Loading...
NPI 1992704035 · Oak Lawn, IL · Hematology & Oncology Physician
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Ghassan Zalzaleh is a hematology & oncology physician provider located in Oak Lawn, Illinois. This profile covers 66 Medicare and 12 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 | Ghassan Zalzaleh |
| Address | 4400 W 95th St |
| City | Oak Lawn |
| State | IL |
| ZIP | 60453 |
| Taxonomy | Hematology & Oncology Physician |
| NPI Enumerated | July 20, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.1M |
| Medicaid | $149K |
This provider’s billing is heavily weighted to Medicare: total Medicare revenue is $3.1M versus total Medicaid revenue of $149K, so Medicare is by far the dominant payer on file. The concentration of revenue and the high absolute Medicare dollars indicate the practice’s financial footprint is primarily in the Medicare market rather than Medicaid.
Revenue concentration on Medicare is very high: the top 3 Medicare codes by revenue account for 70.9% of this provider's total Medicare revenue. Pembrolizumab (J9271) alone accounts for $1.7M (56.3% of Medicare revenue) across 39.2K claims and ranks #31 of 1841 providers nationally (98th percentile), while J9022 ($261.1K, 8.7%) and 78815 ($176.5K, 5.9%) make up the next largest Medicare revenue shares.
The code mix indicates an infusion-centered oncology practice focused on high-volume immunotherapy and chemotherapy administration alongside imaging services. High-volume administration codes and J-codes such as J9271 (pembrolizumab), J9022 (atezolizumab), 96413 (chemotherapy administration, 705 claims, $75.4K; ranks #256 of 7514, 97th percentile) and imaging codes A9595/78815 point to integrated treatment workflows that combine systemic therapy with PET/CT diagnostic support.
On competitive standing, the provider is a major national participant for specific oncology drugs and procedures: J9271 is described as notably above typical national volume (98th percentile), and procedural/visit codes like 96413 (97th percentile) and 99214 (Medicare rank in the 96th percentile) are also high relative to national peers. Other drug and infusion codes (for example J9264, J0897) land in more typical ranges, so dominance appears concentrated on a subset of high-revenue oncology therapeutics.
Medicaid activity is tightly concentrated and oriented toward outpatient management and chemotherapy: the top 3 Medicaid codes by revenue account for 94.8% of this provider's total Medicaid revenue. Medicaid billing is led by 99214 ($104.6K, 70.0% of Medicaid revenue; in-state rank #1414 of 14681, 90th percentile) and 96413 ($33.4K, 22.4% of Medicaid revenue; in-state rank #45 of 149, 70th percentile), showing ambulatory E&M plus chemotherapy are the Medicaid drivers.
The practice delivers substantial supportive and biologic therapies alongside checkpoint inhibitors: notable Medicare entries include J0897 (denosumab, $169.6K, 9.4K claims; 87th percentile) and pegfilgrastim entries J2506/Q5122 ($38.4K and $33.1K respectively), as well as biosimilar rituximab Q5119 ($47.9K). These patterns are consistent with comprehensive oncology care that includes bone-support and growth-factor support services in addition to primary antineoplastic agents.
This NPI has long-tenured presence: enumerated 2005-07-20 (~21 years ago), indicating established practice patterns that likely underlie the concentrated drug and administration volumes seen in both payers. Tenure combined with the high Medicare rank for selected codes suggests sustained specialty service delivery rather than a recent surge.
