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NPI 1780628495 · Clovis, NM · Rheumatology Physician
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Jayashree Sinha is a rheumatology physician provider located in Clovis, New Mexico. This profile covers 33 Medicare and 1 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 | Jayashree Sinha |
| Address | 1600 W 21st St |
| City | Clovis |
| State | NM |
| ZIP | 88101 |
| Taxonomy | Rheumatology Physician |
| NPI Enumerated | June 15, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $662.2K |
| Medicaid | $270 |
Payer mix is heavily Medicare‑weighted: lifetime Medicare revenue on file is $662.2K versus only $271 in Medicaid, so Medicare accounts for virtually all billed revenue while Medicaid is effectively negligible. The provider’s Medicaid billing is concentrated entirely in a single code (99214), which accounts for 100.0% of Medicaid revenue and is ranked low in-state (99214 ranks #930 of 963 in‑state, 2th percentile; typical, unremarkable volume for this code).
Medicare revenue concentration is high: the top 3 Medicare codes by revenue account for 77.7% of the provider’s total Medicare revenue. This means a small set of services drives most of the $662.2K in Medicare receipts, increasing exposure to reimbursement or utilization changes affecting those specific codes.
Top Medicare revenue drivers point to an in‑office biologics/infusion focus: J0129 (abatacept) generates $277.9K (42.0% of Medicare revenue) and J9312 (rituximab) generates $203.5K (30.7% of Medicare revenue). Those two drug codes together dominate the clinical profile by revenue and, alongside office visit code 99214, indicate the practice delivers biologic infusions and manages follow‑up E/M visits for chronic rheumatologic conditions.
Competitive standing for the lead drug codes is modest rather than dominant: J0129 ranks #485 of 1221 providers nationally (60th percentile; typical, unremarkable volume for this code) and J9312 ranks #132 of 317 providers nationally (58th percentile; typical, unremarkable volume for this code). Those percentiles and the provided labels suggest routine, expected volumes for a community rheumatology infusion provider rather than a regional center of excellence.
Operational footprint is corroborated by supportive infusion and procedure codes: presence of IV administration and chemotherapy administration codes (96413, 96415, 96375) plus 99214 office visits and arthrocentesis (20611) point to an office that combines medication infusions with hands‑on rheumatology care. The mix of drug‑administration, infusion add‑ons, and procedure codes is consistent with a practice that maintains infusion capability rather than referring all biologic therapy out.
Diagnostic and monitoring activity aligns with routine rheumatology care: multiple immunology and autoimmune lab codes (86200, 86225, 86226, 86235, 86376, 86481) appear among top Medicare codes, often with percentile ranks described as typical or above-typical (for example 86235 ranks #143 of 746 nationally, 81th percentile; typical, unremarkable volume for this code). This pattern supports ongoing monitoring of autoimmune disease activity and therapeutic response within the same practice.
Service mix includes imaging and telehealth components that are above many peers: musculoskeletal ultrasound 76881 ranks #83 of 1606 nationally (95th percentile; typical, unremarkable volume for this code) and telehealth/remote visit code 99443 ranks #699 of 14283 nationally (95th percentile; typical, unremarkable volume for this code). Those high percentiles suggest relatively heavy use of joint ultrasound and remote visit modalities compared with national peers, which may reflect local practice style or patient access strategies.
Provider tenure is long: the NPI was enumerated on 2006-06-15 (~20 years ago), indicating an established presence in the market. Given the long tenure combined with concentrated Medicare revenue (77.7% from the top three Medicare codes), the practice appears to be a steady, established community rheumatology operation with operational dependence on a few high‑revenue biologic infusion codes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
33 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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) | 9,930 | $30 | $277.9K |
| J9312 | Injection, rituximab, 10 mg | 3,700 | $60 | $203.5K |
| 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 | $90 | $33.2K |
| J0897 | Injection, denosumab, 1 mg | 1,440 | $20 | $23K |
| 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… | 250 | $90 | $22.1K |
| 86235 | The lab analyst performs an assay to evaluate the patient’s serum for each antibody to an extractable nuclear antigen, also called ENA. Types of ENA antibodies include anti ribonuclear protein,… | 1,240 | $20 | $21.1K |
| 76881 | In this procedure, the provider uses ultrasound to examine the complete joint for any defect or abnormality. The image appears in real time on a monitor, and a permanent image with interpretation is… | 340 | $40 | $13K |
| 99443 | N/A | 160 | $80 | $12.6K |
| 86481 | The lab analyst performs a test to evaluate an antigen response to certain tuberculosis (TB) antibodies by enumerating T cells that produce gamma interferon. | 120 | $100 | $11.9K |
| 96401 | The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient. | 110 | $50 | $5.6K |
Showing 1–10 of 33
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
Full comparison — all codes billed, vs. state median
33 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0129 | 5 | 10 | 9,930 | $30 | $358.6K |
| J9312 | 2 | 10 | 3,700 | $60 | $225.8K |
| J0897 | 36 | 50 | 3,150 | $20 | $113.2K |
| 86235 | 2 | 10 | 1,240 | $20 | $19.7K |
| 96413 | 11 | 40 | 170 | $90 | $17.7K |
| 84443 | 30 | 60 | 110 | $20 | $13.3K |
| 99214 | 298 | 2,700 | 90 | $70 | $12.9K |
| 86481 | 2 | 10 | 130 | $100 | $12.6K |
| 80053 | 56 | 90 | 100 | $10 | $11.5K |
| 86376 | 2 | 10 | 540 | $10 | $7.7K |
Showing 1–10 of 33
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.
1 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… | 10 | $20 | $270 |
How this provider's Medicaid billing volume and revenue compare to other New Mexico providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Mexico median
1 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… | 930 | 960 | 1,010 | $90 | $490K |
Other providers in the same ZIP code as Jayashree Sinha, ranked by combined Medicare and Medicaid revenue.
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