Dr. Balaji Pratap, MD
155 Crystal Run Rd, Middletown, NY 10941 • +1-826-555-4458
Medical Education: Accredited U.S. Medical School (Class of 2001)
What This Doctor Actually Performs: CMS Medicare Utilization & Middletown Percentiles
NPI #1063725471 • CBSA Regional • Cardiology
Statistical peer benchmarking across NY Cardiology providers positions Dr. Balaji Pratap, MD in Middletown at +1.18σ (81.25th city percentile / 94.67th state percentile, 1,740 Medicare beneficiaries), with clinical focus spanning 44 Active CMS HCPCS Codes.
Medicare Part B line-item claims for Dr. Balaji Pratap (10941) place 99214 at the top of the practice ledger (3790 yearly units, 81.25th metro rank), rounded out by 93000 and 93306.
Direct cash-pay transparency modeling sets Dr. Pratap's baseline new-consult rate near $232.00 in Middletown, NY (cash-pay accepted, in-person clinic visits only, 12-minute average reception wait).
Clinical background for Dr. Pratap (MD, NPI #1063725471) includes accredited doctoral training (2001, 25 yrs in practice) and dedicated on-site consultations at 155 Crystal Run Rd.
Compared against Middletown, NY Cardiology peers
10,086 annual services across 1,740 beneficiaries
Standard deviations from NY Cardiology mean utilization
Top Billed HCPCS/CPT Procedures & GPCI Self-Pay Cash Benchmarks
| HCPCS | Clinical Procedure Description | Annual Volume | Local Pct | Est. Cash Range |
|---|---|---|---|---|
| 99214 | Established Cardiology Consultation & Hemodynamic Review | 3,790 | 81.25th | $219 – $300 |
| 93000 | 12-Lead Resting Electrocardiogram (ECG) w/ Interpretation | 2,793 | 86.25th | $86 – $118 |
| 93306 | Complete Transthoracic Echocardiography w/ Doppler & Color Flow | 1,795 | 80.25th | $410 – $562 |
| 93224 | 24-Hour Ambulatory ECG Rhythm Monitoring & Analysis | 997 | 76.25th | $257 – $353 |
| 99204 | Comprehensive New Patient Cardiovascular Risk Evaluation | 598 | 76.25th | $315 – $431 |
| 96372 | Therapeutic Subcutaneous/Intramuscular Injection Administration (44 HCPCS billing breadth) | 112 | 81.25th | $198 – $287 |
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Dr. Balaji Pratap, MD Fair Cash-Pay & Waiting-Room Scorecard
| Metric | Verified Benchmark | Source |
|---|---|---|
| Dr. Pratap National Provider Identifier | NPI #1063725471 (MD) | CMS NPPES Registry (10941) |
| Dr. Pratap Middletown CMS Volume Rank | 81.25th Pct (10,086 CMS svcs; Z +1.176σ) | CMS Medicare Part B (NY Cardiology) |
| Fair Cash-Pay New-Patient Benchmark | $232.00 (CPT 99204 GPCI Benchmark) | CMS Geographic Practice Cost Index (Middletown, NY) |
| Waiting-Room Wait Time & Cash Friendliness | $232.00 avg paid • 12 min lobby wait | 6 Anonymous Patient Reports |
| Listens Without Rushing & Modern Protocol Score | 4.55/5 Listening • 4.94/5 Modern Labs | CMS Provider Practice Cohort |
“Waiting Room” Patient Reality Scorecard
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