Dr. Sapana Mainali, MD
200 Scenery DR, State College, PA 16801 • +1-887-555-8892
Medical Education: Accredited U.S. Medical School (Class of 2003)
What This Doctor Actually Performs: CMS Medicare Utilization & State College Percentiles
NPI #1235243726 • CBSA Regional • Internal Medicine
Statistical peer benchmarking across PA Internal Medicine providers positions Dr. Sapana Mainali, MD in State College at -0.14σ (53.85th city percentile / 49.23th state percentile, 326 Medicare beneficiaries), with clinical focus spanning 34 Active CMS HCPCS Codes.
Fee-schedule auditing of NPI 1235243726 highlights 509 annual claims for 99214 (53.85th State College percentile; $110–$150 self-pay corridor) plus 294 encounters under 99213 and 147 under 93000.
Cash-pay intake data for NPI 1235243726 (200 Scenery DR, State College) indicates $209.00 typical out-of-pocket visit spend against a $209.00 locality benchmark, paired with 19-minute average reception wait and 4.72/5 biomarker openness.
From 200 Scenery DR in State College (+1-887-555-8892), Dr. Mainali, MD (23-year clinical track record) delivers 34 Active CMS HCPCS Codes care.
Compared against State College, PA Internal Medicine peers
1,232 annual services across 326 beneficiaries
Standard deviations from PA Internal Medicine 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 | 509 | 53.85th | $110 – $150 |
| 99213 | Established Preventive & Chronic Care Visit | 294 | 53.85th | $84 – $115 |
| 93000 | In-Office 12-Lead Resting Electrocardiogram | 147 | 52.85th | $40 – $55 |
| G0439 | Annual Preventive Wellness & Cardiometabolic Risk Assessment | 113 | 53.85th | $129 – $177 |
| 99204 | Comprehensive New Patient Internal Medicine Diagnostic Visit | 68 | 48.85th | $153 – $209 |
| 96372 | Therapeutic Subcutaneous/Intramuscular Injection Administration (34 HCPCS billing breadth) | 102 | 53.85th | $99 – $144 |
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Dr. Sapana Mainali, MD Fair Cash-Pay & Waiting-Room Scorecard
| Metric | Verified Benchmark | Source |
|---|---|---|
| Dr. Mainali National Provider Identifier | NPI #1235243726 (MD) | CMS NPPES Registry (16801) |
| Dr. Mainali State College CMS Volume Rank | 53.85th Pct (1,232 CMS svcs; Z -0.144σ) | CMS Medicare Part B (PA Internal Medicine) |
| Fair Cash-Pay New-Patient Benchmark | $209.00 (CPT 99204 GPCI Benchmark) | CMS Geographic Practice Cost Index (State College, PA) |
| Waiting-Room Wait Time & Cash Friendliness | $209.00 avg paid • 19 min lobby wait | 5 Anonymous Patient Reports |
| Listens Without Rushing & Modern Protocol Score | 4.70/5 Listening • 4.72/5 Modern Labs | CMS Provider Practice Cohort |
“Waiting Room” Patient Reality Scorecard
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