Nayani, Rahul

Nayani, Rahul was paid $66K by Medicaid between Jan 2019 and Aug 2023, across 8 billing codes. Its largest line is 43239, Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple — 63% of everything it billed.

33Billing provider infoNAYANI, RAHUL
SPRINGFIELD, IL 62701

33aNPI1144515115assigned 06/17/2011

33bProvider typeGastroenterology Physician

28Total paid$66K

24GClaims607

24DCodes billed8

24AFirst – last monthJan 2019 – Aug 2023

Compared with peers

Next to other Gastroenterology Physician providers in Illinois

Rank by total paid#88 of 370

Median peer was paid$16K

This provider vs. median4.1×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2019	68	$6K
2020	77	$3K
2021	201	$22K
2022	144	$18K
2023	117	$18K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
43239	Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	63%	264	238	$41K
45385	Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s)	19%	53	49	$12K
99204	Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	6.5%	66	66	$4K
99223	Prolong inpt eval add15 m	4.4%	42	39	$3K
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	2.7%	56	37	$2K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	2.1%	52	51	$1K
99214	Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	1.7%	28	28	$1K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	1.3%	46	44	$847.66

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.