Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Massachusetts for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Massachusetts only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Massachusetts (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Hesham Malik (NPI 1194942011)

Field	Value
Entity Type	Individual
Organization	Hesham Malik
Address	55 Lake Ave N
City	Worcester
State	MA
ZIP	01655
Taxonomy	Diagnostic Radiology Physician
NPI Enumerated	April 20, 2007

Payer Source	Total Paid
Medicare	$3.9M
Medicaid	$0

Key Findings

The provider's Medicare code mix is strongly interventional-radiology focused: high-revenue CPTs include 37243 (embolization for tumors or organ ischemia), 37242 (arterial occlusion unrelated to tumor/hemorrhage), and multiple angiography and supervision codes such as 36247, 36248, and 75774. Presence of sedation codes (99152, 99153), ultrasound-guidance 76937, and high-volume supervision codes suggests the practice delivers end-to-end vascular interventional services including access, imaging, procedural sedation, and post-procedure interpretation.

Revenue concentration is extreme at the procedure level: the precomputed top-3 Medicare codes (37243, 37242, 36247) account for 88.0% of the provider's total Medicare revenue, with 37243 alone representing $2.2M (56.4% of Medicare revenue) and 37242 contributing $925.6K (24.0%). This indicates the practice's financial performance is heavily dependent on a very small set of high-value interventional procedures.

The provider is effectively single-payer in the available data: Total Medicare revenue is $3.9M while Medicaid revenue is listed as none (no Medicaid billing on file). This asymmetric payer mix means reimbursement exposure and patient volume are concentrated in Medicare, and absence of Medicaid billing should be treated as a notable gap to investigate for network participation or billing pathway differences.

Competitive standing on key procedures is dominant at the national level: 37242 ranks #1 of 55 providers nationally (100th percentile; extreme outlier) and 37243 ranks #2 of 271 providers nationally (100th percentile; extreme outlier), while 36247 ranks #7 of 903 (99th percentile; extreme outlier). These rank/percentile positions indicate the provider is a major national outlier in volume for primary interventional codes and likely operates as a high-volume specialist or regional referral source for these procedures.

A broader pattern of unusually high national ranks extends beyond the top three codes: 36248 (1.8K claims, $173.4K revenue) ranks #1 of 229 (100th percentile; extreme outlier) and 75774 (4.1K claims, $170.1K revenue) ranks #1 of 634 (100th percentile; extreme outlier). That combination of selective catheterization codes plus radiological supervision and interpretation at extreme outlier levels supports the view that the practice performs large volumes of multi-vessel angiography and associated supervisory services rather than isolated diagnostic imaging.

Long tenure in the NPI registry indicates an established operation: NPI enumerated 2007-04-20 (~19 years ago), which aligns with sustained high procedural volume rather than a short-term spike. Analysts should view the high-volume profile in light of near two decades of enumeration when assessing stability and historical practice patterns.

Clinical and financial risk is concentrated in a narrow set of interventional services: with 88.0% of Medicare revenue tied to three codes, changes in utilization, clinical referral patterns, or reimbursement for embolization and selective angiography could materially affect revenue. Given this concentration, payer negotiations, utilization review, and referral-source stability are likely key drivers of the provider's financial performance.

The absence of any Medicaid billing on file is notable and warrants follow-up: this could reflect non-participation in Medicaid, billing under a different NPI or group, or a genuinely low Medicaid caseload, and it materially shapes the provider's payer mix and access profile. Analysts should check facility-level billing, group affiliations, and credentialing records to determine whether Medicaid services are routed through other entities or truly absent.

