be weighted toward Medicare arrangements and oncology drug reimbursement.
Competitive standing on key drugs is mixed. For J0897 the provider ranks #588 of 10057 nationally (94th percentile) and is described as "notably above typical national volume," indicating a strong relative role in denosumab administration; by contrast J9271 ranks #771 of 1841 (57th percentile) and is described as "typical, unremarkable volume," so pembrolizumab use is meaningful in dollar terms but not unusually concentrated compared with national peers.
The provider shows extreme billing intensity for some office and injection services: 99213 is an "extreme outlier, far above typical national volume" (rank #2262 of 457151, 100th percentile) and 96372 is also labeled an "extreme outlier" (rank #320 of 58224, 99th percentile). These labels suggest unusually high volumes of routine E/M encounters and injection events relative to national peers, which may reflect practice structure, patient throughput, or billing assignment to this NPI.
Medicaid activity is negligible and highly concentrated: precomputed data state the top 3 Medicaid codes by revenue account for 100.0% of this provider's total Medicaid revenue, and that revenue is entirely from 99213 ($1.4K, 46 claims). In-state ranking for that Medicaid 99213 volume is low (rank #1470 of 1735, 15th percentile), indicating the provider is not a major Medicaid billing source in Arkansas.
Tenure is substantial: the NPI was enumerated on 2010-02-02 (~16 years ago), indicating an established presence in the market. That longevity combined with the drug-centric revenue profile suggests an ongoing oncology practice rather than a newly opened clinic.
Operational implications for payers and network managers: given the high share of Medicare revenue tied to a small set of oncology drug codes and the provider's notable national percentile for denosumab (94th), payers should prioritize contract terms and utilization management for infused oncology agents and supportive-care biologics when evaluating this provider. The negligible Medicaid footprint means state-plan negotiations or Medicaid network considerations are likely lower priority for this NPI.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
51 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 13,800 | $40 | $593.4K |
| J0897 | Injection, denosumab, 1 mg | 14,340 | $20 | $272.5K |
| 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… | 1,480 | $60 | $88.6K |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | 8,540 | $10 | $51.2K |
| 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… | 500 | $80 | $42.1K |
| 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.… | 40 | $1,000 | $38.8K |
| 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… | 390 | $90 | $33.9K |
| Q5122 | Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg | 290 | $80 | $24.2K |
| 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… | 2,030 | $10 | $16.2K |
| J1442 | Injection, filgrastim (g-csf), excludes biosimilars, 1 microgram | 15,240 | $1 | $15.2K |
Showing 1–10 of 51
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 51 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
51 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J9271 | 31 | 40 | 20,700 | $40 | $896.3K |
| J0897 | 12 | 160 | 2,580 | $20 | $89.7K |
| 78815 | 68 | 100 | 90 | $550 | $83.7K |
| J0885 | 12 | 40 | 4,070 | $10 | $38K |
| 96413 | 40 | 80 | 380 | $90 | $36.6K |
| A9552 | 29 | 40 | 180 | $150 | $28.9K |
| Q5122 | 2 | 10 | 250 | $90 | $24.9K |
| 99214 | 708 | 4,300 | 130 | $70 | $18.8K |
| 99233 | 752 | 960 | 130 | $90 | $18.2K |
| 99232 | 648 | 1,450 | 130 | $60 | $14.7K |
Showing 1–10 of 51
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… | 50 | $30 | $1.4K |
| 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… | 50 | $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… | 1,470 | 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… | 274 | 330 | 680 | $10 | $48.3K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 509 | 550 | 330 | $1 | $10K |
Other providers in the same ZIP code as Lingyi Chen, ranked by combined Medicare and Medicaid revenue.
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