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

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

Jamal Balouch (NPI 1922254705)

Field	Value
Entity Type	Individual
Organization	Jamal Balouch
Address	500 15th Ave S
City	Great Falls
State	MT
ZIP	59405
Taxonomy	Pain Medicine (Physical Medicine & Rehabilitation) Physician
NPI Enumerated	August 13, 2008

Payer Source	Total Paid
Medicare	$372.6K
Medicaid	$0

Key Findings

JAMAL BALOUCH (GREAT FALLS, MT), taxonomy Pain Medicine (Physical Medicine & Rehabilitation) Physician, has been enumerated since 2008-08-13 (~18 years ago) and reports total Medicare revenue of $372.6K. There is no Medicaid billing on file for this provider, so Medicare is the sole recorded public-payer revenue source in the dataset.

Revenue is highly concentrated in a small set of inpatient/observation E/M codes: the top three Medicare codes (99232, 99222, 99233) account for 81.6% of this provider's total Medicare revenue. Those three codes are reported as 99232: $215.8K (58.0%), 99222: $45.6K (12.2%), and 99233: $42.4K (11.4%), indicating most revenue is driven by a narrow service mix.

The code mix strongly points to inpatient and observation care delivery rather than outpatient procedural work: 99232, 99222, 99233 and 99231 all describe hospital inpatient or observation E/M visits and 99239 captures discharge-day management. Presence of 99239 with $31.3K (8.4% of Medicare revenue) and 99231 with $37.2K (10.0%) further suggests frequent involvement in transition-of-care and repeated inpatient follow-up encounters.

Several individual codes place this provider well above typical national volumes: 99232 is an extreme outlier and ranks #346 of 177383 providers nationally (100th percentile), and 99222 is also an extreme outlier and ranks #332 of 117621 providers nationally (100th percentile). These rank/percentile positions indicate this provider is a nationally prominent biller for those specific inpatient E/M codes.

Not all top codes are uniformly extreme: 99233, while a top-three revenue driver ($42.4K, 11.4%), is described as typical/unremarkable volume and ranks #10065 of 128818 providers nationally (92th percentile). This mixed profile — some codes extreme outliers and one typical — suggests unusually high activity on a subset of inpatient E/M services rather than uniformly elevated billing across all related codes.

Operational volume metrics reinforce the inpatient-focused pattern: the provider reported 3.5K claims for 99232, 954 claims for 99231, 456 claims for 99233, 451 claims for 99222, and 348 claims for 99239. Those claim counts, paired with the revenue concentration, imply a practice model that generates frequent, shorter-interval inpatient encounters and significant throughput of hospital E/M visits.

Payer mix risk is notable: with $372.6K in Medicare revenue and no Medicaid billing on file, the provider is effectively single-payer (Medicare) in the available public data. Analysts should consider the implications of that concentration for contracting and revenue exposure given no recorded Medicaid activity.

Business implications for networks and referral partners: as a Pain Medicine (PM&R) physician whose paid services are concentrated in hospital inpatient/observation E/M and discharge management codes, the provider more closely resembles an inpatient consultative service line than an outpatient pain-procedural practice. This pattern may affect competitive positioning for hospital contracts, inpatient consult staffing, and payer negotiations targeting inpatient care bundles.

Medicare: Complete Services Breakdown

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

5 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…	3,480	$60	$215.8K
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…	450	$100	$45.6K
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…	460	$90	$42.4K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	950	$40	$37.2K
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…	350	$90	$31.3K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Montana Distribution

Jamal Balouch — 5 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99233	6	370	60	$90	$8.9K
99232	1	560	70	$60	$8K
99239	1	260	60	$90	$5.8K
99222	1	390	20	$100	$3.3K
99231	1	240	40	$40	$2.2K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Allegiant Institute Inc.	NV	Orthopaedic Surgery of the Spine Physician	$0	$5.6M
Nic Sparrow	NV	Physical Therapist	$311.5K	$74.4K
Jaswinder Grover	NV	Orthopaedic Surgery of the Spine Physician	$87.8K	$98.5K
Christopher Fisher	NV	Pain Medicine Physician	$52.1K	$122.1K
Ziad Sawi	NV	Anesthesiology Physician	$81.9K	$88.6K
Yevgeniy Khavkin	NV	Neurological Surgery Physician	$126.3K	$12.4K
Babuk Ghuman	NV	Pain Medicine (Anesthesiology) Physician	$55.1K	$76.4K
Arlene Carungcong-otado	NV	Physician Assistant	$31.1K	$57.8K
Douglas Lynch	NV	Physician Assistant	$66.8K	$1.4K
Curtis Boardman	NV	Certified Registered Nurse Anesthetist	$28.2K	$5.1K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Benefis Hospitals Inc	MT	Multi-Specialty Clinic/Center	$0	$38.2M
Great Falls Public Schools	MT	Local Education Agency (LEA)	$0	$15M
Great Falls Pediatric Dentistry, LLC	MT	Pediatric Dentistry	$0	$14.9M
Benefis Community Care, Inc.	MT	Case Management Agency	$0	$13.2M
Great Falls Clinic LLC	MT	Multi-Specialty Clinic/Center	$0	$11.2M
Easterseals-goodwill Northern Rocky Mountain, Inc.	MT	Developmentally Disabled Services Day Training Agency	$0	$7.4M
Levi C Maltby Dmd P.C.	MT	Dentist	$0	$6M
Great Falls Emergency Services Inc	MT	Land Ambulance	$842.6K	$4.4M
Benefis Hospitals, Inc.	MT	Air Ambulance	$0	$5.2M
Easterseals Goodwill N. Rocky Mtn	MT	Developmentally Disabled Services Day Training Agency	$0	$3.7M

Jamal Balouch — Billing Profile & Reimbursement Data

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Jamal Balouch — 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