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    OpenPayerNPI Medicare & MedicaidAshley Amaireh
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    Ashley Amaireh — Billing Profile & Reimbursement Data

    NPI 1801350152 · Oklahoma City, OK · Family Nurse Practitioner

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    Ashley Amaireh is a family nurse practitioner provider located in Oklahoma City, Oklahoma. This profile covers 22 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationAshley Amaireh
    Address10400 S Western Ave Ste 7
    CityOklahoma City
    StateOK
    ZIP73139
    TaxonomyFamily Nurse Practitioner
    NPI EnumeratedJanuary 30, 2019

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$2.2M
    Medicaid$0

    Key Findings

    This provider is effectively single-payer: lifetime Medicare revenue is $2.2M and there is no Medicaid billing on file. The profile therefore reflects Medicare-driven clinical and revenue patterns rather than a mixed Medicaid/Medicare practice, and the precomputed metric shows the top 3 Medicare codes account for 78.2% of total Medicare revenue. Payer concentration toward Medicare heightens sensitivity to Medicare coverage and coding changes for the provider's highest-volume items.

    The code mix and descriptions indicate an advanced wound-care and surgical debridement practice that also performs skin substitute applications and related graft preparation. The three largest Medicare revenue drivers are Q4194 ($686K, 30.7%), Q4229 ($650K, 29.1%), and Q4257 ($412.9K, 18.5%), all of which are per-square-centimeter add-on products (amniotic/placental/skin substitute products) and are complemented by debridement codes such as 11043 and grafting codes such as 15271 and 15002. This combination of device/product add-ons plus debridement/grafting procedures is characteristic of wound-clinic or specialty procedural work rather than routine primary care.

    Revenue is highly concentrated in a very small set of product codes: Q4194, Q4229, and Q4257 together account for 78.2% of Medicare revenue, indicating the provider’s financial performance is driven predominantly by a few high-value, per-square-centimeter skin/placental products. Each of those three codes contributes large, named-dollar amounts to the $2.2M Medicare total (Q4194 $686K, Q4229 $650K, Q4257 $412.9K), so changes in utilization or reimbursement for any single product could materially affect the provider’s revenue.

    Competitive standing is mixed: the provider is a clear national high-volume user for some product lines but more modest overall. For Q4229 the provider ranks #4 of 46 nationally (93th percentile; notably above typical national volume), and for 15271 the provider ranks #39 of 1157 (97th percentile; notably above typical national volume), indicating above-typical national participation for specific skin-substitute codes. By contrast, Q4194 (rank #14 of 69, 81th percentile; typical, unremarkable volume) and Q4257 (rank #6 of 19, 72th percentile; typical, unremarkable volume) are described as typical or unremarkable in volume relative to peers, so the provider is a major national participant for some products but not uniformly dominant across all top codes.

    Several secondary procedure and facility E/M codes supplement the product-driven revenue stream, signaling mixed care settings. High-volume E/M codes include 99308 (829 claims, $38.1K, 1.7% of Medicare revenue) and multiple nursing-facility and inpatient E/M codes (99305, 99309, 99307, 99232, 99231), and debridement codes appear frequently (11043 339 claims, $41.4K; 11046 577 claims, $21.3K; 11042 310 claims, $18.6K). This mix demonstrates that the provider delivers both procedural wound-care services and hands-on post-operative or facility-based follow-up, which aligns with strong utilization of product add-ons listed above.

    There are notable percentile/label contrasts in the dataset that analysts should note when benchmarking utilization. For example, 11045 is listed at the 97th percentile but the dataset label for that code is "typical, unremarkable volume," while 15271 is also at the 97th percentile and labeled "notably above typical national volume." These labels and percentiles together suggest the provider sits at the high end of national distribution for multiple skin-substitute and debridement codes, but the narrative label applied to specific codes may vary by product or peer group.

    Tenure and credentialing are straightforward: the NPI was enumerated 2019-01-30 (~7 years ago), so this pattern reflects roughly a multi-year operational history under the current NPI. Given the concentrated revenue mix, this ~7-year tenure provides multiple years of Medicare billing behavior for review but also implies that historical trends and any recent shifts in code-level utilization should be reviewed across the full enumerated period.

