Public Medicare billing profile
Neeraj Kaushik, MD
Gastroenterology · Greenvale, NY · NPI 1376517847
Medicare allowed
$746,905
Services
3,970
Top 5 codes are
70%
70% of your Medicare revenue sits in five codes
That concentration is the useful part. It means a few percent of variance on a handful of codes moves real money, and it means checking whether you are being paid correctly is a small job rather than an audit of everything you bill.
| Code | Service | Volume | You charge | Medicare allows |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 1,086 | $379.00 | $142.09 |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 1,092 | $254.68 | $101.20 |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | 538 | $850.00 | $186.85 |
| 43239 | Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 215 | $3,607.18 | $380.61 |
| 45380 | Biopsy of large bowel using a flexible endoscope | 210 | $3,691.24 | $367.36 |
| 45388 | Destruction of polyp or growth of large bowel using a flexible endoscope | 18 | $6,500.00 | $2,784.39 |
| 45385 | Removal of polyps or growths of large bowel using an endoscope with mechanical snare | 102 | $3,421.85 | $450.03 |
| 91110 | Imaging of digestive tract done from the inside of the digestive tract | 27 | $4,038.24 | $832.71 |
Ranked by total Medicare allowed. Allowed amounts are already adjusted by CMS for your locality.
Here is what this does not tell you
CMS publishes what Medicare allowed you. It publishes nothing about what Aetna, Cigna, United or your Blues plan allowed for the same codes. Commercial contracts are conventionally written as a percentage of Medicare and normally sit above it, so the numbers in that table are a floor your commercial payers should clear.
Most practices have never checked. A claim paid at 70% of the allowable does not show up as a denial or land in anyone's work queue. It shows up as paid.
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Where these numbers come from
Medicare Physician & Other Practitioners, by Provider and Service, published by the Centers for Medicare & Medicaid Services. It is public data covering Part B fee-for-service claims. Service descriptions are CMS's own.
Nothing here is modelled and nothing is an estimate of what you could recover. The totals are sums of what CMS published for NPI 1376517847. Beneficiary counts overlap across codes, so we do not add them up.
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