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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Saira Bilal (NPI 1770899627)

Field	Value
Entity Type	Individual
Organization	Saira Bilal
Address	2300 M St Nw
City	Washington
State	DC
ZIP	20037
Taxonomy	Rheumatology Physician
NPI Enumerated	August 28, 2010

Payer Source	Total Paid
Medicare	$755.4K
Medicaid	$0

Key Findings

This provider’s billed activity is effectively single‑payer: total Medicare revenue is $755.4K and there is no Medicaid billing on file ("none below"), so the practice’s revenue stream is concentrated in Medicare patients rather than a mixed Medicaid/Medicare panel. That concentration increases exposure to Medicare reimbursement changes and limits Medicaid-driven volume insights for in‑state comparisons.

Revenue is highly concentrated in a small set of biologic drug codes: J0717 accounts for $333.6K (43.2% of this provider’s Medicare revenue) and the precomputed top three Medicare codes together represent 66.6% of total Medicare revenue. The top three revenue drivers are J0717, J0129, and J0897, indicating that a majority of Medicare dollars come from a few high‑cost injectable/infusion products rather than routine office visits.

The code mix points to an infusion/injection‑center operational model within a rheumatology scope of care: high revenue from J0717, J0129, J0897 and the presence of infusion codes such as J1602 and J1745 suggest regular in‑office administration of biologic therapies. Administration and chemotherapy‑infusion administration CPTs (96401, 96413, 96415) further support that substantial clinical resources are devoted to drug preparation and administration rather than only exam‑based outpatient care.

On competitive standing, this provider shows a mixed national footprint across individual codes: J0717 ranks #196 of 848 providers nationally (77th percentile; typical, unremarkable volume), while administration code 96401 ranks #258 of 3868 (93th percentile; typical, unremarkable volume). In plain terms, the practice has a stronger-than-average presence in administration/infusion activity relative to peers while its leading drug code sits above median but is characterized in the dataset as typical.

There is notable heterogeneity across specific biologics: J0129 ranks #1102 of 1221 (10th percentile; typical, unremarkable volume) and J1745 ranks #1203 of 1352 (11th percentile; typical, unremarkable volume), indicating relatively modest use of those particular agents compared with national peers. This suggests the practice concentrates on a narrower set of biologic products (notably J0717) rather than a broad spread of all rheumatology biologics.

Evaluation & management visits constitute a meaningful but secondary revenue stream: 99214 generated $43.7K (5.7% of Medicare revenue) and 99215 generated $29.8K (3.9% of Medicare revenue), both described in the dataset as typical, unremarkable volume for those codes. These E/M revenues are substantially smaller than the top drug/infusion codes, consistent with a services model where drug administration is the dominant revenue driver.

Several chemotherapy‑administration and infusion codes appear with above‑median national percentiles for this provider (for example, 96401 at the 93th percentile and 99214 at the 85th percentile), which aligns with an operational emphasis on in‑office infusions and prolonged chair time. Even so, most individual codes in the top 25 are labeled in the source as "typical, unremarkable volume," so the provider’s activity is stronger in administration relative to many peers but not characterized as an extreme outlier in this dataset.

The provider’s NPI was enumerated on 2010-08-28 (~16 years ago), indicating an established practice tenure that could support stable referral patterns and the infrastructure needed for in‑office infusion services. Given the absence of Medicaid billing and the concentration in a few biologic codes, analysts should treat future shifts in Medicare drug reimbursement or utilization policy as primary operational risks for this provider.

Medicare: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0717	Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	83,400	$1	$333.6K
J0129	Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	2,700	$30	$91.8K
J0897	Injection, denosumab, 1 mg	4,680	$20	$88.9K
J1602	Injection, golimumab, 1 mg, for intravenous use	7,720	$10	$77.2K
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…	390	$110	$43.7K
96401	The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient.	500	$70	$35.3K
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…	190	$160	$29.8K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	1,060	$30	$27.6K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	130	$130	$16.6K
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…	100	$140	$14.6K

Showing 1–10 of 16

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. District of Columbia Distribution

Saira Bilal — 2 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. state median

16 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0717	1	10	82,300	$1	$317.9K
J0129	2	10	5,200	$30	$175K
J0897	8	20	4,680	$20	$91.2K
J1602	1	10	7,720	$10	$78.5K
J1745	1	10	1,010	$30	$26.1K
99214	141	1,400	90	$100	$15.3K
96401	2	10	160	$70	$14.3K
99215	88	660	50	$130	$12.3K
96413	6	20	60	$120	$11.4K
99213	674	1,200	50	$70	$8.5K

Showing 1–10 of 16

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mariam Ameri	MD	Rheumatology Physician	$1.9M	$0
Phillip Kempf	VA	Rheumatology Physician	$1.6M	$0
Ashok Jacob	MD	Rheumatology Physician	$1.4M	$0
Jonathan Miller	DC	Internal Medicine Physician	$795.7K	$0
Sumit Kunwar	MD	Rheumatology Physician	$724.6K	$0
Susan Berger	MD	Rheumatology Physician	$714.2K	$0
Navera Ahmed	VA	Rheumatology Physician	$659.7K	$0
Primaljyot Bhatia	MD	Rheumatology Physician	$377.8K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
District Hospital Partners L P	DC	General Acute Care Hospital	$0	$136.3M
Medical Faculty Associates, Inc	DC	Anesthesiology Physician	$0	$75.7M
Baymark Health Services Of West Virginia, Inc.	DC	Substance Use Disorder Rehabilitation Clinic/Center	$571.6K	$6.4M
Medical Home Development Group	DC	Family Medicine Physician	$0	$6.7M
The Foundation For Contemporary Mental Health	DC	Public Health or Welfare Agency	$0	$5.4M
Dva Renal Healthcare Inc	DC	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.9M
Miriam's Kitchen	DC	Case Management Agency	$0	$3.1M
Faysal Haroun	DC	Hematology & Oncology Physician	$2.4M	$0
Rishi Sood	DC	Vascular & Interventional Radiology Physician	$2.2M	$0
Matthew Forsthoefel	DC	Radiation Oncology Physician	$1.1M	$0

Saira Bilal — 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