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NPI 1013987924 · Hutchinson, KS · Hematology & Oncology Physician
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Fadi Estephan is a hematology & oncology physician provider located in Hutchinson, Kansas. This profile covers 53 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 | Fadi Estephan |
| Address | 2101 N Waldron St |
| City | Hutchinson |
| State | KS |
| ZIP | 67502 |
| Taxonomy | Hematology & Oncology Physician |
| NPI Enumerated | January 24, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.2M |
| Medicaid | $1.2K |
This provider’s business is effectively Medicare-centric: reported Total Medicare revenue is $1.2M versus Total Medicaid revenue of $1.2K, so Medicaid is de minimis compared with Medicare and the practice is functionally single‑payer at scale. The Medicaid book is tiny in absolute dollars, while Medicare drives the economics of the operation.
Medicare revenue is materially concentrated: the precomputed top‑3 Medicare codes account for 49.5% of the provider’s Medicare revenue, with J0897 at 18.2%, J9271 at 17.2%, and 99214 at 14.1%. This indicates that a small set of high‑revenue items—two injectable agents plus a high‑volume E/M code—dominate receipts.
Service mix and operations are consistent with an office‑based hematology/oncology infusion practice: high billing for oncology/immunotherapy agents (J9271 pembrolizumab and J0897 denosumab) alongside chemotherapy/infusion administration codes (96413, 96365) and frequent E/M visits (99213/99214). The code mix also includes routine lab work (85025, 80053) and phlebotomy (36415), supporting an integrated clinic model that delivers infusions, monitoring labs, and ongoing outpatient management.
Competitive standing on the two top drug codes is mixed: J0897 ranks #887 of 10057 nationally (91th percentile) and is described as "typical, unremarkable volume," indicating a solid but not dominant presence in denosumab administration, while J9271 ranks #1732 of 1841 nationally (5th percentile) and is also labeled "typical, unremarkable volume," which in this context reflects relatively low national participation in pembrolizumab compared with oncology peers. In short, the provider participates in high‑cost drug delivery but is not a national leader for these agents.
The provider is an extreme outlier for office E/M volume: 99214 (1.8K claims) and 99213 (1.9K claims) are both described as "extreme outlier, far above typical national volume," and 99214 alone represents 14.1% of Medicare revenue. This suggests a very high cadence of established‑patient visits and ongoing longitudinal management typical of a busy specialty clinic rather than occasional consultative visits.
Although Medicaid billing is negligible in dollar terms, the Medicaid revenue is highly concentrated: the precomputed top‑3 Medicaid codes account for 100.0% of the provider’s Medicaid revenue, with 99214 making up 87.3% and 85025 the remainder. However, Medicaid ranks for 99214 are modest in‑state (rank #790 of 882, 10th percentile, labeled "typical, unremarkable volume"), reinforcing that the provider’s Medicaid footprint is small relative to local peers.
Ancillary diagnostic and support services are a meaningful part of the practice footprint: 85025 (CBC) and 80053 (CMP) appear among top Medicare codes and 85025 ranks #366 of 32833 nationally (99th percentile, labeled "typical, unremarkable volume"), while 36415 (venipuncture) ranks #404 of 86467 (100th percentile). These high percentile ranks for routine labs and blood draws are consistent with in‑office monitoring tied to infusion and chronic treatment workflows.
The provider has long tenure on file, enumerated NPI since 2006-01-24 (~20 years ago), which supports interpretation of the current billing mix as the product of an established outpatient hematology/oncology practice rather than a recent startup or short‑term program. Tenure combined with the high E/M volumes suggests a sustained, clinic‑based patient panel and ongoing treatment relationships.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
53 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0897 | Injection, denosumab, 1 mg | 11,580 | $20 | $208.4K |
| J9271 | Injection, pembrolizumab, 1 mg | 4,600 | $40 | $197.8K |
| 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… | 1,840 | $90 | $161.7K |
| 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… | 1,850 | $60 | $109.2K |
| J3111 | Injection, romosozumab-aqqg, 1 mg | 11,550 | $10 | $92.4K |
| J1602 | Injection, golimumab, 1 mg, for intravenous use | 6,250 | $10 | $62.5K |
| J1439 | Injection, ferric carboxymaltose, 1 mg | 60,750 | $1 | $60.8K |
| 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… | 4,490 | $10 | $36K |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 1,330 | $30 | $34.6K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 3,390 | $10 | $33.9K |
Showing 1–10 of 53
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 53 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
53 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J9271 | 20 | 20 | 28,900 | $40 | $1.1M |
| J3111 | 7 | 10 | 17,700 | $10 | $198.5K |
| J1602 | 16 | 20 | 14,360 | $10 | $167.7K |
| J1745 | 18 | 20 | 3,110 | $30 | $96.9K |
| J0897 | 16 | 180 | 2,160 | $20 | $81.5K |
| J1439 | 3 | 10 | 41,250 | $1 | $66.1K |
| J0881 | 12 | 10 | 10,830 | $1 | $33.8K |
| J1454 | 9 | 10 | 90 | $350 | $31.7K |
| 96413 | 30 | 80 | 80 | $90 | $26.3K |
| 82784 | 5 | 10 | 110 | $10 | $26.1K |
Showing 1–10 of 53
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 |
|---|---|---|---|---|
| 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… | 20 | $50 | $1K |
| 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 | $1 | $150 |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 30 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Kansas providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Kansas median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 790 | 880 | 400 | $60 | $136K |
| 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… | 164 | 200 | 580 | $1 | $44.4K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 279 | 320 | 350 | $1 | $1.5K |
Other providers in the same ZIP code as Fadi Estephan, ranked by combined Medicare and Medicaid revenue.
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