NPI 1811996887 — Billing Profile & Reimbursement Data
NPI 1811996887 · XX · healthcare
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NPI 1811996887 is a healthcare provider located in Unspecified Location. 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. Note: "XX" is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; claims coded under it are grouped and benchmarked here the same way a traditional state would be.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | NPI 1811996887 |
| Address | |
| City | |
| State | XX (Unspecified Location) |
| ZIP | |
| Taxonomy | N/A |
| NPI Enumerated | |
| NPI Deactivated | April 10, 2025 |
(source: CMS Medicare & Medicaid claims data)
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 Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 180 | $200 | $34.9K |
| 43274 | The physician performs an ERCP (a diagnostic procedure that combines upper endoscopy and retrograde (reverse or backward) injection of contrast material, a type of dye, into the biliary ducts to… | 40 | $300 | $13.3K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 190 | $60 | $11.8K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 60 | $160 | $9.2K |
| 43248 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum; then through the scope, he passes a guidewire over which he passes dilators through the… | 80 | $100 | $7.8K |
| 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… | 90 | $90 | $7.7K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 50 | $170 | $7.6K |
| 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… | 70 | $100 | $7K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 80 | $90 | $6.9K |
| 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… | 60 | $100 | $6.2K |
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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. Note: this provider's state, "XX," is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; the State panel below benchmarks against other providers coded under the same designation.
View: State1 / 2
Full comparison — all codes billed, vs. state median
22 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 99213 | 2,306 | 10 | 140 | $60 | $18.8K |
| 99214 | 2,801 | 10 | 80 | $90 | $15.8K |
| 99232 | 1,717 | 10 | 110 | $60 | $6.9K |
| 85025 | 357 | 10 | 820 | $10 | $6.2K |
| 36415 | 631 | 10 | 230 | $10 | $5.5K |
| 99222 | 58 | 10 | 40 | $100 | $3.9K |
| 99204 | 467 | 10 | 20 | $120 | $2.8K |
| 80053 | 461 | 10 | 120 | $10 | $1.1K |
| 43235 | 20 | 0 | N/A | $N/A | $N/A |
| 43239 | 9 | 0 | N/A | $N/A | $N/A |
Showing 1–10 of 22
Frequently Asked Questions
References
- 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
- 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.
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