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NPI 1942302864 · Elgin, IL · Dermatology Physician
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Suleman Bangash is a dermatology physician provider located in Elgin, Illinois. This profile covers 50 Medicare and 4 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 | Suleman Bangash |
| Address | 1750 N Randall Rd |
| City | Elgin |
| State | IL |
| ZIP | 60123 |
| Taxonomy | Dermatology Physician |
| NPI Enumerated | September 1, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3M |
| Medicaid | $5.2K |
This provider is effectively Medicare‑dominated: lifetime Medicare revenue totals $3M versus just $5.2K in Medicaid, so commercial/Medicaid payer exposure is negligible compared with Medicare. The NPI was enumerated 2006-09-01 (~20 years ago), indicating an established practice footprint that is primarily realized through Medicare billing.
Medicare revenue is highly concentrated: the precomputed top 3 Medicare codes account for 75.5% of this provider's Medicare revenue, led by J3245 at 59.0%, with Q4159 at 8.3% and 17311 at 8.1%. This concentration shows the practice derives most Medicare dollars from a very small set of services rather than broad, even distribution across many codes.
The code mix points to a dermatology practice built around high-cost biologic administration and surgical dermatologic care: J3245 (tildrakizumab injection) is the single largest Medicare revenue driver ($1.7M) and Mohs surgery codes (17311 and related 17312/17313 series) also appear among top revenue codes. Substantial pathology billing via 88305 ($128.4K, 4.4% of Medicare revenue) further supports an on‑site surgical/procedural workflow consistent with excisions and histopathologic assessment.
J3245 is an extreme national outlier: the provider reports $1.7M on J3245 (59.0% of Medicare revenue) and ranks #3 of 225 providers nationally (99th percentile; extreme outlier, far above typical national volume for this code). That single code alone is the dominant revenue generator and positions the provider unusually high at a national level for tildrakizumab administration.
Beyond the biologic, the practice shows above‑typical volumes for several general dermatology service codes: 99213 on Medicare generated $54.3K and ranks #8767 of 457151 providers nationally (98th percentile; notably above typical national volume for this code), and 88305 ranks in the 90th percentile nationally (typical, unremarkable volume label). These elevated E/M and pathology percentiles indicate steady procedural throughput and follow‑up visit volume in addition to the high biologic drug billing.
Medicaid billing is minimal and concentrated in standard E/M codes: the precomputed top 3 Medicaid codes account for 89.1% of Medicaid revenue, with 99213 contributing 55.6%, 99203 18.8%, and 99202 14.7%. Absolute Medicaid dollars are small ($5.2K), and in‑state ranks for those codes are modest or low (e.g., 99213 ranks #9694 of 14191 in‑state, 32th percentile), indicating a very limited Medicaid footprint relative to peer providers in Illinois.
The commercial and payer‑diversification implications are material: reliance on a single high‑revenue biologic code (J3245 at 59.0% of Medicare revenue and part of a top‑3 set that makes up 75.5%) means changes in drug pricing, Medicare coverage, or site‑of‑care policy could disproportionately affect total Medicare revenue. Combined with negligible Medicaid receipts ($5.2K), the practice appears exposed to payer or formulary shifts unless other payers or service lines absorb impact.
Operationally, the combination of long tenure (NPI enumerated 2006-09-01, ~20 years), very high national rank on a biologic administration code, and meaningful pathology/Mohs coding suggests the provider operates as an established dermatology practice that both performs surgical oncology procedures and administers complex biologic therapies on a sustained basis. This mix is consistent with a specialty dermatology practice that blends in‑office procedures, Mohs surgery workflow, and high-volume biologic drug administration rather than a low‑acuity primary dermatology clinic.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
50 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J3245 | Injection, tildrakizumab, 1 mg | 15,600 | $110 | $1.7M |
| Q4159 | Affinity, per square centimeter (add-on, list separately in addition to primary procedure) | 700 | $340 | $242.2K |
| 17311 | Mohs surgery is a multi–staged procedure that is performed to excise a malignant lesion layer by layer, along with histo–pathological assessment. The assessment is performed to ensure that the… | 450 | $520 | $235.4K |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 2,380 | $50 | $128.4K |
| 17312 | Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins. | 360 | $350 | $124.9K |
| 96910 | The provider applies tar or petrolatum to the skin and exposes the area to ultraviolet B, or UVB, rays to treat certain skin diseases such as psoriasis. | 590 | $100 | $56.6K |
| 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… | 880 | $60 | $54.3K |
| 17313 | Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins. | 100 | $510 | $51.1K |
| 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 | $31.7K |
| 13132 | The provider repairs a wound measuring 2.6 cm to 7.5 cm in size of the cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet, which may require scar revision, debridement extensive… | 130 | $210 | $28.3K |
Showing 1–10 of 50
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 50 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
50 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J3245 | 1 | 10 | 3,300 | $110 | $472.2K |
| Q4159 | 1 | 10 | 480 | $340 | $152.3K |
| 17311 | 25 | 80 | 230 | $450 | $144K |
| 17312 | 8 | 80 | 150 | $330 | $61.8K |
| 88305 | 41 | 580 | 610 | $30 | $38.2K |
| 17313 | 18 | 60 | 50 | $450 | $34K |
| 96910 | 5 | 30 | 230 | $90 | $27.4K |
| 13132 | 17 | 80 | 50 | $220 | $18.8K |
| 15260 | 16 | 40 | 20 | $780 | $18K |
| 99214 | 3,095 | 18,540 | 110 | $80 | $17.1K |
Showing 1–10 of 50
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.
4 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… | 100 | $30 | $2.9K |
| 99203 | The provider sees a new 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 provider… | 20 | $40 | $990 |
| 99202 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider… | 30 | $30 | $780 |
| 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… | 10 | $50 | $580 |
How this provider's Medicaid billing volume and revenue compare to other Illinois providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Illinois median
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 14,351 | 14,680 | 300 | $50 | $48.7K |
| 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… | 9,694 | 14,190 | 280 | $20 | $38.9K |
| 99202 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider… | 682 | 930 | 60 | $40 | $12.2K |
| 99203 | The provider sees a new 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 provider… | 2,530 | 3,270 | 80 | $40 | $11.1K |
Other providers in the same ZIP code as Suleman Bangash, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Ecker Center For Behavioral Health | IL | Mental Health Clinic/Center (Including Community Mental Health Center) | $0 | $20M |
| A-tec Ambulance Service Inc | IL | Land Ambulance | $3.4M | $8.3M |
| Kenneth Laferle | IL | Audiologist | $8K | $5.8M |
| Vna Health Care | IL | Federally Qualified Health Center (FQHC) | $0 | $5.1M |
| Cranial Technologies, Inc. | IL | Prosthetic/Orthotic Supplier | $0 | $4M |
| Syed Zahir | IL | Hematology & Oncology Physician | $3.1M | $72.4K |
| Rashmi Kapur | IL | Ophthalmology Physician | $1.6M | $1.1M |
| Rehan Hussain | IL | Ophthalmology Physician | $2.2M | $236K |
| Nexgen Labs Inc | IL | Clinical Medical Laboratory | $204.3K | $2.1M |
| Muhammad Asad Ali | IL | Interventional Cardiology Physician | $584.8K | $1.4M |
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