    Implications for payer oversight and contracting: because a large share of the provider’s Medicare revenue is driven by a handful of per-square-centimeter skin/placental product codes (Q4194, Q4229, Q4257), utilization management policies, product-specific coverage decisions, and supplier contracting for those products could disproportionately affect this provider’s payments. Payers or network managers evaluating this entity should prioritize review of Q4229 (rank #4 of 46; 93th percentile; notably above typical national volume) and related high-dollar product codes when assessing medical necessity, pricing, and program integrity exposure, while recognizing the provider also performs debridement and facility-based E/M work that supports the procedural product usage.

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    22 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    Q4194Novachor, per square centimeter (add-on, list separately in addition to primary procedure)850$810$686K
    Q4229Cogenex amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)3,370$190$650K
    Q4257Relese, per square centimeter (add-on, list separately in addition to primary procedure)740$560$412.9K
    Q4197Puraply xt, per square centimeter (add-on, list separately in addition to primary procedure)1,950$140$263.1K
    11043The provider uses surgical instruments to remove the dead tissue in muscle and/or fascia, including any debridement of the epidermis, dermis, and subcutaneous tissue, for the first or only 20 cm2 or…340$120$41.4K
    99308The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…830$50$38.1K
    15271The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the patient’s trunk, arms, and/or legs up to an area of 100 cm2. This code covers up to the first 25 cm2.350$100$33.3K
    11046The provider uses surgical instruments to remove the dead tissue from the muscle and/or fascia, as well as the subcutaneous tissue layer, epidermis, and dermis if needed. She performs this service at…580$40$21.3K
    11042The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.310$60$18.6K
    11045The provider uses surgical instruments to remove dead tissue from the subcutaneous layer, as well as the epidermis and dermis if needed. She performs this service at the same session as a separately…800$20$18.4K

    Showing 1–10 of 22

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    22 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    Q4194310740$810$637.6K
    Q42291102,160$190$414.3K
    Q4257110740$560$412.6K
    Q41973101,310$130$202.8K
    99309164270170$70$42.7K
    9930848270180$50$26.5K
    1104334090$140$21.7K
    992328061,77090$60$14K
    110422314090$60$11.1K
    15271130100$90$10.9K

    Showing 1–10 of 22

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Danh PhamOKFamily Medicine Physician$546.1K$0
    Richard HolsoppleOKEmergency Medicine Physician$376.4K$0
    Ahmad AshfaqOKInfectious Disease Physician$225.7K$0
    Kate GrimmOKFamily Nurse Practitioner$221.7K$0
    Vijay KolliOKInfectious Disease Physician$207.1K$0
    Marlee RobinsonOKFamily Nurse Practitioner$193.5K$0
    Cuong NguyenOKNephrology Physician$173.9K$0
    Francesca BoulosOKSurgery Physician$168.4K$0
    Brant BennettOKFamily Medicine Physician$123.5K$0
    Julie HincheyOKFamily Nurse Practitioner$119.5K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Variety Care, Inc.OKFederally Qualified Health Center (FQHC)$0$53.3M
    Ace Hts, IncOKDevelopmentally Disabled Services Day Training Agency$0$29.9M
    Hope Community Services, Inc.OKCommunity/Behavioral Health Agency$0$16.1M
    Oklahoma Mental Health CouncilOKCommunity/Behavioral Health Agency$0$5M
    New Life Youth's & Family Counseling Services, IncOKCommunity/Behavioral Health Agency$0$3.5M
    Dental Depot 62nd & South Western PLLCOKGeneral Practice Dentistry$0$3.5M
    Dental Depot SouthOKGeneral Practice Dentistry$0$3.4M
    Osu Center For Health SciencesOKClinic/Center$0$3.1M
    Oklahoma Center For Orthopaedic & Multi-specialty Surgery, LLCOKGeneral Acute Care Hospital$0$2.8M
    Empowerment Community ServicesOKCommunity/Behavioral Health Agency$0$2.6M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Oklahoma Distribution
    Ashley Amaireh — 4 of 22 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Oklahoma