Medicare: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
37243	The physician partially or completely blocks vascular blood flow in the target area for benign or malignant tumors (including uterine fibroids), organ ischemia, or infarction.	290	$7,440	$2.2M
37242	The physician partially or completely blocks arterial blood flow in the target area. This code is for services unrelated to hemorrhage or tumor treatment. This code is appropriate for services…	300	$3,080	$925.6K
36247	Angiography is an X–ray study of the blood vessels that helps physicians diagnose and treat medical conditions. Angiography uses a radiopaque substance (dye) to make the blood vessels visible under…	390	$750	$293.3K
36248	Angiography is an X–ray study of the blood vessels that helps physicians diagnose and treat medical conditions. Angiography uses a radiopaque substance (dye) to make the blood vessels visible under…	1,790	$100	$173.4K
75774	Angiography is an X–ray study of the blood vessels that helps physicians diagnose and treat medical conditions. Angiography uses a radiopaque substance (dye) to make the blood vessels visible under…	4,150	$40	$170.1K
75726	The provider performs radiological supervision and interpretation of angiographic imaging of specific vessels with injection of contrast (dye) into a visceral (organ) vessel or a secondary branch of…	600	$70	$42.6K
99442	N/A	520	$70	$36K
99152	The provider performing a diagnostic or therapeutic procedure administers medication to reduce consciousness, but not render the patient unconscious or asleep, in a patient five years of age or…	330	$40	$14K
76937	The provider uses ultrasound to help guide procedures requiring vascular access including central venous, peripheral venous, or arterial access procedures.	600	$20	$10.2K
99153	The provider performing a diagnostic or therapeutic procedure administers medication to reduce consciousness, but not render the patient unconscious or asleep, beyond the 15 minutes of intraservice…	890	$10	$8K

Showing 1–10 of 20

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Massachusetts Distribution

Hesham Malik — 12 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. state median

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
37242	1	10	300	$3,070	$925.6K
37243	1	10	20	$5,180	$279.7K
36248	1	10	20	$90	$22.5K
36247	1	20	20	$480	$20K
75774	1	20	30	$40	$12.3K
75726	1	10	30	$70	$6.6K
51102	1	10	20	$190	$3.5K
77002	107	210	40	$50	$2.9K
99442	7	1,200	20	$60	$2.6K
99153	2	20	180	$10	$2.5K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Imaging Subspecialists Of North Jersey, LLC	NJ	Diagnostic Radiology Physician	$0	$7.5M
James Bleiler	MA	Urology Physician	$941K	$0
Margo Moskos	MA	Diagnostic Radiology Physician	$717.3K	$137.9K
Stephen Gillard	MA	Urology Physician	$755K	$0
Petronela Iorga	MA	Anatomic Pathology & Clinical Pathology Physician	$633K	$0
Jeffrey Potter	MA	Diagnostic Radiology Physician	$355.4K	$201.1K
Vivek Sehgal	NJ	Diagnostic Radiology Physician	$281.4K	$265.1K
Abbas Chamsuddin	IL	Diagnostic Radiology Physician	$368.8K	$114.2K
Stanley Kraus	MA	Urology Physician	$449.4K	$0
Michael Curran	MA	Urology Physician	$440K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Umass Memorial Medical Center, Inc.	MA	General Acute Care Hospital	$0	$490.8M
Umass Memorial Medical Group Inc	MA	Internal Medicine Physician	$0	$98.5M
Bradley Switzer	MA	Internal Medicine Physician	$524.2K	$0
Ilsa Grunder	MA	Nurse Practitioner	$419.2K	$0
Erica Ghosh	MA	Diagnostic Radiology Physician	$286.3K	$110K
Matthew Peckham	MA	Diagnostic Radiology Physician	$348.3K	$1.1K
Umass Memorial Mri & Imaging Center, LLC	MA	Magnetic Resonance Imaging (MRI) Clinic/Center	$102.9K	$216.4K
Thomas Fitzgerald	MA	Radiation Oncology Physician	$293.9K	$0
Ryan Holstead	MA	Hematology & Oncology Physician	$270.2K	$7.6K
Robert Lee	MA	Diagnostic Radiology Physician	$269.3K	$0

Hesham Malik — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References