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NPI 1770700718 · Altoona, PA · Sleep Medicine (Family Medicine) Physician
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Mehrdad Ghaffari is a sleep medicine (family medicine) physician provider located in Altoona, Pennsylvania. This profile covers 18 Medicare and 12 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 | Mehrdad Ghaffari |
| Address | 1414 Ninth Ave |
| City | Altoona |
| State | PA |
| ZIP | 16602 |
| Taxonomy | Sleep Medicine (Family Medicine) Physician |
| NPI Enumerated | April 19, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $219.9K |
| Medicare | $172.6K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
18 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… | 830 | $90 | $70.1K |
| 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… | 190 | $100 | $20K |
| 95811 | During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more. | 190 | $90 | $18K |
| 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… | 310 | $50 | $15.8K |
| 99291 | Critical 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… | 80 | $160 | $12K |
| 99222 | The 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… | 90 | $100 | $9.3K |
| 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… | 120 | $60 | $7.3K |
| 94726 | The provider performs a pulmonary function test, or PFT, to determine the patient’s lung volumes, such as total lung capacity, residual volume, and functional residual capacity. The testing also may… | 140 | $20 | $3.2K |
| 94729 | In this add on procedure, the provider tests the lungs’ diffusing capacity, the ability to exchange gases, moving oxygen into the bloodstream and letting in carbon dioxide from the bloodstream. | 140 | $20 | $3.2K |
| 95806 | A technologist is not in attendance during this sleep study, which involves measuring several parameters while the patient sleeps in a clinic or sleep lab to help diagnose sleep disorders. | 100 | $30 | $3.1K |
Showing 1–10 of 18
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
18 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 99214 | 491 | 23,230 | 100 | $80 | $14.5K |
| 99233 | 5,042 | 6,630 | 70 | $90 | $12K |
| 99291 | 1,090 | 3,800 | 40 | $170 | $11.7K |
| 99232 | 3,918 | 10,870 | 80 | $60 | $9.6K |
| 99223 | 5,926 | 7,020 | 40 | $130 | $7.8K |
| 99213 | 2,252 | 22,370 | 70 | $60 | $7.7K |
| 95811 | 1 | 150 | 30 | $170 | $7.2K |
| 95810 | 136 | 150 | 30 | $140 | $5.7K |
| 99204 | 160 | 10,290 | 30 | $110 | $5K |
| 99222 | 668 | 7,850 | 30 | $100 | $4.3K |
Showing 1–10 of 18
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.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 95811 | During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more. | 870 | $110 | $97.8K |
| 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… | 1,650 | $50 | $74.2K |
| 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… | 160 | $70 | $11.2K |
| 95806 | A technologist is not in attendance during this sleep study, which involves measuring several parameters while the patient sleeps in a clinic or sleep lab to help diagnose sleep disorders. | 390 | $30 | $10.9K |
| 94729 | In this add on procedure, the provider tests the lungs’ diffusing capacity, the ability to exchange gases, moving oxygen into the bloodstream and letting in carbon dioxide from the bloodstream. | 430 | $20 | $6.9K |
| 94726 | The provider performs a pulmonary function test, or PFT, to determine the patient’s lung volumes, such as total lung capacity, residual volume, and functional residual capacity. The testing also may… | 340 | $20 | $6.2K |
| 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… | 180 | $30 | $5.2K |
| 94060 | The spirometry test is performed with a spirometer. The instrument displays a graphical representation, known as a spirogram, of the test results. The basic forced volume vital capacity (FVC) test is… | 500 | $10 | $4.5K |
| 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… | 50 | $50 | $2.4K |
| 94200 | The provider measures the largest volume of air that a patient can voluntarily breathe while the patient breathes as deeply and quickly as possible for a specified period of time. This test helps… | 50 | $1 | $180 |
Showing 1–10 of 12
How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Pennsylvania median
12 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 1,184 | 8,160 | 210 | $60 | $68.4K |
| 95811 | During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more. | 2 | 50 | 90 | $380 | $57.8K |
| 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… | 4,863 | 8,870 | 240 | $40 | $56.1K |
| 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… | 882 | 1,300 | 110 | $40 | $41.5K |
| 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… | 441 | 1,410 | 60 | $90 | $30.5K |
| 95806 | A technologist is not in attendance during this sleep study, which involves measuring several parameters while the patient sleeps in a clinic or sleep lab to help diagnose sleep disorders. | 4 | 40 | 40 | $60 | $9.2K |
| 94729 | In this add on procedure, the provider tests the lungs’ diffusing capacity, the ability to exchange gases, moving oxygen into the bloodstream and letting in carbon dioxide from the bloodstream. | 30 | 160 | 100 | $20 | $6.2K |
| 94726 | The provider performs a pulmonary function test, or PFT, to determine the patient’s lung volumes, such as total lung capacity, residual volume, and functional residual capacity. The testing also may… | 26 | 130 | 80 | $20 | $5.8K |
| 94060 | The spirometry test is performed with a spirometer. The instrument displays a graphical representation, known as a spirogram, of the test results. The basic forced volume vital capacity (FVC) test is… | 28 | 160 | 90 | $20 | $5.3K |
| 94200 | The provider measures the largest volume of air that a patient can voluntarily breathe while the patient breathes as deeply and quickly as possible for a specified period of time. This test helps… | 3 | 10 | 50 | $10 | $3.9K |
Showing 1–10 of 12
Other providers in the same ZIP code as Mehrdad Ghaffari, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| North Star Services, Inc. | PA | Case Management Agency | $0 | $21M |
| Pyramid Healthcare Inc. | PA | Substance Use Disorder Rehabilitation Clinic/Center | $0 | $14.3M |
| Blair Family Solutions, LLC | PA | Community/Behavioral Health Agency | $0 | $9.6M |
| Altoona Logan Twp Mobile Med Emerg Dept Authority | PA | Ambulance | $924.6K | $5.3M |
| Advanced Center For Surgery, LLC | PA | Ambulatory Surgical Clinic/Center | $1.5M | $0 |
| Allegheny Surgery Center LLC | PA | Ambulatory Surgical Clinic/Center | $770.6K | $361.2K |
| Blair Endoscopy Center, LLC | PA | Endoscopy Clinic/Center | $579.7K | $325.8K |
| Gregory Fulchiero | PA | MOHS-Micrographic Surgery Physician | $842.2K | $0 |
| David Bozak | PA | Physical Medicine & Rehabilitation Physician | $768.3K | $0 |
| Christopher Mcclellan | PA | Orthopaedic Surgery Physician | $410.7K | $33.6K |
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