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NPI 1821300526 · Philadelphia, PA · Pulmonary Disease Physician
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Santosh Dhungana is a pulmonary disease physician provider located in Philadelphia, Pennsylvania. This profile covers 14 Medicare and 3 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 | Santosh Dhungana |
| Address | 3401 N Broad St |
| City | Philadelphia |
| State | PA |
| ZIP | 19140 |
| Taxonomy | Pulmonary Disease Physician |
| NPI Enumerated | July 9, 2010 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $88.1K |
| Medicaid | $410 |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
14 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 180 | $170 | $29.9K |
| 99233 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 220 | $100 | $20.9K |
| 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… | 100 | $140 | $13.8K |
| 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… | 70 | $90 | $6.7K |
| 99223 | The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 40 | $140 | $5.3K |
| 99205 | The provider sees a new 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 provider… | 20 | $160 | $2.9K |
| 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. | 90 | $30 | $2.4K |
| 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… | 70 | $30 | $2.2K |
| 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… | 10 | $130 | $1.5K |
| 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… | 60 | $20 | $1.2K |
Showing 1–10 of 14
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
14 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 99214 | 14,095 | 23,230 | 100 | $80 | $14.5K |
| 99233 | 1,102 | 6,630 | 70 | $90 | $12K |
| 99291 | 270 | 3,800 | 40 | $170 | $11.7K |
| 99215 | 1,429 | 7,170 | 40 | $120 | $8.6K |
| 99223 | 3,305 | 7,020 | 40 | $130 | $7.8K |
| 99204 | 9,769 | 10,290 | 30 | $110 | $5K |
| 99205 | 1,953 | 3,090 | 20 | $150 | $4.9K |
| 95806 | 77 | 80 | 40 | $40 | $2K |
| 94729 | 161 | 450 | 60 | $20 | $1.7K |
| 31645 | 20 | 30 | 20 | $70 | $1.5K |
Showing 1–10 of 14
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.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 94618 | The provider performs pulmonary stress testing to evaluate lung function and to diagnose certain lung disorders. The stress component may include a six–minute walk test or other form of exercise. | 10 | $20 | $210 |
| 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. | 10 | $10 | $110 |
| 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… | 10 | $10 | $100 |
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
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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. | 151 | 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… | 119 | 130 | 80 | $20 | $5.8K |
| 94618 | The provider performs pulmonary stress testing to evaluate lung function and to diagnose certain lung disorders. The stress component may include a six–minute walk test or other form of exercise. | 30 | 40 | 70 | $20 | $4.8K |
Other providers in the same ZIP code as Santosh Dhungana, ranked by combined Medicare and Medicaid revenue.
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