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NPI 1164622353 · Lenexa, KS · Diagnostic Radiology Physician
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Bethlehem Gelaw is a diagnostic radiology physician provider located in Lenexa, Kansas. This profile covers 63 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 | Bethlehem Gelaw |
| Address | 8550 Marshall Dr |
| City | Lenexa |
| State | KS |
| ZIP | 66214 |
| Taxonomy | Diagnostic Radiology Physician |
| NPI Enumerated | July 25, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.5M |
| Medicaid | $1.3K |
Practice profile and service line: Billing is concentrated in advanced cross-sectional and nuclear medicine imaging consistent with a diagnostic radiology practice that offers PET/CT and high-end MRI services. The top Medicare revenue drivers are 78815 (PET/CT) with $545.1K (40.5% of Medicare revenue), A9595 (Piflufolastat f-18) with $244.5K (18.1%), and 74183 (MRI abdomen with and without contrast) with $100.5K (7.5%), indicating a workflow oriented around oncologic and metabolic imaging plus complex abdominal MRI protocols.
Medicare revenue concentration: The provider’s Medicare billing is highly concentrated — the precomputed top 3 Medicare codes account for 66.1% of total Medicare revenue. That concentration is led by a single, high-revenue code (78815) which alone contributes $545.1K and 40.5% of Medicare revenue, signaling reliance on a few high-cost imaging procedures.
Payer mix and scale: This clinician is effectively Medicare-dominant in scale, with lifetime Medicare revenue of $1.5M versus lifetime Medicaid revenue of $1.3K. The Medicaid footprint is de minimis relative to Medicare, so operational and strategic assessments should be driven primarily by Medicare activity.
Competitive standing on flagship services: For PET/CT (78815) the provider ranks #359 of 6566 nationally (95th percentile) and is described as notably above typical national volume, and for MRI abdomen (74183) the provider ranks #93 of 7242 nationally (99th percentile) and is labeled an extreme outlier. These ranks indicate the provider is a major/high-volume participant nationally for those specialized imaging services, rather than a modest local-volume contributor.
Mixed competitive signals across radiopharmaceuticals: A9595 (Piflufolastat f-18) produces $244.5K (18.1% of Medicare revenue) and ranks #99 of 528 nationally (81th percentile; typical, unremarkable volume), showing solid but not dominant national positioning for that specific tracer. Conversely, A9587 (Gallium ga-68, dotatate) generates $43.7K (3.2% of Medicare revenue) but ranks #68 of 77 (12th percentile; typical, unremarkable volume), indicating selective use of some radiotracers and limited scale on others.
Medicaid profile and in-state standing: Medicaid billing is tiny at $1.3K total, and the top three Medicaid codes account for 100.0% of Medicaid revenue. Those codes are 71046 ($440, 34.6% of Medicaid revenue; ranks #88 of 141 in-state, 37th percentile), 76830 ($420, 33.0%; ranks #18 of 21, 0th percentile), and 71045 ($413, 32.4%; ranks #77 of 102, 25th percentile), which together show the provider is a modest in-state participant for basic radiography and gynecologic ultrasound services rather than a Medicaid-focused imaging center.
Operational implications of volume: High national percentiles and labels like notably above typical and extreme outlier for core codes suggest substantial local capacity and throughput for PET/CT and abdominal MRI, implying investment in scanner time, radiopharmacy access, and specialized protocols. At the same time, many routine CT/ultrasound codes appear at middle-to-high percentiles (for example, 71250 at the 94th percentile and 76536 at the 96th percentile), suggesting the operation handles both high-acuity specialized studies and a steady volume of routine imaging.
Tenure and longitudinal presence: The provider’s NPI was enumerated on 2007-07-25 (~19 years ago), indicating a long-standing billing presence in Medicare and Medicaid datasets. This longevity, coupled with concentrated high-volume billing on specific advanced imaging codes, points to an established practice pattern rather than a recent change in service mix.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
63 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 78815 | PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.… | 400 | $1,380 | $545.1K |
| A9595 | Piflufolastat f-18, diagnostic, 1 millicurie | 500 | $490 | $244.5K |
| 74183 | The provider performs magnetic resonance imaging of the structures and organs of the abdomen, initially without control and then with additional sequences after injection of contrast. | 320 | $320 | $100.5K |
| 74177 | The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 180 | $280 | $49.4K |
| 74178 | The provider performs computed tomography of the abdomen and pelvis without contrast material in one or both body regions followed by contrast material in one or both body regions and additional… | 150 | $310 | $46.3K |
| A9587 | Gallium ga-68, dotatate, diagnostic, 0.1 millicurie | 230 | $190 | $43.7K |
| 78816 | The patient is injected with a radiopharmaceutical tracer called FDG (fluoro–deoxyglucose, a radioactive substance containing glucose) about one hour before the imaging is scheduled to begin. The… | 30 | $1,420 | $41.2K |
| 71250 | In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the thorax without using contrast material. | 300 | $110 | $32.7K |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 350 | $90 | $29.7K |
| 74176 | The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 150 | $160 | $24K |
Showing 1–10 of 63
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 63 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.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 71046 | In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and… | 60 | $10 | $440 |
| 76830 | The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient. | 10 | $40 | $420 |
| 71045 | In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby… | 60 | $10 | $410 |
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 |
|---|---|---|---|---|---|---|
| 71045 | In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby… | 77 | 100 | 390 | $1 | $24.1K |
| 71046 | In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and… | 88 | 140 | 100 | $10 | $8.2K |
| 76830 | The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient. | 18 | 20 | 40 | $30 | $4.3K |
Other providers in the same ZIP code as Bethlehem Gelaw, ranked by combined Medicare and Medicaid revenue.
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