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 Unspecified Location for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Unspecified Location 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. Unspecified Location (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.

Arif Nawaz (NPI 1457569386)

Key Findings

Field	Value
Entity Type	Individual
Organization	Arif Nawaz
Address	460-y, Dha
City	Lahore
State	XX (Unspecified Location)
ZIP	001
Taxonomy	Gastroenterology Physician
NPI Enumerated	May 21, 2007

Payer Source	Total Paid
Medicare	$69.9K
Medicaid	$0

This provider is effectively single‑payer in the claims on file: total Medicare revenue is $69.9K and there is no Medicaid billing on file, so Medicaid does not contribute to the billed revenue mix. The absence of Medicaid activity means analyses of payer diversification or Medicaid network strategy are not supported by the available data.

Revenue is concentrated in a small set of procedure and E/M codes: the precomputed top‑3 Medicare codes account for 43.8% of this provider's total Medicare revenue, with 45380 contributing 17.0%, 99232 contributing 15.8%, and 43239 contributing 11.1%. That concentration indicates the practice derives nearly half of its Medicare revenue from a tight cluster of diagnostic/therapeutic endoscopy and inpatient E/M services.

The CPT mix points to a gastroenterology practice with both diagnostic and therapeutic endoscopy capability. High‑revenue procedure codes include 45380 (flexible colonoscopy with biopsy, 111 claims, $11.9K revenue) and 43239 (upper endoscopy with biopsy, 127 claims, $7.7K revenue), while therapeutic procedures such as 45385 (polypectomy, $6.6K revenue) and ERCP with stent 43274 ($6.2K revenue) together show capacity for interventional GI work beyond routine outpatient endoscopy.

Claims and percentile patterns indicate substantial hospital/inpatient involvement compared with outpatient office work: inpatient/observation subsequent visit 99232 appears 190 times and contributes $11K (ranks in the 72th percentile, described as typical, unremarkable volume), while initial inpatient visit 99221 ranks in the 93th percentile (69 claims, $3.9K revenue) and 99231 ranks in the 85th percentile (109 claims, $3.9K revenue). By contrast, higher‑level office E/M codes are lower in volume and rank (for example, 99214 ranks in the 6th percentile and 99213 in the 58th percentile), suggesting the provider does more hospital‑based E/M than high‑volume outpatient clinic visits.

Competitive standing on core endoscopy codes is modest to moderate nationally: 45380 ranks #3070 of 16427 providers (81th percentile, typical, unremarkable volume for this code) and 43239 ranks #3311 of 17140 providers (80th percentile, typical, unremarkable volume for this code). These ranks indicate the provider is not a national outlier on volume for major endoscopy codes but does operate at or above median activity for several key GI procedures.

There is a visible capability for advanced biliary intervention despite small absolute Medicare revenue: ERCP with stent 43274 accounts for $6.2K (8.8% of Medicare revenue) and ranks #383 of 976 providers (57th percentile, typical, unremarkable volume). The presence and revenue share of 43274 and related codes (43264, 43249) point to procedural breadth that includes therapeutic ERCP and ductal stone removal.

Although a number of codes rank at or above the national median, the overall Medicare revenue level of $69.9K is modest in absolute terms, so the provider’s market footprint appears limited in scale. This combination—routine to above‑median per‑code activity on some GI procedures but low total Medicare dollars—suggests a small practice or part‑time Medicare panel rather than a large, high‑volume GI center.

The provider has long tenure in the NPI file, enumerated on 2007-05-21 (~19 years ago), which indicates an established billing history; however, the current Medicare billing profile is concentrated and limited in dollar scale, so longevity has not translated into large Medicare revenue on the claims observed.

Medicare: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	110	$110	$11.9K
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…	190	$60	$11K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	130	$60	$7.7K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	40	$180	$6.6K
43274	The physician performs an ERCP (a diagnostic procedure that combines upper endoscopy and retrograde (reverse or backward) injection of contrast material, a type of dye, into the biliary ducts to…	30	$250	$6.2K
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…	100	$60	$6K
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…	40	$110	$4.6K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	70	$60	$3.9K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	110	$40	$3.9K
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…	40	$90	$3.1K

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Arif Nawaz — 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

Frequently Asked Questions

References

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99213	4	10	140	$60	$18.8K
99214	16	10	80	$90	$15.8K
99232	3	10	110	$60	$6.9K
36415	2	10	230	$10	$5.5K
99222	3	10	40	$100	$3.9K
99204	3	10	20	$120	$2.8K
99212	2	10	30	$30	$960
43239	1	0	N/A	$N/A	$N/A
43249	1	0	N/A	$N/A	$N/A
43264	1	0	N/A	$N/A	$N/A