NPI 1225096357 — Billing Profile & Reimbursement Data
NPI 1225096357 · XX · healthcare
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NPI 1225096357 is a healthcare provider located in Unspecified Location. This profile covers 12 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. Note: "XX" is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; claims coded under it are grouped and benchmarked here the same way a traditional state would be.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | NPI 1225096357 |
| Address | |
| City | |
| State | XX (Unspecified Location) |
| ZIP | |
| Taxonomy | N/A |
| NPI Enumerated | |
| NPI Deactivated | September 13, 2023 |
(source: CMS Medicare & Medicaid claims data)
Medicare: Total Revenue Breakdown by CPT/HCPCS Code
Medicare revenue breakdown by CPT/HCPCS procedure code.
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Medicare: Complete Services Breakdown
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 96910 | The provider applies tar or petrolatum to the skin and exposes the area to ultraviolet B, or UVB, rays to treat certain skin diseases such as psoriasis. | 930 | $90 | $83.9K |
| 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… | 370 | $100 | $38.5K |
| 17004 | The provider destroys 15 or more premalignant lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. | 200 | $140 | $27.4K |
| 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… | 270 | $70 | $19.6K |
| 17311 | Mohs surgery is a multi–staged procedure that is performed to excise a malignant lesion layer by layer, along with histo–pathological assessment. The assessment is performed to ensure that the… | 20 | $590 | $10.6K |
| 17110 | The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or… | 120 | $80 | $9.5K |
| 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… | 80 | $120 | $8.9K |
| 99203 | The provider sees a new 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 provider… | 90 | $80 | $6.9K |
| 11102 | The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette. | 60 | $90 | $5.6K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 100 | $50 | $4.3K |
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Medicare: Competitive Analysis & Benchmarks
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes. Note: this provider's state, "XX," is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; the State panel below benchmarks against other providers coded under the same designation.
View: State1 / 2
Full comparison — all codes billed, vs. state median
12 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 99213 | 6,796 | 10 | 140 | $60 | $18.8K |
| 99214 | 7,480 | 10 | 80 | $90 | $15.8K |
| 99203 | 2,410 | 10 | 140 | $90 | $12.2K |
| 99204 | 4,508 | 10 | 20 | $120 | $2.8K |
| 99212 | 1,518 | 10 | 30 | $30 | $960 |
| 11102 | 1,188 | 0 | N/A | $N/A | $N/A |
| 17000 | 1,478 | 0 | N/A | $N/A | $N/A |
| 17003 | 1,509 | 0 | N/A | $N/A | $N/A |
| 17004 | 186 | 0 | N/A | $N/A | $N/A |
| 17110 | 882 | 0 | N/A | $N/A | $N/A |
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Frequently Asked Questions
References
- 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
- 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.
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