Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Missouri for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Missouri only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Missouri (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Nibash Budhathoki (NPI 1861876526)

Field	Value
Entity Type	Individual
Organization	Nibash Budhathoki
Address	4150 N Mulberry Dr Ste 150
City	Kansas City
State	MO
ZIP	64116
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	July 13, 2015

Payer Source	Total Paid
Medicare	$2.2M
Medicaid	$0

Key Findings

This provider’s Medicare footprint is the sole payer presence in the data: Total Medicare revenue is $2.2M and there is no Medicaid billing on file, so the practice is effectively single-payer (Medicare) in the available records. The NPI was enumerated on 2015-07-13 (~11 years ago), indicating roughly a decade of active billing history to establish this pattern.

Revenue is highly concentrated in three oncology drug codes: J9271 accounts for 41.7% of Medicare revenue, J9144 for 19.5%, and J9299 for 19.2%, with the top 3 codes together making up 80.4% of the provider’s Medicare revenue. These top codes are high-volume injections of pembrolizumab, daratumumab, and nivolumab and the listed average paid/claim values ($43 for J9271, $38 for J9144, $22 for J9299) underscore an infusion-centered oncology business model focused on monoclonal antibodies and checkpoint inhibitors.

National ranking and percentile data show a modest-to-moderate competitive position on the core drug lines: J9271 is ranked #358 of 1841 providers (80th percentile; typical, unremarkable volume), J9144 is #180 of 615 (71th percentile; typical, unremarkable volume), and J9299 is #188 of 505 (63th percentile; typical, unremarkable volume). These placements indicate the provider is not a national leader in any of these agents but does operate above the median in at least J9271 and maintains a presence in national provider cohorts for major oncology infusions.

Procedure-level chemo administration and infusion-related codes show meaningful activity consistent with an outpatient infusion practice: 96413 is reported with 490 claims, $92 avg paid/claim, $45.1K revenue (2.1% of Medicare revenue) and ranks #732 of 7514 providers (90th percentile; typical, unremarkable volume), while add-on and IV push codes such as 96417 (130 claims, $46 avg, 76th percentile) and 96375 (663 claims, $11 avg, 93th percentile) also appear. These entries support a workflow that combines in-office administration, sequential infusions, and IV push medications in addition to the high-cost biologic agents.

Evaluation-and-management patterns skew toward higher-complexity office visits: 99215 shows 358 claims, $112 avg paid/claim, $40.1K revenue (1.9% of Medicare revenue) and is described as notably above typical national volume (rank #4084 of 145531 providers; 97th percentile). Lower-level E/M codes such as 99214 and 99213 are present but at lower share, so the clinical mix is consistent with frequent high-complexity patient management and decision-making for oncology patients.

Ancillary services and onsite testing are elevated relative to peers: 80053 (CMP) has 1.4K claims, $10 avg, $14K revenue (0.7%) at the 96th percentile, 85025 (CBC) has 1.5K claims, $8 avg, $12K revenue (0.6%) at the 96th percentile, and 36415 (phlebotomy) shows 1K claims, $8 avg, $8.3K revenue (0.4%) at the 97th percentile. The high percentiles for basic labs and specimen collection suggest frequent per-visit monitoring and lab-dependent care workflows that align with infusion oncology.

The payer and revenue concentration create a business sensitivity: with the top three drugs comprising 80.4% of Medicare revenue, the practice’s financial profile is heavily dependent on continued use and reimbursement of pembrolizumab (J9271), daratumumab (J9144), and nivolumab (J9299). This concentration implies that changes in utilization patterns, reimbursement, or drug availability for these specific agents would materially affect the provider’s Medicare revenue base.

Use of biosimilar and select agents is mixed: Q5107 (bevacizumab-awwb) appears with 1.8K claims, $22 avg paid/claim, $39.6K revenue (1.8%) but ranks #57 of 78 providers (27th percentile), while J9305 (pemetrexed) ranks #27 of 33 providers (19th percentile). Those lower percentiles indicate modest national standing for these specific agents despite measurable local utilization, suggesting the provider prioritizes particular biologics and checkpoint inhibitors over some chemotherapy agents or biosimilars at a national scale.

Medicare: Complete Services Breakdown

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

75 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	20,800	$40	$894.4K
J9144	Injection, daratumumab, 10 mg and hyaluronidase‑fihj	10,980	$40	$417.2K
J9299	Injection, nivolumab, 1 mg	18,700	$20	$411.4K
J0897	Injection, denosumab, 1 mg	6,420	$20	$115.6K
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…	490	$90	$45.1K
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…	360	$110	$40.1K
Q5107	Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg	1,800	$20	$39.6K
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…	360	$90	$31.6K
J2506	Injection, pegfilgrastim, excludes biosimilar, 0.5 mg	290	$80	$24.2K
J9305	Injection, pemetrexed, not otherwise specified, 10 mg	1,590	$10	$19.1K

Showing 1–10 of 75

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 75 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Missouri Distribution

Nibash Budhathoki — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. state median

75 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	7	40	9,100	$40	$502K
J9299	4	20	14,170	$20	$360.3K
J9144	4	20	7,200	$40	$308.4K
J0897	32	210	2,400	$20	$82.4K
Q5107	1	10	1,520	$20	$41K
83520	2	10	1,220	$20	$33.1K
J2506	12	40	310	$80	$25.9K
96413	14	160	140	$100	$19.1K
J3490	14	80	40	$150	$14K
99214	816	8,960	100	$80	$13.9K

Showing 1–10 of 75

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mary Washington Hospital Inc.	VA	General Acute Care Hospital	$0	$80.1M
Northwest Iowa Hospital Corporation	IA	General Acute Care Hospital	$0	$22.8M
Thomas Buroker	IA	Medical Oncology Physician	$9.4M	$0
University Of Kansas Hospital Authority	KS	General Acute Care Hospital	$0	$9.2M
Kyle Alliman	IA	Ophthalmology Physician	$8.7M	$0
Alex Kartvelishvili	IA	Ophthalmology Physician	$8.1M	$0
Northwest Iowa Hospital Corporation	IA	Emergency Medical Services (Emergency Medicine) Physician	$0	$7.9M
Paul Boeke	IA	Ophthalmology Physician	$7.1M	$0
Austin Strohbehn	IA	Retina Specialist (Ophthalmology) Physician	$5.8M	$0
Jeremy Deutsch	KS	Hematology & Oncology Physician	$5.7M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Life Unlimited, Inc.	MO	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$58.1M
North Kansas City Hospital	MO	General Acute Care Hospital	$0	$18.3M
1st Priority Homecare LLC	MO	In Home Supportive Care Agency	$0	$5.2M
Midwest Emergency Medical Services PC	MO	Emergency Medicine Physician	$0	$5M
St Magdalena Of Kansas City	MO	Developmentally Disabled Services Day Training Agency	$0	$4.2M
Stephen Reintjes	MO	Neurological Surgery Physician	$431.5K	$0
Amy Carpenter	MO	Nurse Practitioner	$415.6K	$0
Steven Kosa	MO	Neurology Physician	$393.6K	$0
Christopher Wise	MO	Orthopaedic Trauma Physician	$367.7K	$0
Adam Schulte	MO	Physical Medicine & Rehabilitation Physician	$328.7K	$2.4K

Nibash Budhathoki — Billing Profile & Reimbursement Data

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Nibash Budhathoki — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References