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    OpenPayerNPI Medicare & MedicaidGautam Balakrishnan
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    Gautam Balakrishnan — Billing Profile & Reimbursement Data

    NPI 1609214519 · Saint Joseph, MO · Pulmonary Disease Physician

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    Gautam Balakrishnan is a pulmonary disease physician provider located in Saint Joseph, Missouri. This profile covers 20 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.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationGautam Balakrishnan
    Address5301 Faraon St Ste 210b
    CitySaint Joseph
    StateMO
    ZIP64506
    TaxonomyPulmonary Disease Physician
    NPI EnumeratedJune 13, 2013

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$126.9K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    20 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99232The 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…540$60$32.6K
    99291Critical 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…170$160$27.7K
    99214The 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…350$70$24.1K
    99233The 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…80$90$7.3K
    99204The 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…70$90$6.1K
    99222The 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…50$100$5.2K
    99213The 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$50$4.4K
    31645The provider uses a rigid or flexible bronchoscope to view the airways and aspirates (sucks out) fluid from the tracheobronchial tree, the branched distribution of airways of the lung that includes…40$100$3.7K
    99223The 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…30$120$3.3K
    31624In this procedure, the provider uses a rigid or flexible bronchoscope for bronchial alveolar lavage, a procedure using saline solution to wash the cells from alveoli, the air sacs at the end of the…80$30$2.6K

    Showing 1–10 of 20

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    20 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992141,3258,960100$80$13.9K
    992331,1632,66070$90$12.1K
    992911161,48050$160$11.3K
    992322764,32090$60$10.8K
    992231,6992,72040$130$8.2K
    992133,3228,73070$50$7K
    992151,5812,30030$110$6.8K
    992048424,36030$100$4.8K
    992227363,10030$100$4.3K
    31629142020$120$2.9K

    Showing 1–10 of 20

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Heartland Regional Medical CenterMOGeneral Acute Care Hospital$0$57.1M
    Heartland Regional Medical CenterMOGeneral Practice Physician$0$20.4M
    Corey KrenzMOFamily Nurse Practitioner$491.4K$0
    Jack KotlarzILPlastic Surgery within the Head & Neck (Otolaryngology) Physician$455.2K$0
    Blake PetersonVAOrthopaedic Surgery Physician$412K$0
    Andrew WalkerMORadiation Oncology Physician$317.6K$0
    Kala DanushkodiMOPhysical Medicine & Rehabilitation Physician$306.4K$0
    Rony Abou-jawdeMOMedical Oncology Physician$303K$0
    Sam AlnajjarAZCritical Care Medicine (Internal Medicine) Physician$280.2K$0
    Habib MunshiMOPulmonary Disease Physician$227.5K$530

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Res-care Kansas, Inc.MOHome Health Agency$0$64.8M
    Choices Of St Joseph, IncMOIntellectual and/or Developmental Disabilities Residential Treatment Facility$0$64.3M
    Family Guidance Center For Behavioral HealthcareMOCommunity/Behavioral Health Agency$0$63.4M
    Heartland Residential Care, Inc.MOIntellectual and/or Developmental Disabilities Residential Treatment Facility$0$49.1M
    Peace Of Mind Home Care, LLCMOHome Health Agency$0$39.8M
    Progressive Community ServicesMOCase Management Agency$0$14M
    United Cerebral Palsy Of Northwest MissouriMOVoluntary or Charitable Agency$0$12.2M
    Regional Emergency Medical Services AuthorityMOLand Ambulance$1.3M$7.4M
    St Joseph Center For Outpatient Surgery, LLCMOAmbulatory Surgical Clinic/Center$2M$92.9K
    Murphy Watson Burr Surgery Center IncMOOphthalmologic Surgery Clinic/Center$1.3M$89.6K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Missouri Distribution
    Gautam Balakrishnan — 2 of 20 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Missouri