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

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

Lydia Clements (NPI 1942618962)

Field	Value
Entity Type	Individual
Organization	Lydia Clements
Address	4701 Ogletown Stanton Road
City	Newark
State	DE
ZIP	19713
Taxonomy	Medical Oncology Physician
NPI Enumerated	July 23, 2014

Payer Source	Total Paid
Medicare	$1.3M
Medicaid	$0

Key Findings

This provider's Medicare activity is concentrated in high-cost oncology biologics, with J9271 (pembrolizumab) accounting for $670.8K and 53.1% of the provider's Medicare revenue, and the top three Medicare codes together accounting for 70.9% of total Medicare revenue. Those three drugs (J9271, J0897, J9144) dominate billing, indicating the practice’s revenue is heavily dependent on a small number of infused cancer therapies rather than dispersed office-based services.

The overall Medicare scale for this provider is $1.3M in lifetime revenue while Medicaid shows none (no Medicaid billing on file), so the provider is effectively single-payer with exposure concentrated in Medicare. Absence of any Medicaid billing suggests either a clinical focus on Medicare-aged oncology patients or a billing/networking configuration that does not engage Medicaid populations.

Clinical/service-line signals point to an infusion-centered oncology practice: large volumes of infused immunotherapy and monoclonal antibody codes (J9271, J9144) together with supportive-care injectables (J0897 denosumab, J1449 eflapegrastim, Q5122 pegfilgrastim biosimilar) and chemotherapy administration codes (96413, 96365, G0498). This mix implies routine outpatient infusion operations, likely with on-site nursing and drug procurement capacity to administer high-cost biologics.

Revenue concentration creates operational sensitivity: J9271 alone is $670.8K (53.1% of Medicare revenue) and the top three Medicare codes account for 70.9% of Medicare revenue, so changes in utilization, coverage, or supplier pricing for these agents could materially affect revenue. From a payer-management perspective, utilization review or contract design around these specific J-codes would likely capture the majority of the provider’s Medicare spend.

Competitive standing versus national peers is mixed across codes: J9271 ranks #640 of 1841 providers nationally (65th percentile), indicating above-median but not dominant use of pembrolizumab; J0897 ranks #2106 of 10057 (79th percentile), showing relatively strong denosumab use; conversely J9144 ranks #592 of 615 providers nationally (3th percentile), indicating minimal national activity for that code. These rank patterns suggest the provider is a notable user of some osteoporosis/oncology supportive injections and pembrolizumab, but not a major national provider of every specialty biologic.

Visit-level coding shows sustained office activity: 99213 generated $32.1K (2.5% of Medicare revenue) and ranks #26909 of 457151 providers nationally (94th percentile), and 99214 contributed $26.8K (2.1% of Medicare revenue) with a 78th percentile rank. High percentile rankings on common E/M codes indicate the provider maintains substantial routine outpatient evaluation volume alongside infusion services, supporting a combined clinic/infusion model rather than purely procedural billing.

There are low-percentile outliers in certain ancillary drug codes that warrant attention: J1568 (immune globulin) reports $25.2K and ranks #374 of 381 (2th percentile), and J9144 (daratumumab) despite $109.4K in revenue ranks at the 3th percentile nationally. These low-percentile positions mean the provider’s activity for those specific codes is small compared with national distributions and could reflect niche, episodic, or recently adopted services rather than core volume drivers.

Tenure data show the provider’s NPI was enumerated 2014-07-23 (~12 years ago), establishing a multi-year presence in the Medicare market. That tenure combined with a concentrated drug mix and active E/M billing pattern suggests an established oncology practice with stable operations focused on Medicare beneficiaries and outpatient infusion services.

Medicare: Complete Services Breakdown

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

47 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	15,600	$40	$670.8K
J0897	Injection, denosumab, 1 mg	6,420	$20	$115.6K
J9144	Injection, daratumumab, 10 mg and hyaluronidase‑fihj	2,880	$40	$109.4K
J1449	Injection, eflapegrastim-xnst, 0.1 mg	2,510	$30	$62.7K
Q5122	Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg	380	$100	$37.2K
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…	350	$110	$37.1K
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…	500	$60	$32.1K
J1437	Injection, ferric derisomaltose, 10 mg	1,800	$20	$28.8K
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…	290	$90	$26.8K
J1568	Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg	740	$30	$25.2K

Showing 1–10 of 47

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 47 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Delaware Distribution

Lydia Clements — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. state median

47 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	6	10	17,600	$40	$992.4K
J9144	7	10	9,360	$40	$420.8K
J1568	4	10	2,660	$30	$146.7K
J0897	16	60	3,360	$20	$132.9K
J1449	2	10	3,960	$20	$97.4K
Q5122	4	10	400	$100	$61.8K
J0881	3	10	25,410	$1	$57.7K
J1437	4	10	1,800	$20	$47.1K
J1454	6	10	90	$340	$38.1K
96413	12	30	280	$100	$36.6K

Showing 1–10 of 47

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Medical Oncology Hematology Consultants PA	DE	Hematology & Oncology Physician	$0	$7.7M
Jamal Misleh	DE	Hematology & Oncology Physician	$6.8M	$0
Dhaval Shah	DE	Hematology & Oncology Physician	$2.5M	$0
Gregory Masters	DE	Medical Oncology Physician	$2.3M	$0
Evan Lapinsky	DE	Hematology & Oncology Physician	$1.7M	$0
Sujung Park	DE	Hematology & Oncology Physician	$1.2M	$0
Amy Mcghee Jez	DE	Hematology & Oncology Physician	$1.1M	$0
Andrew Himelstein	DE	Hematology & Oncology Physician	$1.1M	$0
Roberto Ferro Valdes	SD	Hematology & Oncology Physician	$1.1M	$0
Martha Hosford Skapof	DE	Hematology & Oncology Physician	$748.2K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Associated Retinal Consultants LLC	DE	Ophthalmology Physician	$0	$25.2M
Columbus Medical Services, LLC	DE	Case Management Agency	$0	$18.7M
Christiana Care Health Services Inc	DE	Hospitalist Physician	$0	$13.6M
Caritas Home Health Services, Inc	DE	Home Health Agency	$0	$11.2M
Delaware Center For Maternal Fetal Medicine Of Christiana Care	DE	Maternal & Fetal Medicine Physician	$0	$9.8M
Christiana Care Health Services Inc	DE	Neonatal-Perinatal Medicine Physician	$0	$8.9M
Christiana Care Quality Partners	DE	Urgent Care Clinic/Center	$0	$7M
Mid-atlantic Behavioral Health, LLC	DE	Intellectual & Developmental Disabilities Psychologist	$0	$6.5M
First State Orthopaedics, PA	DE	Orthopaedic Surgery Physician	$0	$6M
Autism Delaware	DE	Intellectual & Developmental Disabilities Psychologist	$0	$5.8M

Lydia Clements — 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