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

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

Babak Baharloo (NPI 1740662147)

Field	Value
Entity Type	Individual
Organization	Babak Baharloo
Address	11515 Chimney Rock Rd
City	Houston
State	TX
ZIP	77035
Taxonomy	Podiatrist
NPI Enumerated	June 22, 2015

Payer Source	Total Paid
Medicare	$18.3M
Medicaid	$0

Key Findings

This Houston-based podiatrist has generated $18.3M in lifetime Medicare revenue and has no Medicaid billing on file, making the practice effectively single-payer (Medicare) in the claims dataset; the provider’s NPI was enumerated 2015-06-22 (~11 years ago), indicating roughly a decade of billable activity reflected here.

Revenue is highly concentrated in amniotic membrane and related biologic add-on products: the top three Medicare codes (Q4205, Q4236, Q4253) together account for 65.2% of the provider’s Medicare revenue, with Q4205 at 27.8%, Q4236 at 24.5%, and Q4253 at 12.9%. This mix indicates a service-line focus on advanced wound care and biologic graft materials rather than primarily office-based procedure volume.

Claim volumes for the leading biologic codes are large and recurring: Q4253 shows 4.8K claims ($485 avg paid/claim, $2.4M revenue), Q4236 shows 4.5K claims ($991 avg paid/claim, $4.5M revenue), and Q4205 shows 4.4K claims ($1163 avg paid/claim, $5.1M revenue). These high claim counts across multiple amniotic membrane products suggest routine, repeated use of products per patient and an operational workflow centered on graft application.

On competitive standing for the top biologics, this provider ranks comparatively high among national peers: Q4205 ranks #6 of 63 (92th percentile), Q4236 ranks #14 of 79 (83th percentile), and Q4253 ranks #12 of 73 (85th percentile), which positions the practice among higher-volume national billers for these products even though the dataset labels these volumes as typical for the code set. Q4227 (6.6K claims, $229 avg paid/claim, $1.5M revenue) also ranks #2 of 9 (88th percentile), reinforcing a broad product mix across amniotic options.

Several codes show singular or otherwise notable market positions for specific products: Q4238 (1K claims, $1505 avg paid/claim, $1.6M revenue) is listed as rank #1 of 1 (0th percentile, no national peer volume comparison available), indicating this provider may be the only biller of Derm-maxx in the national sample. That concentration in a niche product line accounts for 8.5% of Medicare revenue and may reflect vendor relationships or specialized inventory use.

The provider posts multiple statistical outliers relative to national peers on non-add-on codes: 99213 (2.1K claims, $68 avg paid/claim, $141.4K revenue) and 15275 (638 claims, $121 avg paid/claim, $77.2K revenue) are both identified as 100th percentile ‘extreme outlier’ volumes, and 29581 (922 claims, $42 avg paid/claim, $38.7K revenue) is a 99th percentile ‘extreme outlier.’ These patterns indicate unusually high volumes of established outpatient visits, skin-substitute applications, and multilayer compression therapy compared with peers.

The broader procedural mix—codes such as 15275, 15004, 11042, 29445, and 11721—aligns with wound care, debridement, skin substitute use, and diabetic ulcer management (for example, 29445 total contact cast: 134 claims, $55 avg paid/claim, $7.4K revenue). Together with the dominant amniotic membrane billing, this supports a clinical model oriented toward complex lower-extremity wound management rather than general podiatry.

From a payer-analytics and contracting perspective, the provider’s Medicare-only exposure and heavy dependence on high-cost biologic add-ons (top three codes = 65.2% of Medicare revenue) suggest significant sensitivity to reimbursement rates and product pricing. Analysts evaluating network value or pricing risk should consider that changes in coverage or payment for amniotic membrane products would disproportionately affect this provider’s revenue base.

Medicare: Complete Services Breakdown

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

33 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Q4205	Membrane graft or membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)	4,370	$1,160	$5.1M
Q4236	Carepatch, per square centimeter (add-on, list separately in addition to primary procedure)	4,520	$990	$4.5M
Q4253	Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)	4,850	$490	$2.4M
Q4238	Derm-maxx, per square centimeter (add-on, list separately in addition to primary procedure)	1,030	$1,510	$1.6M
Q4227	Amniocore, per square centimeter (add-on, list separately in addition to primary procedure)	6,610	$230	$1.5M
Q4248	Dermacyte amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)	1,500	$810	$1.2M
Q4234	Xcellerate, per square centimeter (add-on, list separately in addition to primary procedure)	1,880	$630	$1.2M
J0875	Injection, dalbavancin, 5 mg	18,610	$10	$223.3K
Q4229	Cogenex amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)	960	$200	$188.2K
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…	2,080	$70	$141.4K

Showing 1–10 of 33

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 33 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Texas Distribution

Babak Baharloo — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. state median

33 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q4205	2	10	1,450	$1,160	$3.7M
Q4236	2	10	2,010	$990	$2.5M
Q4238	1	10	1,030	$1,510	$1.6M
Q4227	1	10	6,610	$230	$1.5M
Q4248	1	10	1,500	$810	$1.2M
Q4253	1	10	730	$650	$1.1M
Q4234	1	10	1,150	$700	$802.8K
Q4229	3	10	620	$190	$233.3K
J0875	7	20	11,350	$10	$182.2K
Q4030	1	10	210	$70	$14.9K

Showing 1–10 of 33

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southern Coos Health District	OR	Critical Access Hospital	$0	$3.5M
Bert Stewart	OR	Surgery Physician	$222.3K	$0
Douglas Crane	OR	Internal Medicine Physician	$159.3K	$11.1K
Davina Bledsoe	OR	Nurse Practitioner	$123.4K	$5.8K
Sharon Monsivais	OR	Plastic and Reconstructive Surgery Physician	$90.8K	$0
Robert Evans	OR	Emergency Medicine Physician	$67.9K	$0
Jennifer Webster	OR	Family Medicine Physician	$58.2K	$4.3K
Patricia Rotter	OR	Emergency Medicine Physician	$58.1K	$0
Scott Smith	OR	Emergency Medicine Physician	$51.1K	$0
Nicholas Kovacs	OR	Emergency Medicine Physician	$39.7K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Primetime Home Health Services, Inc	TX	Home Health Agency	$0	$46.5M
Assurancej Homecare Services ,inc.	TX	Home Health Agency	$0	$22.8M
Biocentra LLC	TX	Clinical Medical Laboratory	$231.8K	$9K
Caren Gertner Fritts	TX	Psychologist	$54.2K	$0

Babak Baharloo — 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