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NPI 1376515692 · Morgantown, WV · Internal Medicine Physician
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Sanjay Bharti is a internal medicine physician provider located in Morgantown, West Virginia. This profile covers 37 Medicare and 2 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 | Sanjay Bharti |
| Address | 1526 Mileground Rd |
| City | Morgantown |
| State | WV |
| ZIP | 26505 |
| Taxonomy | Internal Medicine Physician |
| NPI Enumerated | February 2, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $934.5K |
| Medicaid | $5.9K |
Practice focus is concentrated on inpatient and nursing-facility E/M services: the provider’s top Medicare revenue codes are 99232 (subsequent hospital inpatient care), 99309 (subsequent nursing facility care), and 99239 (discharge day management), which together drive the bulk of billed Medicare activity. This mix of high-volume hospital and SNF evaluation-and-management codes is consistent with a provider who primarily delivers inpatient and post-acute care rather than office-based primary care workflows.
Extremely high national volume on select Medicare codes indicates a dominant role in those service lines: 99232 shows 6.1K claims and $365.5K revenue (39.3% of this provider's total Medicare revenue) and is ranked #45 of 177383 providers nationally (100th percentile; extreme outlier), while 99309 reports 3.2K claims and $248.6K revenue (26.7% of Medicare revenue) and ranks #241 of 28092 providers nationally (99th percentile; extreme outlier). These ranks and volumes suggest the provider is a major outlier nationally for hospital and nursing-facility follow-up visits.
Revenue concentration is high on Medicare: the precomputed top 3 Medicare codes by revenue account for 70.6% of this provider's total Medicare revenue, signaling material exposure if utilization patterns for those specific E/M codes change. On Medicaid the concentration is even more extreme in the recorded claims mix: the precomputed top 3 Medicaid codes by revenue account for 100.0% of this provider's total Medicaid revenue, highlighting single-code dependence at the state-payer level.
Payer mix is effectively Medicare-dominant: total Medicare revenue is $934.5K compared with total Medicaid revenue of $5.9K, so the provider’s commercial and public-financed volume (as represented here) is overwhelmingly on Medicare. Medicaid billing is present but immaterial in scale relative to Medicare, indicating operational and revenue sensitivity mainly tied to Medicare policies and utilization.
State-level Medicaid participation is modest despite shared code presence with Medicare: the Medicaid activity is dominated by 99309 (234 claims, $24 avg paid/claim, $5.6K revenue — 92.9% of this provider's total Medicaid revenue) but ranks #42 of 78 providers in-state (45th percentile; typical, unremarkable volume). That ranking shows the provider is not a leading Medicaid SNF biller within West Virginia even though 99309 is a top Medicare driver nationally for this provider.
Service breadth includes both acute and preventive services: beyond high-volume inpatient and SNF codes, the Medicare claims list also shows discharge management (99239), critical care (99291), initial hospital care (99222/99223), and annual wellness visits (G0438/G0439). This coding pattern indicates the provider bills across acute inpatient episodes, time-intensive care events, post-acute nursing facility visits, and some preventive outpatient work, implying operational coverage across hospital and post-acute settings.
Several Medicare codes are flagged as statistical outliers nationally, reinforcing exceptional activity in certain service lines: 99232 and 99222 are labeled extreme outlier (100th percentile) and 99309 is labeled extreme outlier (99th percentile), while other codes such as 99223 and 99497 are described as notably above typical. These outlier labels suggest concentration of expertise or assignment to specific clinical roles with above-typical volumes rather than routine office-based practice patterns.
Provider tenure: the NPI was enumerated on 2006-02-02 (~20 years ago), establishing a long period of Medicare/Medicaid eligibility. That extended enrollment window supports the view that the current high-volume inpatient and nursing-facility billing profile is not a short-term artifact but reflects an established practice pattern over many years.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
37 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 6,090 | $60 | $365.5K |
| 99309 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider… | 3,190 | $80 | $248.6K |
| 99239 | The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the… | 500 | $90 | $43.2K |
| 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… | 490 | $80 | $39.9K |
| 99222 | The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 400 | $100 | $38.3K |
| 99308 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider… | 530 | $50 | $28.4K |
| 99223 | The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 210 | $130 | $28.3K |
| 99497 | The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30… | 390 | $60 | $22.8K |
| 99233 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 200 | $90 | $18.1K |
| 99291 | Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is… | 100 | $160 | $16K |
Showing 1–10 of 37
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 37 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
37 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 99309 | 2 | 160 | 160 | $70 | $26.3K |
| 87636 | 6 | 10 | 30 | $140 | $19K |
| 99310 | 39 | 50 | 80 | $100 | $12.8K |
| 99232 | 1 | 1,340 | 90 | $60 | $11.9K |
| 99214 | 174 | 2,740 | 100 | $70 | $11.8K |
| 99233 | 118 | 660 | 60 | $90 | $11.4K |
| 99308 | 19 | 150 | 110 | $50 | $10.7K |
| 99306 | 13 | 60 | 50 | $130 | $10.3K |
| 99291 | 67 | 420 | 40 | $160 | $9.8K |
| G0439 | 185 | 560 | 60 | $120 | $9.3K |
Showing 1–10 of 37
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.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99309 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider… | 230 | $20 | $5.6K |
| 99283 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making. | 20 | $30 | $430 |
How this provider's Medicaid billing volume and revenue compare to other West Virginia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. West Virginia median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99283 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making. | 160 | 160 | 3,690 | $80 | $714.8K |
| 99309 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider… | 42 | 80 | 310 | $10 | $37.1K |
Other providers in the same ZIP code as Sanjay Bharti, ranked by combined Medicare and Medicaid revenue.
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