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

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

Julian Espiritu (NPI 1730174970)

Field	Value
Entity Type	Individual
Organization	Julian Espiritu
Address	24 Maccorkle Ave Sw
City	South Charleston
State	WV
ZIP	25303
Taxonomy	Specialist
NPI Enumerated	September 14, 2005

Payer Source	Total Paid
Medicare	$578.8K
Medicaid	$0

Key Findings

This provider’s payment mix is effectively single‑payer: total Medicare revenue on file is $578.8K and there is no Medicaid billing on file, so all analyzed clinical activity and revenue flows in the dataset come from Medicare. Analysts should treat Medicaid-related competitive or access questions as unobserved for this NPI.

Revenue is concentrated in a small set of CPT/HCPCS codes: the precomputed top‑3 Medicare codes (99215, J0897, J1439) account for 39.8% of the provider’s total Medicare revenue. The single largest line is 99215 at 18.2% of Medicare revenue, followed by J0897 at 14.1% and J1439 at 7.5%, indicating a handful of services drive a disproportionate share of receipts.

The mix of high-volume drug administration and ESRD codes plus related labs indicates an outpatient infusion and renal-care focus. High claim counts for J1439 (39K claims, $39K revenue), J0881 (14.1K claims, $28.3K revenue), and J0897 (4.1K claims, $73.4K revenue), together with ESRD management codes 90960/90961/90962, suggest regular injectable/infusion therapies and chronic kidney disease or dialysis patient management are core service lines.

For certain procedure types this provider is a national outlier in scale: 99215 ranks #627 of 145531 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code) and 96372 ranks #107 of 58224 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code). In contrast, several high‑revenue drugs (J0897 and J1439) are in mid‑range national percentiles (65th–66th) and should be interpreted as strong but not dominant in the national supply of those medications.

The provider’s activity spans outpatient office care and inpatient/observation work. Substantial volumes for inpatient E/M codes (99232: 522 claims, $31.8K revenue; 99233: 286 claims, $26.3K revenue; 99223: 135 claims, $17.4K revenue) indicate regular hospital/observation follow‑up and admission management services in addition to office visits. This mix implies staffing and operational workflows that cover clinic‑based infusions and inpatient consultations.

Routine and specialty laboratory testing is a meaningful ancillary revenue stream and supports the clinical focus on renal/metabolic care. Notable lab contributions include 83970 parathyroid hormone testing (653 claims, $26.1K revenue, 5.0% of Medicare revenue), 80053 CMP (809 claims, $8.1K), 82306 vitamin D (481 claims, $13.9K), and 82570 creatinine (837 claims, $4.2K), suggesting frequent biochemical monitoring of chronic disease patients.

Unit payment patterns show a mix of higher‑value face‑to‑face E/M encounters and low‑unit‑price, high‑volume drug administrations. For example, 99215 averages $125 paid/claim across 761 claims ($95.1K revenue) while J1439 averages $1 paid/claim but appears 39K times ($39K revenue), illustrating an operating model that pairs relatively high‑paid office visits with large volumes of low‑unit infusion or injection items. These dynamics affect margins and supply‑chain planning differently across services.

The provider has long tenure in Medicare billing, with the NPI enumerated on 2005-09-14 (~21 years ago), which supports interpreting the observed patterns as established practice behavior rather than a short‑term anomaly. Long enumeration combined with concentrated service lines should guide due diligence on referral sources, capacity, and regional market positioning.

Medicare: Complete Services Breakdown

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

66 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	760	$130	$95.1K
J0897	Injection, denosumab, 1 mg	4,080	$20	$73.4K
J1439	Injection, ferric carboxymaltose, 1 mg	39,000	$1	$39K
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…	520	$60	$31.8K
J0881	Injection, darbepoetin alfa, 1 microgram (non-esrd use)	14,150	$1	$28.3K
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…	100	$270	$26.3K
99233	The 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…	290	$90	$26.3K
83970	Parathyroid hormone test measures the level of PTH in the blood. This test is done to ascertain the level of calcium and evaluate the parathyroid function.	650	$40	$26.1K
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…	330	$70	$24.2K
90966	The provider manages all the physician related services for one full month for the home dialysis care of a patient who is 20 years old or older and has a condition known as end stage renal disease,…	80	$230	$18.4K

Showing 1–10 of 66

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 66 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. West Virginia Distribution

Julian Espiritu — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. state median

66 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0897	4	20	2,160	$20	$50.3K
J0881	2	10	16,220	$1	$37.2K
90960	19	30	110	$270	$37.2K
J1439	1	10	39,000	$1	$34K
90966	4	10	70	$220	$16.9K
90961	24	30	40	$220	$15K
99232	95	1,340	90	$60	$11.9K
83970	1	10	250	$40	$11.9K
99214	385	2,740	100	$70	$11.8K
99233	66	660	60	$90	$11.4K

Showing 1–10 of 66

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Charleston Area Medical Center Inc	WV	General Acute Care Hospital	$0	$200.1M
Charleston Area Medical Center, Inc.	WV	General Acute Care Hospital	$0	$50.9M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Rainelle Medical Center Inc	WV	Federally Qualified Health Center (FQHC)	$0	$14.3M
Mark Le	FL	Diagnostic Radiology Physician	$10.7M	$0
Renal Consultants, PLLC	WV	Specialist	$0	$2.2M
Rajiv Khanna	WV	Medical Oncology Physician	$2M	$0
Charleston Area Medical Center, Inc.	WV	Hospitalist Physician	$0	$1.4M
Mayez El-harake	WV	Medical Oncology Physician	$1.1M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Loved Ones In Home Care	WV	Home Health Agency	$0	$35M
Solutions Positive Behavior Strategies	WV	Specialist	$0	$15.3M
Special Touch Nursing Services, Inc.	WV	Home Health Agency	$0	$6.7M
Damous Psychological Services PLLC	WV	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.6M
A Special Touch In-home Care	WV	In Home Supportive Care Agency	$0	$4M
Special Touch Nursing Services, Inc.	WV	In Home Supportive Care Agency	$0	$2.7M
A Special Touch For Seniors, LLC	WV	Case Management Agency	$0	$2M
Bassam Haffar Inc	WV	Gastroenterology Physician	$0	$1.4M
Taylor Eye Associates, PLLC	WV	Optometrist	$0	$1.4M
Total Renal Care Inc	WV	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.2M

Julian Espiritu — Billing Profile & Reimbursement Data

Sign up for Julian Espiritu — Billing Profile & Reimbursement Data policy alerts

Julian Espiritu — Billing Profile & Reimbursement Data

Sign up for Julian Espiritu — Billing Profile & Reimbursement Data policy alerts

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