Claima

Public Medicare billing profile

Sripad Dhawlikar, MD

Orthopedic Surgery · Toms River, NJ · NPI 1659327898

Medicare allowed

$955,429

Services

23,722

Top 5 codes are

74%

74% 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.

CodeServiceVolumeYou chargeMedicare allows
22513Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance48$22,750.00$5,625.78
22514Treatment of broken lower spine bone with placement of stabilizing device40$24,000.00$5,597.36
62323Injection of substance into lower spine canal using imaging guidance411$4,500.00$256.25
22515Treatment of broken spine bone with stabilizing device, each additional segment23$12,402.17$2,875.79
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more507$128.46$87.50
63650Insertion of spinal neurostimulator electrode array through skin21$18,333.33$1,615.70
64483Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level83$6,443.37$281.77
62321Injection of substance into middle or upper spine canal using imaging guidance77$4,800.00$261.45

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.

The report is free, needs no signup, and the file never leaves your browser. Open your network tab before you drop it and you will see no request.

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 1659327898. Beneficiary counts overlap across codes, so we do not add them up.

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