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NPI 1831289891 · Beckley, WV · Internal Medicine Physician
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Mustafa Rahim is a internal medicine physician provider located in Beckley, West Virginia. This profile covers 37 Medicare and 11 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 | Mustafa Rahim |
| Address | 250 Stanaford Rd |
| City | Beckley |
| State | WV |
| ZIP | 25801 |
| Taxonomy | Internal Medicine Physician |
| NPI Enumerated | October 13, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $437.6K |
| Medicaid | $166.5K |
This provider’s payer mix is weighted toward Medicare by scale: total Medicare revenue is $437.6K compared with total Medicaid revenue of $166.5K. Both payers are active, but Medicare represents the larger share of lifetime billed revenue for this NPI.
Revenue concentration is high on a small set of E/M codes for both payers: the top three Medicare codes (including 99232 and 99213) account for 67.1% of Medicare revenue, while the top three Medicaid codes (led by 99213 and 99212) account for 98.2% of Medicaid revenue. This indicates the provider derives the bulk of reimbursement from a narrow set of evaluation-and-management services.
The code mix points to a clinically broad internal medicine practice with a heavy hospital and outpatient E/M footprint: high Medicare revenue from 99232 (subsequent inpatient/observation), 99222 (initial inpatient/observation), and 99213 (office visits) suggests frequent inpatient/observation care plus office-based chronic care. Additional Medicaid and Medicare lines such as 99308/99304 (nursing facility visits) and imaging codes 93880/93925 and 93306 indicate the provider performs nursing facility rounds and offers noninvasive vascular and cardiac imaging as part of the service mix.
On Medicare the provider is a clear high-volume national outlier for core E/M services: 99213 ranks in the 100th percentile and is labeled an "extreme outlier," 99232 ranks in the 99th percentile and is an "extreme outlier," and 99222 is also a 99th percentile "extreme outlier." These rankings imply the provider bills substantially more of these inpatient and outpatient E/M services than typical national peers.
By contrast, the provider’s standing within West Virginia Medicaid is modest for the same office E/M services: 99213 is at the 62th percentile in-state (typical), 99212 is at the 64th percentile (typical), and 99232 is at the 38th percentile (typical). This suggests that while Medicare volumes are unusually high relative to national peers, the provider is a conventional, not dominant, Medicaid participant in-state.
Multiple inpatient/observation E/M codes appear repeatedly as statistical outliers on Medicare (for example 99232, 99222 and 99238 are each described as "extreme outlier" or far above typical national volume), signaling an operational profile strongly weighted to hospital-based visits rather than a purely office-based practice. Payers and network managers should note this pattern when considering care setting incentives and utilization controls.
The Medicaid revenue base is highly concentrated in office-level visits: 99213 alone generates $131.7K and represents 78.8% of this provider’s total Medicaid revenue, while 99212 contributes a further 12.8%. Such dependence on a single office-level code for Medicaid revenue exposes the provider’s Medicaid business line to policy or reimbursement shifts focused on outpatient E/M fees.
The NPI has tenure consistent with an established practice: enumerated on 2006-10-13 (~20 years ago), indicating long-standing presence in the local market. Combined with the high Medicare volumes for inpatient and observation E/M, the data are consistent with a long-tenured internal medicine physician who maintains both hospital-based and outpatient responsibilities.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
37 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 2,300 | $60 | $142.6K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 2,090 | $60 | $121K |
| 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… | 250 | $100 | $25.4K |
| 99308 | The 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… | 420 | $50 | $22.8K |
| 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… | 140 | $130 | $18.5K |
| 99238 | The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the… | 270 | $60 | $16.5K |
| 93880 | Duplex scanning of arteries for the evaluation of blood flow is a type of non–invasive vascular diagnostic process. A physician can visualize and selectively assess the flow patterns of peripheral… | 160 | $90 | $14.3K |
| 93925 | The provider performs a duplex ultrasound scan of the lower extremity arteries or bypass grafts on both sides. Providers perform noninvasive arterial diagnostic procedures to examine the rate of… | 110 | $120 | $12.9K |
| 99304 | The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves straightforward or low medical decision making or the provider… | 160 | $60 | $9.4K |
| 99239 | The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the… | 80 | $90 | $6.7K |
Showing 1–10 of 37
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 37 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
37 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 99309 | 157 | 160 | 160 | $70 | $26.3K |
| 93306 | 86 | 110 | 190 | $60 | $15.8K |
| 99232 | 11 | 1,340 | 90 | $60 | $11.9K |
| 99214 | 2,618 | 2,740 | 100 | $70 | $11.8K |
| 99233 | 485 | 660 | 60 | $90 | $11.4K |
| 99308 | 23 | 150 | 110 | $50 | $10.7K |
| 99223 | 73 | 780 | 30 | $130 | $7.9K |
| 99213 | 1 | 2,860 | 80 | $50 | $7.5K |
| 99239 | 167 | 370 | 70 | $90 | $7K |
| 99457 | 8 | 10 | 120 | $30 | $7K |
Showing 1–10 of 37
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.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 2,580 | $50 | $131.7K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 790 | $30 | $21.4K |
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 280 | $40 | $11K |
| 93880 | Duplex scanning of arteries for the evaluation of blood flow is a type of non–invasive vascular diagnostic process. A physician can visualize and selectively assess the flow patterns of peripheral… | 10 | $100 | $1.2K |
| 90756 | This code represents a flu vaccine product that protects against four strains of influenza. It is derived from cell cultures, contains no antibiotics, and is administered as a 0.5 mL injection into… | 40 | $20 | $740 |
| Q2037 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin) | 40 | $20 | $610 |
| 90688 | This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It uses split virus technology and is given as a 0.5 mL dose. | 50 | $10 | $260 |
| 90471 | In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route. | 30 | $10 | $200 |
| G0008 | Administration of influenza virus vaccine | 60 | $1 | $60 |
| 3074F | No Summary found for this code | 20 | $0 | $0 |
Showing 1–10 of 11
How this provider's Medicaid billing volume and revenue compare to other West Virginia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. West Virginia median
11 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 480 | 1,270 | 1,240 | $30 | $245K |
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 115 | 190 | 660 | $40 | $226.4K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 195 | 540 | 320 | $20 | $43.2K |
| 93880 | Duplex scanning of arteries for the evaluation of blood flow is a type of non–invasive vascular diagnostic process. A physician can visualize and selectively assess the flow patterns of peripheral… | 46 | 50 | 110 | $60 | $34.7K |
| 90471 | In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route. | 343 | 430 | 200 | $10 | $18.3K |
| 3074F | No Summary found for this code | 153 | 160 | 360 | $1 | $2.7K |
| 3079F | No Summary found for this code | 95 | 110 | 170 | $1 | $1.9K |
| 90756 | This code represents a flu vaccine product that protects against four strains of influenza. It is derived from cell cultures, contains no antibiotics, and is administered as a 0.5 mL injection into… | 12 | 30 | 30 | $20 | $1.2K |
| 90688 | This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It uses split virus technology and is given as a 0.5 mL dose. | 30 | 90 | 40 | $20 | $1K |
| G0008 | Administration of influenza virus vaccine | 98 | 230 | 50 | $10 | $870 |
Showing 1–10 of 11
Other providers in the same ZIP code as Mustafa Rahim, ranked by combined Medicare and Medicaid revenue.
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