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

Why is the Medicaid comparison limited to Maine 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. Maine (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.

Stephan Babirak (NPI 1689619884)

Field	Value
Entity Type	Individual
Organization	Stephan Babirak
Address	71 Us Route 1 Ste J
City	Scarborough
State	ME
ZIP	04074
Taxonomy	Endocrinology, Diabetes & Metabolism Physician
NPI Enumerated	June 19, 2006

Payer Source	Total Paid
Medicare	$400K
Medicaid	$0

Key Findings

Provider STEPHAN BABIRAK is effectively a single-payer Medicare provider with $400K in lifetime Medicare revenue and no Medicaid billing on file; the absence of Medicaid activity indicates the provider’s operations and revenue are concentrated entirely in the Medicare population.

Revenue concentration is extremely high: the precomputed top-3 Medicare codes account for 98.5% of this provider’s total Medicare revenue, indicating business activity is dominated by a very small set of services rather than a broad mix of outpatient visits or ancillary testing.

The dominant revenue driver is code 36516 (apheresis), which accounts for $364.1K and 91.0% of the provider’s Medicare revenue; this suggests the practice is organized around therapeutic apheresis services and that apheresis is the core service line for this clinician.

Secondary office evaluation codes 99214 and 99215 collectively comprise a small portion of revenue ($16.6K and $13.3K respectively) and reflect ongoing ambulatory management of established patients, but these codes are minor revenue contributors relative to apheresis.

Competitive standing for the apheresis service is strong: the provider ranks #1 of 2 nationally for 36516 and sits at the 100th percentile for that code, indicating this clinician is one of the very few national billers concentrated in this procedure and achieves a high relative standing for volume of 36516. By contrast, evaluation-and-management codes show typical to modest participation: 99214 ranks in the 66th percentile and 99215 in the 80th percentile, reflecting average-to-above-average E/M activity compared with national peers.

Tenure: the NPI was enumerated on 2006-06-19 (around 20 years ago), indicating long-term Medicare enrollment which supports the development of a specialized apheresis practice over time.

Service mix signals an ambulatory procedure-focused practice model: a high-volume, high-revenue procedural code (36516) combined with routine E/M codes (99214/99215) and diabetes-related monitoring codes (95251, 83036) suggests the provider treats complex chronic metabolic or hematologic conditions requiring repeated apheresis with some ongoing outpatient management and diabetes surveillance.

Given the extreme revenue concentration in a single procedural code, payer or network analysts should view this provider as a niche apheresis specialist whose financial and utilization profile could be sensitive to changes in authorization, reimbursement, or referral patterns for 36516; routine E/M and diabetes codes are secondary and unlikely to offset major fluctuations in procedural volume.

Medicare: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
36516	Apheresis (also known as pheresis or therapeutic pheresis) is a medical procedure utilizing specialized equipment to remove selected blood constituents (plasma, leukocytes, platelets, or cells) from…	260	$1,400	$364.1K
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…	180	$90	$16.6K
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…	100	$130	$13.3K
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…	50	$50	$2.5K
95251	A provider analyzes and interprets data from a patient’s continuous glucose monitor (CGM) and writes a report based on interpretation. This code represents the professional component of the service…	50	$30	$1.4K
83036	Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…	150	$10	$1.3K
99443	N/A	10	$60	$710

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Maine Distribution

Stephan Babirak — 1 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. state median

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
36516	1	10	260	$1,400	$364.1K
99214	422	2,500	70	$70	$7.2K
99215	79	780	30	$100	$4.8K
99213	1,171	2,350	50	$50	$4.3K
95251	16	30	70	$20	$1.7K
99443	74	80	20	$60	$1.4K
83036	10	230	40	$10	$690

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mainegeneral Medical Center	ME	General Acute Care Hospital	$0	$168.1M
Brian Daikh	ME	Specialist	$1.2M	$0
Rachit Kumar	VA	Hematology & Oncology Physician	$802.4K	$0
Bo Pang	ME	Facial Plastic Surgery Physician	$434.3K	$0
Mainegeneral Medical Center	ME	Family Medicine Physician	$0	$375.3K
Aamir Rai	TX	Anesthesiology Physician	$334.5K	$0
David Rancourt	MA	Internal Medicine Physician	$315.4K	$0
Jose Ventura	ME	Family Medicine Physician	$50.9K	$197.8K
Ellie Mueller	ME	Interventional Cardiology Physician	$201.2K	$0
James Johnston	MN	Orthopaedic Surgery Physician	$199K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nordx	ME	Clinical Medical Laboratory	$2.4M	$21.8M
New England Life Care, Inc.	ME	Home Infusion Therapy Pharmacy	$0	$12.4M
Northeast Mobile Health Services	ME	Ambulance	$930.3K	$9.5M
Choices Are For Everyone, Inc.	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$9.7M
Skilled Care Solutions	ME	Home Health Agency	$0	$6.8M
Surgi-care, Inc	ME	Prosthetic/Orthotic Supplier	$0	$5.6M
Mainehealth	ME	Family Medicine Physician	$0	$5M
Mainehealth	ME	Neurology Physician	$0	$4.2M
Mainehealth	ME	Cardiovascular Disease Physician	$0	$3.9M
Maine Home Care Solutions	ME	In Home Supportive Care Agency	$0	$3.2M

Stephan Babirak — Billing Profile & Reimbursement Data

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Stephan Babirak — 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