Dr. Sushma Pai, MD
751 S Bascom Ave, San Jose, CA 95128 • +1-870-555-5086
Medical Education: Accredited U.S. Medical School (Class of 2010)
What This Doctor Actually Performs: CMS Medicare Utilization & San Jose Percentiles
NPI #1619188596 • CBSA Regional • Hospitalist
Statistical peer benchmarking across CA Hospitalist providers positions Dr. Sushma Pai, MD in San Jose at -0.09σ (12.5th city percentile / 3.44th state percentile, 219 Medicare beneficiaries), with clinical focus spanning 8 Active CMS HCPCS Codes.
Medicare Part B line-item claims for Dr. Sushma Pai (95128) place 99214 at the top of the practice ledger (296 yearly units, 12.5th metro rank), rounded out by 99213 and 93000.
Self-pay new patient consultations with Dr. Pai (CPT 99204 GPCI-adjusted benchmark) estimate around $239.00 (community reported average: $239.00) with in-person clinic visits only, 18-minute average reception wait, and a 4.82/5 modern protocol openness score across 12 patient logs.
From 751 S Bascom Ave in San Jose (+1-870-555-5086), Dr. Pai, MD (16-year clinical track record) delivers 8 Active CMS HCPCS Codes care.
Compared against San Jose, CA Hospitalist peers
658 annual services across 219 beneficiaries
Standard deviations from CA Hospitalist mean utilization
Top Billed HCPCS/CPT Procedures & GPCI Self-Pay Cash Benchmarks
| HCPCS | Clinical Procedure Description | Annual Volume | Local Pct | Est. Cash Range |
|---|---|---|---|---|
| 99214 | Moderate-to-High Complexity Internal Medicine Follow-Up | 296 | 12.5th | $185 – $254 |
| 99213 | Established Preventive & Chronic Care Visit | 171 | 12th | $142 – $194 |
| 93000 | In-Office 12-Lead Resting Electrocardiogram | 86 | 12.5th | $68 – $93 |
| G0439 | Annual Preventive Wellness & Cardiometabolic Risk Assessment | 66 | 12th | $217 – $298 |
| 99204 | Comprehensive New Patient Internal Medicine Diagnostic Visit | 39 | 12th | $258 – $353 |
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Dr. Sushma Pai, MD Fair Cash-Pay & Waiting-Room Scorecard
| Metric | Verified Benchmark | Source |
|---|---|---|
| Dr. Pai National Provider Identifier | NPI #1619188596 (MD) | CMS NPPES Registry (95128) |
| Dr. Pai San Jose CMS Volume Rank | 12.50th Pct (658 CMS svcs; Z -0.088σ) | CMS Medicare Part B (CA Hospitalist) |
| Fair Cash-Pay New-Patient Benchmark | $239.00 (CPT 99204 GPCI Benchmark) | CMS Geographic Practice Cost Index (San Jose, CA) |
| Waiting-Room Wait Time & Cash Friendliness | $239.00 avg paid • 18 min lobby wait | 12 Anonymous Patient Reports |
| Listens Without Rushing & Modern Protocol Score | 4.56/5 Listening • 4.82/5 Modern Labs | CMS Provider Practice Cohort |
“Waiting Room” Patient Reality Scorecard
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