Loading...
NPI 1063851335 · La Habra, CA · Nuclear Medicine Technology Radiologic Technologist
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Modern Nuclear, Inc. is a nuclear medicine technology radiologic technologist provider located in La Habra, California. This profile covers 9 Medicare and 10 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 | Organization |
| Organization | Modern Nuclear, Inc. |
| Address | 511 S Harbor Blvd Ste E |
| City | La Habra |
| State | CA |
| ZIP | 90631 |
| Taxonomy | Nuclear Medicine Technology Radiologic Technologist |
| NPI Enumerated | June 20, 2013 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $14.6M |
| Medicaid | $1.6M |
MODERN NUCLEAR, INC. operates as a high-volume nuclear cardiology/PET myocardial perfusion center: its billing mix is dominated by PET myocardial imaging and associated radionuclide supply and pharmacologic stress agents (notably 78431, A9555, and J2785). On Medicare the provider reported 78431 with 4.9K claims ($1651 avg paid/claim) generating $8M, A9555 with 10.5K claims ($408 avg paid/claim) generating $4.3M, and J2785 with 17.7K claims ($43 avg paid/claim) generating $761.4K, reflecting a clinical model centered on rubidium-based PET and pharmacologic stress testing.
Revenue is highly concentrated by code for both payers. On Medicare the precomputed top-3 codes account for 89.2% of the provider’s Medicare revenue, and on Medicaid the top-3 codes account for 93.0% of the provider’s Medicaid revenue, indicating that most sales derive from a very narrow set of nuclear cardiology services.
The provider’s payer mix is heavily skewed toward Medicare in scale: reported lifetime Medicare revenue is $14.6M versus $1.6M in Medicaid, so while both payers are present the business is effectively Medicare-dominant in absolute revenue. Medicaid activity is meaningful for core PET services but remains a much smaller contributor to overall revenue.
MODERN NUCLEAR is a national-volume outlier on multiple Medicare codes, demonstrating market dominance in specific services. For Medicare the provider ranks #2 of 1377 for 78431 (100th percentile; extreme outlier), #2 of 1266 for A9555 (100th percentile; extreme outlier), and #2 of 6388 for J2785 (100th percentile; extreme outlier), indicating throughput far above typical national peers for these items.
State-level competitive standing in California for Medicaid mirrors the Medicare pattern: the provider ranks #1 in-state for 78431 (1.8K claims, $460 avg paid/claim, $834.4K revenue) and A9555 (2.4K claims, $255 avg paid/claim, $599.5K revenue) at the 100th percentile, marking it as a dominant in-state source for PET myocardial imaging and rubidium supply. Additional in-state leadership is shown for 78434 (2K claims, $27 avg paid/claim, $53.9K revenue), further underscoring a focused service-line dominance.
Operational profile implications flow from the billing mix: large volumes of A9555 (rubidium rb-82 doses) alongside frequent J2785 (regadenoson) and high-count PET myocardial procedure codes imply a workflow built around short-lived radiotracer logistics, scheduled pharmacologic-stress PET studies, and significant throughput. The claim counts supporting this (e.g., Medicare A9555 10.5K claims and Medicare J2785 17.7K claims) suggest specialized staffing, supply-chain reliance on rubidium generators or inventory, and scheduling optimized for repeated cardiac PET studies.
Several additional CPT/HCPCS ranks confirm concentrated, repeatable service patterns rather than broad multispecialty billing. Codes such as 93015 (Medicare 4.4K claims, $62 avg paid/claim; ranks #1 of 7716 nationally, 100th percentile) and 96374 (Medicare 5.2K claims, $34 avg paid/claim; ranks #1 of 2539 nationally, 100th percentile) support frequent use of monitored stress testing and IV medication administration as part of the cardiac imaging workflow.
