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 Hawaii for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Hawaii 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. Hawaii (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.

Sherleen Mohamdi-osman (NPI 1871706358)

Field	Value
Entity Type	Individual
Organization	Sherleen Mohamdi-osman
Address	Wake Island Dispensary
City	Wake Island
State	HI
ZIP	96898
Taxonomy	Nephrology Physician
NPI Enumerated	May 8, 2007

Payer Source	Total Paid
Medicare	$929K
Medicaid	$0

Key Findings

The provider’s Medicare lifetime revenue totals $929K and there is no Medicaid billing on file, which makes this practice effectively single-payer Medicare in scale and financial footprint within the available data. This payer concentration means analyses of utilization and risk should focus on Medicare ESRD payment patterns rather than Medicaid behavior for this NPI.

Revenue is extremely concentrated in dialysis-related monthly management codes: the precomputed top-3 Medicare codes account for 98.6% of the provider’s total Medicare revenue. In particular, 90960 alone generates $842.6K (90.7% of Medicare revenue), indicating a narrow, highly specialized revenue base.

Code-level activity confirms a dominant ESRD care operation: 90960 (3.1K claims, $276 avg paid/claim) and 90961 (292 claims, $228 avg paid/claim) are the two primary drivers of revenue, together making up the vast majority of receipts. The code descriptions for 90960 and 90961 — monthly ESRD management with multiple face-to-face visits — imply this provider’s volume reflects ongoing in-person dialysis management rather than occasional outpatient consults.

Competitive standing on core ESRD codes is nationally prominent: the provider ranks #1 of 6549 providers nationally for 90960 (100th percentile; extreme outlier) and ranks #88 of 6091 providers for 90961 (99th percentile; extreme outlier). These rankings position the provider as an outlier well above typical national volume for ESRD monthly management.

Non-ESRD office visit codes are minimal both in revenue and rank, underscoring the ESRD focus: 99213 accounts for $7.5K (0.8% of Medicare revenue) with 136 claims and ranks #144846 of 457151 providers nationally (68th percentile), a typical volume for general office visits. Other E/M codes such as 99214 and 99204 contribute only small fractions of revenue, signaling limited general outpatient clinic throughput.

Service-mix implications for business operations are clear: the predominance of 90960 and 90961 suggests staffing, scheduling, and capacity are likely optimized for recurring, high-frequency ESRD encounters rather than episodic nephrology consults or broad multispecialty care. Billing mix and operational metrics (claims counts and average paid per claim for 90960 and 90961) support an ongoing, procedure-centric practice model.

Tenure and geographic context: the provider’s NPI was enumerated on 2007-05-08 (~19 years ago) and is located in WAKE ISLAND, HI, indicating long-standing enrollment in Medicare which may reflect sustained ESRD service delivery over time. Longevity combined with the extreme outlier status on ESRD codes suggests an established local or niche operational footprint.

From a risk and contracting perspective, the lack of Medicaid activity (none below — no Medicaid billing on file) combined with heavy Medicare concentration increases revenue vulnerability to Medicare policy or reimbursement changes specific to ESRD monthly management codes. Payers and network planners should treat this provider as a Medicare-driven ESRD specialist rather than a mixed-payer general nephrology provider.

Medicare: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	3,050	$280	$842.6K
90961	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…	290	$230	$66.6K
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…	140	$60	$7.5K
90962	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	30	$160	$5.2K
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…	30	$100	$3K
36593	The provider administers a drug, such as a tissue plasminogen activator (TPA), to dissolve a clot in an implanted venous access device or catheter.	90	$30	$2.6K
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…	20	$120	$1.8K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Hawaii Distribution

Sherleen Mohamdi-osman — 2 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Hawaii

Full comparison — all codes billed, vs. state median

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90960	1	30	150	$270	$71K
90961	1	40	50	$220	$17K
99214	1,136	1,440	100	$80	$15.2K
90962	18	30	50	$150	$10.3K
99213	460	1,460	70	$60	$8.4K
99204	509	630	30	$110	$5.3K
36593	1	10	90	$30	$2.6K

Sherleen Mohamdi-osman — Billing Profile & Reimbursement Data

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Sherleen Mohamdi-osman — 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

Frequently Asked Questions

References