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NPI 1033100581 · Washington, DC · Cardiovascular Disease Physician
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Norman Allen is a cardiovascular disease physician provider located in Washington, District of Columbia. This profile covers 22 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 | Norman Allen |
| Address | 1647 Benning Rd Ne |
| City | Washington |
| State | DC |
| ZIP | 20002 |
| Taxonomy | Cardiovascular Disease Physician |
| NPI Enumerated | November 3, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $339.4K |
| Medicaid | $4.6K |
This provider’s revenue mix is heavily Medicare‑centric: total Medicare revenue is $339.4K versus total Medicaid revenue of $4.6K, indicating Medicare dominates the payer mix and the provider is effectively a Medicare-focused practice. The NPI was enumerated on 2005-11-03 (~21 years ago), so this is an established clinician with a long tenure in the Medicare program.
Revenue concentration on Medicare is high: the precomputed top 3 Medicare codes by revenue account for 65.8% of this provider's total Medicare revenue, with 99214 ($98.5K, 29.0%), 93306 ($74.9K, 22.1%), and 99213 ($50K, 14.7%) as the leading drivers. That concentration — dominated by two office E/M codes and one major echocardiography code — signals that follow-up outpatient management plus in‑office cardiac imaging are the core service lines.
The clinical mix suggests a cardiology practice focused on outpatient management and diagnostics: high revenue from 99214 and 99213 indicates substantial office/established‑patient visits, while 93306 and related imaging codes (for example 78452 at $30.3K and A9502 at $7.7K) show significant use of echocardiography and nuclear cardiac studies. Together these codes imply the provider operates an ambulatory cardiology service line that performs both evaluation/management and on‑site diagnostic testing.
On national competitive standing for key Medicare codes, this provider reports notably above‑typical national volumes for 99214 (rank #14686 of 479517, 97th percentile) and 99213 (rank #9501 of 457151, 98th percentile), and also for 93000 (rank #2415 of 71016, 97th percentile). By contrast, 93306 (rank #4089 of 24624, 83rd percentile) and several imaging codes sit at more typical national volumes. This profile indicates the provider is a high‑volume office E/M and ECG interpreter nationally, while echocardiography volume is solid but not extreme.
Medicaid activity is very limited and highly concentrated: the precomputed top 3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue, with 93306 representing $2.5K (56.4%), 93010 $1.2K (27.1%), and 93000 $741 (16.5%). In‑state ranks for those Medicaid codes are modest to low (93306 rank #31 of 34, 9th percentile; 93010 rank #18 of 26, 32nd percentile; 93000 rank #29 of 38, 24th percentile), indicating the provider is not a major Medicaid imaging or ECG resource within the state.
The presence of care‑coordination and transition codes (99497: $8.2K, 99495: $3.9K) and the annual wellness visit code G0439 ($13.8K) suggests the practice also engages in advance care planning and post‑discharge transition management in addition to diagnostics. These non‑procedural codes complement the office E/M dominance and indicate a broader outpatient cardiology care model that includes preventive and transitional services.
Although the largest single Medicare revenue item is an office visit code (99214 at $98.5K, 29.0%), procedural diagnostic testing remains an important secondary revenue stream (93306 at $74.9K, 22.1% and 78452 at $30.3K, 8.9%). This split implies operational investments in imaging capability or access to imaging facilities, and suggests payer contracting and utilization reviews should consider both high ambulatory visit volumes and significant in‑office cardiac diagnostics.
Given the stark Medicare/Medicaid revenue imbalance ($339.4K vs $4.6K) and the Medicaid rank percentiles, payer strategies that focus on Medicare population management and outpatient cardiology utilization will be more relevant for assessing this provider’s impact on cost and access than Medicaid initiatives. The provider’s long tenure (~21 years) and high national percentiles on several Medicare codes support treating them as an experienced, Medicare‑oriented ambulatory cardiology clinician rather than a high‑volume Medicaid provider.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
22 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… | 900 | $110 | $98.5K |
| 93306 | The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent… | 470 | $160 | $74.9K |
| 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… | 850 | $60 | $50K |
| 78452 | In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood… | 70 | $410 | $30.3K |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 100 | $150 | $13.8K |
| 99204 | The provider sees a new 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 provider… | 70 | $150 | $10K |
| 93000 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 790 | $10 | $8.7K |
| 99497 | The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30… | 120 | $70 | $8.2K |
| 93925 | The provider performs a duplex ultrasound scan of the lower extremity arteries or bypass grafts on both sides. Providers perform noninvasive arterial diagnostic procedures to examine the rate of… | 40 | $220 | $7.8K |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | 70 | $110 | $7.7K |
Showing 1–10 of 22
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
22 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 93306 | 13 | 80 | 240 | $110 | $32.4K |
| 78452 | 15 | 40 | 60 | $340 | $22.6K |
| 99214 | 20 | 1,400 | 90 | $100 | $15.3K |
| 93925 | 17 | 30 | 40 | $160 | $12.4K |
| G0439 | 81 | 250 | 60 | $140 | $12.2K |
| 93880 | 37 | 60 | 40 | $130 | $11.1K |
| 99213 | 20 | 1,200 | 50 | $70 | $8.5K |
| J2785 | 20 | 30 | 150 | $40 | $6.8K |
| 99204 | 162 | 670 | 30 | $130 | $6.4K |
| 93978 | 9 | 10 | 40 | $140 | $6K |
Showing 1–10 of 22
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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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 |
|---|---|---|---|---|
| 93306 | The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent… | 10 | $180 | $2.5K |
| 93010 | The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram. | 200 | $10 | $1.2K |
| 93000 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 60 | $10 | $740 |
How this provider's Medicaid billing volume and revenue compare to other District of Columbia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. District of Columbia median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 93306 | The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent… | 31 | 30 | 450 | $130 | $439.5K |
| 93010 | The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram. | 18 | 30 | 1,150 | $1 | $68.2K |
| 93000 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 29 | 40 | 250 | $10 | $13.4K |
Other providers in the same ZIP code as Norman Allen, ranked by combined Medicare and Medicaid revenue.
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