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    OpenPayerNPI Medicare & MedicaidSarah Estes
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    Sarah Estes — Billing Profile & Reimbursement Data

    NPI 1033668637 · Owensboro, KY · Family Nurse Practitioner

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    Sarah Estes is a family nurse practitioner provider located in Owensboro, Kentucky. This profile covers 16 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationSarah Estes
    Address1000 Breckenridge St Ste 303
    CityOwensboro
    StateKY
    ZIP42303
    TaxonomyFamily Nurse Practitioner
    NPI EnumeratedSeptember 25, 2016

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$981.6K
    Medicaid$0

    Key Findings

    This provider’s Medicare footprint is the sole payer activity on file: total Medicare revenue is $981.6K while there is no Medicaid billing on file, so the practice is effectively single-payer (Medicare)-dependent for the available public claims data. This concentration of payers means overall revenue trends and payor-policy changes on Medicare will disproportionately affect the provider’s topline.

    Revenue is highly concentrated in a very small number of drug-administration codes: the precomputed top 3 Medicare codes by revenue account for 91.6% of this provider's total Medicare revenue, with J0129 contributing $622.9K (63.7%), J0717 contributing $137.6K (14.1%), and J1602 contributing $135.2K (13.8%). That concentration signals a narrow service-line focus and elevated financial sensitivity to volume or reimbursement changes for those specific drugs.

    The code mix is dominated by biologic and infusion administrations: J0129, J0717, and J1602 are all injectable biologic/infusion drugs, and the presence of infusion/chemotherapy administration codes such as 96413, 96365 and the add-on 96415 further indicates the operation provides on‑site infusion and parenteral drug delivery services rather than being primarily a pure primary‑care E/M practice. Together, these codes point to an infusion-oriented service model (e.g., biologic administration and chemotherapy/infusion workflows).

    Volume dynamics drive the drug revenue: the top three drug codes show very large claim counts (J0717 34.4K claims, J0129 18.9K claims, J1602 13.5K claims) but low average paid per claim ($4 for J0717, $33 for J0129, $10 for J1602), indicating that total revenue is being generated by high claim volumes rather than high per-claim payments. This profile is consistent with a high-throughput infusion administration operation where aggregate dollars accrue from many low-dollar drug billing events.

    Competitive standing is mixed across the leading codes: for J0129 the provider ranks #155 of 1221 nationally (87th percentile) — indicating a stronger-than-average national presence on that code even though the dataset labels the volume as “typical, unremarkable.” By contrast, J0717 ranks #592 of 848 (30th percentile) and J1602 ranks #511 of 1041 (51th percentile), both described as “typical, unremarkable,” which places the provider as a modest participant for those drugs on the national stage.

    Non-drug E/M activity is present and relatively elevated: 99214 accounts for 645 claims, $75 avg paid/claim, and $48.4K revenue (4.9% of Medicare revenue), and the provider ranks #30965 of 479517 (94th percentile) on 99214 with the label “notably above typical national volume.” This suggests the practice combines ongoing office-based management with its infusion work, supporting longitudinal patient follow-up in addition to procedural drug administration.

    Additional lower-value infusion and procedural codes appear at modest volumes (96413, 96365, 96372 and 96415 are all present with dataset labels of “typical, unremarkable”), reinforcing the interpretation that the operation conducts routine infusion and injection services rather than a broad mix of unrelated specialties. These ancillary codes each represent small shares of total Medicare revenue but align with an infusion/administration service-line.

    The provider has an established billing history with an NPI enumerated 2016-09-25 (~10 years ago), indicating roughly a decade of recorded Medicare activity. That tenure, combined with the concentrated biologic/infusion revenue profile, suggests an established practice model specializing in drug administration services within the Medicare population.

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    16 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J0129Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)18,880$30$622.9K
    J0717Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)34,400$1$137.6K
    J1602Injection, golimumab, 1 mg, for intravenous use13,520$10$135.2K
    99214The 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…650$80$48.4K
    96413Chemotherapy 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…160$80$12.3K
    96365The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.300$40$11.6K
    99204The 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…40$90$3.6K
    96372A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…270$10$2.4K
    96415In this add on procedure, the provider continues administration of a chemotherapy drug into a vein using an infusion technique. He uses this code to report each additional hour of infusion beyond the…90$20$1.5K
    20610In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…20$40$800

    Showing 1–10 of 16

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    16 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J01299309,700$30$415.4K
    J0717203046,400$1$288.1K
    J160282011,560$10$141.6K
    964131850100$90$16.7K
    992143467,230110$70$14.1K
    992137,0347,25080$50$7.7K
    2061056964080$40$6.6K
    96365870110$40$6.4K
    992041,2993,20030$100$4.8K
    96415164080$20$2.1K

    Showing 1–10 of 16

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Owensboro Health Medical Group, IncKYFamily Medicine Physician$0$10.6M
    Owensboro Health Medical Group, Inc.KYSpecialist$0$3.9M
    Kishor VoraKYCardiovascular Disease Physician$2M$334.5K
    Timothy LoneskyKYRheumatology Physician$1.5M$0
    Scott LewisKYRheumatology Physician$1.5M$0
    Roneka RavenellINRheumatology Physician$1.3M$0
    Todd ScarbroughTNTherapeutic Radiology Physician$1.3M$0
    Roshan MathewKYInterventional Cardiology Physician$1M$0
    Dana MannKYFamily Nurse Practitioner$824.8K$0
    Melissa ChengKYNurse Practitioner$703.4K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Owensboro Health IncKYGeneral Acute Care Hospital$0$148.8M
    Green River District Home HealthKYEarly Intervention Provider Agency$0$22.1M
    Wendell Foster's Campus For Developmental DisabilitiesKYComprehensive Outpatient Rehabilitation Facility (CORF)$0$19M
    Puzzle Pieces, Inc.KYCommunity/Behavioral Health Agency$0$13.2M
    Caretenders Vs Of Western Ky, LLCKYHome Health Agency$0$12.8M
    Truenorth Treatment Center, LLCKYSubstance Use Disorder Rehabilitation Clinic/Center$0$11.8M
    Community Alternatives Kentucky, Inc.KYCase Management Agency$0$9.5M
    Owensboro Pediatrics LLCKYPediatrics Physician$0$9.2M
    Owensboro Health Medical Group, IncKYPediatrics Physician$0$7.4M
    Green River District Health DeptKYHome Health Agency$0$7.2M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Kentucky Distribution
    Sarah Estes — 2 of 15 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Kentucky