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NPI 1548280084 · Las Vegas, NV · Cardiovascular Disease Physician
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Sanjay Malhotra is a cardiovascular disease physician provider located in Las Vegas, Nevada. This profile covers 40 Medicare and 9 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 Malhotra |
| Address | 3150 N Tenaya Way |
| City | Las Vegas |
| State | NV |
| ZIP | 89128 |
| Taxonomy | Cardiovascular Disease Physician |
| NPI Enumerated | July 20, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2M |
| Medicaid | $59.5K |
Clinical/service-line profile centers on advanced cardiac imaging: the provider’s Medicare top revenue drivers are myocardial perfusion PET and associated radiotracer codes (78492, 78431, A9526, A9555 and related PET codes like 78434), which indicates an operation built around high-volume cardiac nuclear imaging and stress testing rather than primarily clinic-only cardiology. Supporting codes for stress ECG interpretation and supervised stress testing (93015, 93010, 93000) further reinforce a combined imaging-and-diagnostic stress lab workflow.
High Medicare revenue concentration in a few imaging codes: the provider’s top three Medicare codes (78492, 78431, A9526) account for 56.5% of total Medicare revenue, with those codes contributing $457.3K, $326.7K, and $320.1K respectively to the reported $2M Medicare revenue. This concentration indicates reliance on a narrow set of high-value imaging services for the majority of Medicare revenue.
Medicaid revenue is highly concentrated in office visits and basic echo: the top three Medicaid codes (99214, 93306, 78452) account for 75.8% of the provider’s $59.5K Medicaid revenue, with 99214 contributing $22.6K and 93306 $15.9K. The Medicaid mix implies that, in-state, the provider sees more conventional outpatient E/M and transthoracic echo volume versus the PET-focused services dominating Medicare.
Provider is effectively Medicare-dominant: reported Medicare revenue is $2M versus Medicaid revenue of $59.5K, meaning commercial and Medicare-reimbursed imaging likely drive the business while Medicaid is a small portion of overall billings. From a payer-strategy perspective this suggests contracting and network access efforts should prioritize Medicare and commercial imaging reimbursement and capacity.
National competitive standing is strong for specific nuclear imaging inputs and pharmacologic stress agents: 78492 ranks #35 of 926 (96th percentile; notably above typical national volume) and A9526 ranks #4 of 28 (89th percentile; notably above typical national volume), indicating the provider is a high-volume national performer for certain PET radiotracers and studies. J2785 (regadenoson) practices an extreme outlier pattern (rank #28 of 6388; 100th percentile; extreme outlier), and 93015 is also an extreme outlier (rank #30 of 7716; 100th percentile; extreme outlier), signaling outsized use of pharmacologic stress agents and supervised stress testing relative to peers.
In-state (Medicaid) competitive footprint is modest: 99214 ranks #1255 of 2254 in-state (44th percentile) and 93306 ranks #104 of 174 in-state (40th percentile), so for routine office visits and transthoracic echo this provider is a middle-to-lower-volume participant within Nevada Medicaid. The Medicaid imaging ranks (including 78452 at #50 of 51; 0th percentile) suggest limited Medicaid imaging market share compared with its Medicare presence.
Significant ancillary chronic care and remote monitoring billing complements imaging services: Medicare claims include substantive activity in chronic care and RPM codes (99490: 726 claims, $34.8K revenue; 99439: 688 claims, $25.5K revenue; 99487: 54 claims, $5.7K revenue; 99457: 138 claims, $5.2K revenue; 99454: 96 claims, $3.7K revenue). This pattern implies the practice supports ongoing care management workflows alongside episodic imaging, which could be leveraged for longitudinal care programs or bundled-service negotiations.
Provider demonstrates established tenure: the NPI was enumerated 2006-07-20 (~20 years ago), indicating a long-standing presence in the market that likely underpins the developed imaging volumes and the high national ranks for several PET and radiotracer codes. Tenure combined with the concentrated service mix suggests an experienced practice specializing in cardiac imaging and associated stress-testing services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
40 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 78492 | In this diagnostic procedure, the provider performs a myocardial perfusion PET imaging study which means it reveals the flow of oxygenated blood to the heart muscles. The service also includes… | 400 | $1,130 | $457.3K |
| 78431 | The provider performs a PET myocardial imaging scan, a type of nuclear imaging test, with CT transmission scan that reveals blood flow to and from the heart (perfusion). Ejection fraction and… | 230 | $1,450 | $326.7K |
| A9526 | Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries | 550 | $580 | $320.1K |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | 710 | $410 | $288.3K |
| J2785 | Injection, regadenoson, 0.1 mg | 2,730 | $40 | $117.4K |
| 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… | 980 | $80 | $82.1K |
| 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… | 840 | $70 | $56.5K |
| 78434 | The provider performs a positron emission tomography (PET) study at both rest and stress to measure myocardial blood flow. Stress is induced by injection of a drug. Report this code in conjunction… | 500 | $110 | $52.6K |
| 93015 | The provider supervises the recording of the electrical activity of the heart to examine any abnormality in its functioning by obtaining blood pressure and electrocardiograph readings at regular… | 730 | $50 | $39.4K |
| 99490 | The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the… | 730 | $50 | $34.8K |
Showing 1–10 of 40
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 40 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
40 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| A9526 | 3 | 10 | 90 | $580 | $168.3K |
| 78492 | 3 | 20 | 40 | $980 | $107.9K |
| A9555 | 4 | 30 | 60 | $410 | $90.5K |
| 78431 | 5 | 40 | 30 | $1,050 | $88.2K |
| 93229 | 44 | 50 | 30 | $660 | $56.3K |
| 99233 | 1,114 | 1,150 | 150 | $90 | $26.8K |
| 99232 | 543 | 1,340 | 140 | $60 | $23.7K |
| 93306 | 81 | 250 | 190 | $90 | $22.5K |
| 99214 | 123 | 3,610 | 110 | $80 | $19K |
| J2785 | 3 | 90 | 180 | $40 | $16.7K |
Showing 1–10 of 40
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.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 220 | $100 | $22.6K |
| 93306 | The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent… | 120 | $140 | $15.9K |
| 78452 | In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood… | 10 | $550 | $6.6K |
| 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… | 30 | $170 | $5K |
| 93010 | The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram. | 730 | $10 | $3.7K |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 10 | $210 | $2.6K |
| 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… | 20 | $60 | $1.3K |
| 93015 | The provider supervises the recording of the electrical activity of the heart to examine any abnormality in its functioning by obtaining blood pressure and electrocardiograph readings at regular… | 20 | $70 | $1.1K |
| 93000 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 70 | $10 | $860 |
How this provider's Medicaid billing volume and revenue compare to other Nevada providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Nevada median
9 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 410 | 430 | 500 | $40 | $214.4K |
| 78452 | In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood… | 50 | 50 | 120 | $240 | $209.3K |
| 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… | 1,255 | 2,250 | 290 | $60 | $138K |
| 93306 | The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent… | 104 | 170 | 180 | $80 | $120.5K |
| 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… | 568 | 780 | 90 | $100 | $46.6K |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 28 | 30 | 90 | $60 | $39.6K |
| 93010 | The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram. | 56 | 210 | 200 | $1 | $21.9K |
| 93015 | The provider supervises the recording of the electrical activity of the heart to examine any abnormality in its functioning by obtaining blood pressure and electrocardiograph readings at regular… | 25 | 30 | 60 | $30 | $19.6K |
| 93000 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 155 | 230 | 150 | $10 | $10.6K |
Other providers in the same ZIP code as Sanjay Malhotra, ranked by combined Medicare and Medicaid revenue.
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