NPI 1235227794 — Billing Profile & Reimbursement Data
NPI 1235227794 · XX · healthcare
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NPI 1235227794 is a healthcare provider located in Unspecified Location. This profile covers 26 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 1235227794 |
| Address | |
| City | |
| State | XX (Unspecified Location) |
| ZIP | |
| Taxonomy | N/A |
| NPI Enumerated | |
| NPI Deactivated | January 1, 2026 |
(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.
26 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| Q5119 | Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg | 1,310 | $20 | $30.1K |
| 96413 | Chemotherapy 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… | 220 | $100 | $22.4K |
| J2506 | Injection, pegfilgrastim, excludes biosimilar, 0.5 mg | 240 | $80 | $19K |
| 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… | 180 | $100 | $17.4K |
| 96417 | In 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 administration of a different chemotherapy… | 70 | $50 | $3.4K |
| J9070 | Cyclophosphamide, 100 mg | 180 | $20 | $2.9K |
| 38222 | The provider takes a scraping or sample of bone marrow tissue, using biopsy and aspiration techniques, for diagnostic purposes. Bone marrow aspiration is typically performed prior to the biopsy when… | 20 | $130 | $2.8K |
| 96367 | The provider administers an additional intravenous infusion or infusions, after an initial infusion, of a different medication or substance for a period up to one hour to prevent, treat, or diagnose… | 110 | $20 | $2.5K |
| G0498 | Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community… | 20 | $130 | $2.3K |
| 96415 | In 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 | $2K |
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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 26 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
26 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 96413 | 51 | 10 | 350 | $100 | $34.2K |
| 99214 | 2,919 | 10 | 80 | $90 | $15.8K |
| 96367 | 48 | 10 | 350 | $20 | $7.6K |
| 99232 | 3,865 | 10 | 110 | $60 | $6.9K |
| 36415 | 687 | 10 | 230 | $10 | $5.5K |
| 96417 | 40 | 10 | 100 | $50 | $4.7K |
| 96365 | 185 | 10 | 90 | $50 | $4.2K |
| 96372 | 425 | 10 | 400 | $10 | $4.1K |
| 96415 | 36 | 10 | 150 | $20 | $3.2K |
| 99204 | 3,280 | 10 | 20 | $120 | $2.8K |
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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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