Operationally, the provider’s revenue profile is sensitive to a small set of high-revenue items — especially J9271 — which together form the bulk of Medicare income. That concentration creates exposure to changes in utilization, reimbursement policy, or formulary placement for those agents, while other service lines (E&M visits, chemotherapy administration, PET/CT imaging) provide additional but smaller revenue streams.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
66 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 39,200 | $40 | $1.7M |
| J9022 | Injection, atezolizumab, 10 mg | 4,080 | $60 | $261.1K |
| 78815 | PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.… | 140 | $1,300 | $176.5K |
| J0897 | Injection, denosumab, 1 mg | 9,420 | $20 | $169.6K |
| A9595 | Piflufolastat f-18, diagnostic, 1 millicurie | 220 | $490 | $106.2K |
| J9264 | Injection, paclitaxel protein-bound particles, 1 mg | 10,500 | $10 | $105K |
| 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… | 840 | $100 | $80.6K |
| 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… | 710 | $110 | $75.4K |
| Q5119 | Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg | 2,280 | $20 | $47.9K |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 110 | $410 | $46.9K |
Showing 1–10 of 66
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 66 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
66 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J9271 | 1 | 110 | 11,600 | $40 | $564.2K |
| J9022 | 1 | 10 | 2,860 | $60 | $188.9K |
| A9595 | 11 | 20 | 220 | $480 | $132.7K |
| J0897 | 51 | 410 | 2,520 | $20 | $90.8K |
| J9264 | 1 | 10 | 6,850 | $10 | $70.7K |
| Q5119 | 15 | 40 | 1,970 | $20 | $50.6K |
| Q5122 | 17 | 30 | 410 | $90 | $44.1K |
| J0881 | 24 | 70 | 11,600 | $1 | $38.2K |
| J2506 | 18 | 70 | 320 | $80 | $32.9K |
| 78815 | 65 | 370 | 50 | $360 | $30.9K |
Showing 1–10 of 66
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.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | 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… | 2,330 | $50 | $104.6K |
| 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… | 480 | $70 | $33.4K |
| 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… | 180 | $20 | $3.6K |
| 96367 | The provider administers an additional intravenous infusion or infusions, after an initial infusion, of a different medication or substance for a period up to one hour to prevent, treat, or diagnose… | 110 | $20 | $2.1K |
| 96365 | The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease. | 40 | $40 | $1.6K |
| 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… | 70 | $20 | $1.2K |
| 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… | 20 | $50 | $1.1K |
| 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… | 30 | $30 | $810 |
| 96375 | Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the… | 40 | $20 | $640 |
| 96372 | A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician… | 20 | $10 | $160 |
Showing 1–10 of 12
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
12 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… | 1,414 | 14,680 | 300 | $50 | $48.7K |
| 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… | 45 | 150 | 170 | $50 | $39.9K |
| 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… | 12,147 | 14,190 | 280 | $20 | $38.9K |
| 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… | 2,752 | 3,830 | 210 | $40 | $29.4K |
| 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… | 2,554 | 4,800 | 210 | $30 | $29.3K |
| 96365 | The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease. | 61 | 80 | 150 | $40 | $29.3K |
| 96367 | The provider administers an additional intravenous infusion or infusions, after an initial infusion, of a different medication or substance for a period up to one hour to prevent, treat, or diagnose… | 28 | 40 | 280 | $30 | $17.4K |
| J2469 | Injection, palonosetron hcl, 25 mcg | 15 | 20 | 100 | $30 | $17.4K |
| 96375 | Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the… | 54 | 80 | 120 | $20 | $17.1K |
| 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… | 1,791 | 2,320 | 70 | $50 | $13.8K |
Showing 1–10 of 12
Other providers in the same ZIP code as Ghassan Zalzaleh, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Village Of Oak Lawn | IL | Land Ambulance | $649.5K | $11.6M |
| Oda Solutions, Inc | IL | Methadone Clinic | $0 | $9.7M |
| Mazen Rachid | IL | Pediatrics Physician | $0 | $5.1M |
| Ahmed Ramaha | IL | General Practice Dentistry | $0 | $4.9M |
| Omprakash Sawlani | IL | Pediatrics Physician | $0 | $3.3M |
| Amar Hamad | IL | Hematology & Oncology Physician | $3M | $97.1K |
| Sunil Shah | IL | Internal Medicine Physician | $256.6K | $1.6M |
| Chintan Mistry | IL | Emergency Medicine Physician | $301K | $1.5M |
| Rami Haddad | IL | Hematology & Oncology Physician | $1.2M | $219K |
| Ashraf Abourahma | IL | Cardiovascular Disease Physician | $406.9K | $731.9K |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.