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

Why is the Medicaid comparison limited to South Carolina 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. South Carolina (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.

Scott Sommers (NPI 1932275336)

Field	Value
Entity Type	Individual
Organization	Scott Sommers
Address	166 Stoneridge Dr
City	Columbia
State	SC
ZIP	29210
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	November 28, 2006

Payer Source	Total Paid
Medicare	$2.3M
Medicaid	$0

Key Findings

This provider is effectively a Medicare-centric practice with Total Medicare revenue of $2.3M and no Medicaid billing on file, making it a single‑payer profile for state-level Medicaid analysis. The NPI was enumerated 2006-11-28 (~20 years ago), indicating an established presence in Columbia, SC and a long tenure to support ongoing referral relationships and operational infrastructure.

Revenue is highly concentrated in a small number of high-cost oncology drugs: the precomputed top-3 codes account for 60.1% of this provider's total Medicare revenue. The three leading line items are J9271 ($722.4K, 33.2%), J9144 ($328.3K, 15.1%), and J0897 ($259.2K, 11.9%), which together drive the majority of billed Medicare dollars and define the provider’s commercial exposure to these agents.

The code mix points to a specialized hematology/oncology infusion operation: J9271 (pembrolizumab) and J9299 (nivolumab) reflect checkpoint inhibitor immunotherapy use, J9144 (daratumumab) aligns with myeloma-directed therapy, and J0897 (denosumab) shows substantial bone-modifying/supportive care activity. Presence of chemotherapy administration codes (96413, 96401, 96417) and add-on infusion codes alongside these biologics indicates integrated therapeutic infusion and supportive services provided on-site.

Competitive standing is mixed across the top drugs: J9271 ranks #568 of 1841 nationally (69th percentile; typical, unremarkable volume for this code) and J9144 ranks #284 of 615 (53th percentile; typical, unremarkable volume for this code), suggesting a modest-to-typical national presence in those immunotherapy lines. By contrast, J0897 ranks #581 of 10057 (94th percentile; notably above typical national volume for this code), indicating an outsized use of denosumab relative to national peers and a probable emphasis on bone-health management within the practice.

Visit-level E/M activity is a pronounced outlier: 99214 accounts for 1.3K claims and $121.3K (5.6% of Medicare revenue) and ranks #5057 of 479517 (99th percentile; extreme outlier). This high relative volume of moderate-complexity established patient visits suggests frequent follow-up or chronic disease management workflows consistent with ongoing oncology care and monitoring.

Ancillary services and monitoring appear robust compared with peers — several lab and basic-service codes show very high percentile standings (80048 at 98th percentile, 80076 at 96th percentile, 85025 at 95th percentile, and 36415 at 98th percentile; all characterized as typical, unremarkable volume for their codes). These high lab and phlebotomy ranks support an operational model that performs frequent on-site testing and monitoring to accompany infusion therapies.

The practice’s infusion and supportive mix is diversified within oncology: beyond high-revenue biologics, the dataset shows routine use of supportive drugs (J1627, J0185, J1439, Q5122) and imaging claims (78815, 74177) that are characterized as typical volumes. This pattern indicates a comprehensive outpatient oncology service line that combines treatment, antiemetic/supportive regimens, labs, and diagnostic imaging rather than a narrow procedural specialty.

From a payer and risk-management perspective, the combination of single‑payer dependence on Medicare and revenue concentration in a few high-cost agents (top 3 = 60.1% of Medicare revenue) creates focused financial exposure to utilization changes in those drugs. Given the provider’s ~20-year tenure and the mix of infusion, E/M, and high-frequency lab activity, payers should view this as an established oncology infusion practice with operational capacity for both therapeutic and supportive care, while monitoring for shifts in utilization of the top revenue-driving biologics.

Medicare: Complete Services Breakdown

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

72 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	16,800	$40	$722.4K
J9144	Injection, daratumumab, 10 mg and hyaluronidase‑fihj	8,640	$40	$328.3K
J0897	Injection, denosumab, 1 mg	14,400	$20	$259.2K
J9299	Injection, nivolumab, 1 mg	11,080	$20	$243.8K
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…	1,350	$90	$121.3K
J1449	Injection, eflapegrastim-xnst, 0.1 mg	2,240	$30	$56.1K
Q5122	Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg	600	$90	$55.8K
J1627	Injection, granisetron, extended-release, 0.1 mg	12,200	$1	$48.8K
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	$43.9K
J1439	Injection, ferric carboxymaltose, 1 mg	42,000	$1	$42K

Showing 1–10 of 72

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 72 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Carolina Distribution

Scott Sommers — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. state median

72 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	21	30	19,700	$40	$832K
J9299	13	10	15,760	$20	$432K
J9144	5	10	8,460	$40	$349.4K
J1569	20	20	3,860	$40	$161.4K
J1449	12	10	4,090	$30	$98.8K
J0897	23	250	2,400	$20	$91.2K
J3490	19	50	70	$510	$57.7K
Q5122	6	10	540	$90	$55.6K
J1627	5	10	10,400	$1	$46.3K
J1439	17	30	42,750	$1	$42.3K

Showing 1–10 of 72

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Riverside Radiology And Interventional Associates Inc	OH	Diagnostic Radiology Physician	$0	$30.3M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Musc Community Physicians	SC	Internal Medicine Physician	$0	$16.7M
Kershaw Hospital LLC	SC	General Acute Care Hospital	$0	$8M
Musc Community Physicians	SC	Family Medicine Physician	$0	$5.6M
Charles Butler	SC	Internal Medicine Physician	$3.8M	$0
Lindsay Gamble	SC	Family Nurse Practitioner	$3.7M	$0
Aaron Flanders	FL	Hematology & Oncology Physician	$3.5M	$0
Jill Sullivan	SC	Internal Medicine Physician	$3.4M	$0
Robert Collins	SC	Internal Medicine Physician	$2.7M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Carolina Youth Advocate Program	SC	Community/Behavioral Health Agency	$0	$64M
Lifehme, Inc.	SC	Oxygen Equipment & Supplies (DME)	$0	$45.6M
Pal-med, LLC	SC	Durable Medical Equipment & Medical Supplies	$0	$26.2M
Bright Start, LLC	SC	Speech-Language Pathologist	$0	$20.8M
Kids First Dental, LLC	SC	Dentist	$0	$20.6M
Hospice Care Of South Carolina, Lowcountry, LLC	SC	Community Based Hospice Care Agency	$0	$19.9M
Crescent Hospice, Inc.	SC	Community Based Hospice Care Agency	$0	$17.3M
Coram Healthcare/carolina Home Therapeutics	SC	Home Infusion Therapy Pharmacy	$0	$13.9M
Caring Healthcare, Inc.	SC	Nursing Care Agency	$0	$13.3M
Richland/lexington Disabilities And Special Needs Board	SC	Case Management Agency	$0	$11.3M

Scott Sommers — 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