The provider has an established presence with NPI enumerated 2013-06-20 (~13 years ago), which combined with its concentrated high-volume code footprint suggests a sustained, specialized service-line focus rather than a recent pivot or temporary spike in activity.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 78431 | The provider performs a PET myocardial imaging scan, a type of nuclear imaging test, with CT transmission scan that reveals blood flow to and from the heart (perfusion). Ejection fraction and… | 4,860 | $1,650 | $8M |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | 10,510 | $410 | $4.3M |
| J2785 | Injection, regadenoson, 0.1 mg | 17,710 | $40 | $761.4K |
| 78434 | The provider performs a positron emission tomography (PET) study at both rest and stress to measure myocardial blood flow. Stress is induced by injection of a drug. Report this code in conjunction… | 5,050 | $120 | $591.1K |
| 78492 | In this diagnostic procedure, the provider performs a myocardial perfusion PET imaging study which means it reveals the flow of oxygenated blood to the heart muscles. The service also includes… | 380 | $1,300 | $488K |
| 93015 | The provider supervises the recording of the electrical activity of the heart to examine any abnormality in its functioning by obtaining blood pressure and electrocardiograph readings at regular… | 4,380 | $60 | $271.6K |
| 96374 | The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition. | 5,180 | $30 | $175.9K |
| J7050 | Infusion, normal saline solution, 250 cc | 41,500 | $1 | $41.5K |
| 78430 | The provider performs a PET myocardial imaging scan, a type of nuclear imaging test, with CT transmission scan that reveals blood flow to and from the heart (perfusion). Ejection fraction and… | 20 | $1,000 | $20K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
10 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 78431 | The provider performs a PET myocardial imaging scan, a type of nuclear imaging test, with CT transmission scan that reveals blood flow to and from the heart (perfusion). Ejection fraction and… | 1,810 | $460 | $834.4K |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | 2,350 | $260 | $599.5K |
| 78434 | The provider performs a positron emission tomography (PET) study at both rest and stress to measure myocardial blood flow. Stress is induced by injection of a drug. Report this code in conjunction… | 2,000 | $30 | $53.9K |
| G0235 | Pet imaging, any site, not otherwise specified | 250 | $200 | $50.9K |
| 93015 | The provider supervises the recording of the electrical activity of the heart to examine any abnormality in its functioning by obtaining blood pressure and electrocardiograph readings at regular… | 1,550 | $20 | $31K |
| 96374 | The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition. | 2,410 | $10 | $24.1K |
| J2785 | Injection, regadenoson, 0.1 mg | 620 | $10 | $6.2K |
| 78492 | In this diagnostic procedure, the provider performs a myocardial perfusion PET imaging study which means it reveals the flow of oxygenated blood to the heart muscles. The service also includes… | 30 | $0 | $0 |
| G1004 | Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program | 1,060 | $0 | $0 |
| J7050 | Infusion, normal saline solution, 250 cc | 770 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. California median
10 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 96374 | The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition. | 290 | 510 | 3,760 | $50 | $383.4K |
| 78431 | The provider performs a PET myocardial imaging scan, a type of nuclear imaging test, with CT transmission scan that reveals blood flow to and from the heart (perfusion). Ejection fraction and… | 1 | 20 | 60 | $400 | $80.4K |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | 1 | 30 | 150 | $120 | $68.7K |
| J2785 | Injection, regadenoson, 0.1 mg | 66 | 270 | 140 | $110 | $67.9K |
| 93015 | The provider supervises the recording of the electrical activity of the heart to examine any abnormality in its functioning by obtaining blood pressure and electrocardiograph readings at regular… | 47 | 300 | 220 | $60 | $52.9K |
| G0235 | Pet imaging, any site, not otherwise specified | 1 | 10 | 250 | $200 | $50.9K |
| 78492 | In this diagnostic procedure, the provider performs a myocardial perfusion PET imaging study which means it reveals the flow of oxygenated blood to the heart muscles. The service also includes… | 25 | 30 | 200 | $60 | $26.4K |
| J7050 | Infusion, normal saline solution, 250 cc | 161 | 400 | 440 | $10 | $19.7K |
| 78434 | The provider performs a positron emission tomography (PET) study at both rest and stress to measure myocardial blood flow. Stress is induced by injection of a drug. Report this code in conjunction… | 1 | 20 | 70 | $20 | $6.4K |
| G1004 | Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program | 26 | 70 | 430 | $1 | $370 |
Other providers in the same ZIP code as Modern Nuclear, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Friends Of Family Health Center | CA | Federally Qualified Health Center (FQHC) | $0 | $66.2M |
| Vista Community Clinic | CA | Federally Qualified Health Center (FQHC) | $0 | $37M |
| Kevin Rice | CA | Ophthalmology Physician | $244.1K | $0 |
| Benjamin Huang | CA | Diagnostic Radiology Physician | $125K | $0 |
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.