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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Elwin Bustos (NPI 1467543686)

Field	Value
Entity Type	Individual
Organization	Elwin Bustos
Address	1140 Varnum St Ne Ste 202
City	Washington
State	DC
ZIP	20017
Taxonomy	Nephrology Physician
NPI Enumerated	September 27, 2006

Payer Source	Total Paid
Medicare	$305K
Medicaid	$0

Key Findings

This provider is a nephrology specialist focused on end-stage renal disease (ESRD) care: the dominant revenue sources are ESRD monthly management codes 90961, 90960, and 90962, and the code descriptions indicate routine face-to-face monthly dialysis management with varying visit frequencies. The prominence of these dialysis-management codes and the presence of hemodialysis procedure code 90935 in the top list indicate the practice is organized around outpatient dialysis patient management rather than general primary care.

Medicare revenue concentration is high: the precomputed top-3 Medicare codes account for 85.8% of the provider's total Medicare revenue, signaling that the business is heavily dependent on a small set of ESRD-related services rather than a broad mix of evaluation-and-management visits. This concentration suggests revenue and utilization are tightly linked to ongoing dialysis patient panels.

The provider’s Medicare revenue totals $305K while there is no Medicaid billing on file, making this effectively a single-payer (Medicare-only) billing profile in the available records. The absence of Medicaid activity means Medicaid does not contribute to this provider’s payer mix and any Medicaid-related competitive or access considerations cannot be assessed from these data.

Competitive standing on key ESRD codes is strongly skewed: for 90961 the provider ranks #13 of 6091 nationally and is labeled an “extreme outlier” at the 100th percentile, indicating exceptionally high national volume on that code relative to peers. For 90962 the provider ranks #75 of 1844 (96th percentile) and is described as “notably above typical national volume,” while 90960 sits at #1147 of 6549 (82nd percentile) and is characterized as typical or unremarkable; together these ranks show the provider is a major national outlier for some ESRD services but more typical on others.

Day-to-day ambulatory care component is present but secondary: E/M codes 99214 and 99204 appear in the top list and together represent a minority of revenue (99214 accounts for $32.4K, 10.6% of Medicare revenue). This suggests the practice also conducts office-based nephrology management for established and new patients in addition to its primary dialysis-management workload, but these visits are smaller drivers of revenue compared with ESRD monthly management codes.

Clinical tenure is long: the NPI was enumerated on 2006-09-27 (about 20 years ago), which indicates substantial time in the Medicare program and potential longitudinal relationships with dialysis patients and facilities; this duration supports the plausibility of a large, stable ESRD patient panel.

Procedure-level billing patterns show mixed inpatient and dialysis activity but no broad hospital-based revenue concentration: codes such as 99232 (subsequent hospital care) and 90935 (hemodialysis procedure including same-day E/M) are present but represent small shares of total Medicare revenue ($3.3K and $1.6K respectively), implying occasional inpatient or procedure encounters complement the dominant outpatient dialysis management services.

Given the small overall Medicare revenue ($305K) and the extreme concentration in ESRD monthly management codes, financial risk or performance assessments should treat this provider as specialized and volume-driven: payers or contracting analysts evaluating network capacity or rate adequacy should focus on dialysis monthly bundle pricing and utilization rather than broad E/M fee schedules.

Medicare: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90961	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…	530	$260	$140.2K
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	290	$310	$89.5K
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…	470	$70	$32.4K
90962	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	180	$180	$32K
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…	30	$130	$3.7K
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…	50	$70	$3.3K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	20	$100	$1.9K
90935	Hemodialysis is a procedure that involves drawing blood via an intra–arterial or intravenous catheter, then sieving it through a semi permeable membrane to remove the impurities and finally…	30	$60	$1.6K
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…	10	$60	$820

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. District of Columbia Distribution

Elwin Bustos — 1 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. state median

9 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90960	7	30	200	$310	$69K
90961	1	30	90	$250	$35.5K
99214	108	1,400	90	$100	$15.3K
99215	538	660	50	$130	$12.3K
90962	2	20	50	$170	$11.4K
99232	392	640	70	$70	$10K
99213	1,138	1,200	50	$70	$8.5K
90935	26	30	60	$60	$7.2K
99204	358	670	30	$130	$6.4K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Of Hope, Inc.	DC	Federally Qualified Health Center (FQHC)	$0	$17.1M
Community Of Hope Inc.	DC	Federally Qualified Health Center (FQHC)	$0	$6.3M
Community Of Hope, Inc	DC	Federally Qualified Health Center (FQHC)	$0	$3.6M
Community Of Hope Inc.	DC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$205.9K
Bustos Associates LLC	DC	Nephrology Physician	$0	$193.5K
India Rogers	DC	General Practice Dentistry	$0	$94K
Antonina Kolesnikova	DC	Nephrology Physician	$67.2K	$0
Community Of Hope Inc.	DC	Birthing Clinic/Center	$0	$53.3K
Leonard Friedman	DC	Ophthalmology Physician	$0	$10.4K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
My Own Place, Inc.	DC	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$48.7M
Anchor Mental Health Association	DC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$22M
Hsc Home Care, LLC	DC	Home Health Agency	$0	$14.7M
Providence Health Services Inc	DC	Family Medicine Physician	$0	$13.4M
Providence Hospital	DC	General Acute Care Hospital	$0	$12.2M
American Health Care Services Inc	DC	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$5.3M
Hospital For Sick Children	DC	Special Hospital	$0	$4.7M
United Cerebral Palsy Of Washington & No. Virginia, Inc.	DC	Developmentally Disabled Services Day Training Agency	$0	$4.4M
Gerald Family Care	DC	Family Medicine Physician	$0	$3.2M
Cheryl Lee	DC	Dentist	$0	$2.5M

Elwin Bustos — 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