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Sanjay K Agarwal, MD

Critical Care (Intensivists) · Fremont

NPI 1477523249

Medicare standing
1 flag on the record
Listed below.
Plans that list them
29
7 carriers
Office
1

On the public record

  • 1 Medical Board action on record

Offices

1 location

Looking this up.

Hospitals listed: Santa Clara Valley Medical Center. That is not proof they admit you there this week.

Plans that list them

29 plans · 7 carriers

A missing listing does not mean out of network. Directories change, and a listing does not cover every office. Call Dr. Agarwal’s office at (408) 418-0300 to confirm they take your plan. Ask about the office you use, its medical group, referrals and appointments.

29 of 29 plans

Plans whose provider directory lists this clinician
Alignment Health BreathEasy (HMO C-SNP)Alignment Health PlanListedOct 3, 2026
Alignment Health Clarity (HMO C-SNP)Alignment Health PlanListedOct 3, 2026
Alignment Health Harmony (HMO)Alignment Health PlanListedOct 3, 2026
Alignment Health Heart & Diabetes (HMO C-SNP)Alignment Health PlanListedOct 3, 2026
Alignment Health Heart & Diabetes CalPlus (HMO C-SNP)Alignment Health PlanListedOct 3, 2026
Alignment Health Heart & Diabetes Care (HMO C-SNP)Alignment Health PlanListedSep 28, 2026
Alignment Health Heart & Diabetes Choice (HMO C-SNP)Alignment Health PlanListedSep 28, 2026
Alignment Health Honor+ Plan (HMO)Alignment Health PlanListedOct 3, 2026
Alignment Health My Choice CalCare (HMO)Alignment Health PlanListedOct 3, 2026
Alignment Health Silicon (HMO C-SNP)Alignment Health PlanListedOct 3, 2026
Alignment Health smartHMO (HMO)Alignment Health PlanListedOct 3, 2026
Alignment Health the ONE (HMO)Alignment Health PlanListedOct 3, 2026
Anthem Full Dual Advantage Aligned (HMO D-SNP)Anthem Blue CrossListedOct 3, 2026
Anthem Prime (HMO-POS)Anthem Blue Cross Partnership PlanListedOct 3, 2026
Astiva Health C-SNP WOW - NorCal (HMO C-SNP)Astiva HealthListedSep 27, 2026
Astiva Health Premier Plan - NorCal (HMO)Astiva HealthListedSep 27, 2026
Astiva Health Savings Plan - NorCal (HMO)Astiva HealthListedSep 27, 2026
Central Health Classic Care Plan III (HMO)Central Health Medicare PlanListedAug 15, 2026
Central Health Dual Access Plan (HMO D-SNP)Central Health Medicare PlanListedAug 15, 2026
Central Health Embrace Care Plan (HMO C-SNP)Central Health Medicare PlanListed, may be out of dateSep 15, 2025
Central Health Embrace Choice Plan (HMO C-SNP)Central Health Medicare PlanListedAug 15, 2026
Central Health Valor Care Plan (HMO)Central Health Medicare PlanListedAug 15, 2026
Imperial Courage Plan (HMO)Imperial Health Plan of California, Inc.ListedSep 1, 2026
Imperial Dynamic Plan (HMO)Imperial Health Plan of California, Inc.ListedSep 1, 2026
Imperial Senior Value (HMO C-SNP)Imperial Health Plan of California, Inc.ListedSep 1, 2026
SCAN Balance (HMO C-SNP)SCAN Health PlanListedOct 3, 2026
SCAN Classic (HMO)SCAN Health PlanListedOct 3, 2026
SCAN MyChoice (HMO)SCAN Health PlanListedOct 3, 2026
SCAN Strive (HMO C-SNP)SCAN Health PlanListedOct 3, 2026

California Medical Board record

Licence A104257 · Current

Licensed to practise in California · since 2008 · expires 2027-10-31 · Bangalore University, Bangalore Medical College. Board flags: Court Order, Limitations on Practice.

Public record actions

Actions the Medical Board of California publishes for this licence
2026-06-09Court orderDisciplineSuperior court of california, county of santa clara issued an order in case NO. C2519361, the people of the state of california vs. sanjay kumar agarwal, M.D. dr. agarwal shall cease and desist from treating female patients in the practice of medicine.

State licence records

1 licence

  • Washington MD.MD.00047235Physician And Surgeon License · since 2006 · expires 2025-10-21
    ExpiredNo board action on this licenceCheck it with the state

We check Colorado, Delaware, Florida, Illinois, Maryland, New Jersey, New York, Tennessee, Texas, Virginia, Washington, plus California above. A state that is not in this list has not been checked, which is not the same as clear.

Hospitals they work in

1 hospital

These rate the hospital, not this clinician. Most measures at most hospitals are no different from the national rate.

  • Santa Clara Valley Medical CenterSan Jose, CAAcute Care Hospital · Government - Local · Has an emergency department · Birthing-friendlyPart of Santa Clara Valley Health and Hospital System, which runs 3 hospitalsPatients rate it 3 of 5 · 70% would definitely recommend it
    Overall rating: 2 of 5 starsWorse than the national rate — SSI - Colon Surgery: 2.572, Oct 2024 – Sep 2025Better than the national rate — Central Line Associated Bloodstream Infection (ICU + select Wards): 0.563, Oct 2024 – Sep 2025Better than the national rate — Clostridium Difficile (C.Diff): 0.256, Oct 2024 – Sep 2025Better than the national rate — MRSA Bacteremia: 0.369, Oct 2024 – Sep 2025
See every measure and the patient survey for Santa Clara Valley Medical Center

Behind the star rating — Deaths: 2 better, 6 the same, 0 worse of 8 measures. Safety: 2 better, 5 the same, 1 worse of 8 measures. Readmissions: 0 better, 10 the same, 1 worse of 11 measures. The star rating is worked out from an earlier period than the measures below, so the two can disagree.

Every scored measure at Santa Clara Valley Medical Center
SSI - Colon SurgeryInfections2.572WorseOct 2024 – Sep 2025
Central Line Associated Bloodstream Infection (ICU + select Wards)Infections0.563BetterOct 2024 – Sep 2025
Clostridium Difficile (C.Diff)Infections0.256BetterOct 2024 – Sep 2025
MRSA BacteremiaInfections0.369BetterOct 2024 – Sep 2025
Abdominopelvic accidental puncture or laceration rateComplications and deaths1.25 (0.3 to 2.2) · 1,535 casesNo differentJul 2022 – Jun 2024
CMS Medicare PSI 90: Patient safety and adverse events compositeComplications and deaths1.07 (0.76 to 1.38)No differentJul 2022 – Jun 2024
Death rate among surgical inpatients with serious treatable complicationsComplications and deaths214.59 (167.38 to 261.8) · 108 casesNo differentJul 2022 – Jun 2024
Death rate for CABG surgery patientsComplications and deaths2.8 · 41 casesNoneJul 2022 – Jun 2025
Death rate for COPD patientsComplications and deaths6 · 141 casesNoneJul 2022 – Jun 2025
Death rate for heart attack patientsComplications and deaths10.2 · 124 casesNoneJul 2022 – Jun 2025
Death rate for heart failure patientsComplications and deaths8.3 · 501 casesNoneJul 2022 – Jun 2025
Death rate for pneumonia patientsComplications and deaths14.9 · 653 casesNoneJul 2022 – Jun 2025
Death rate for stroke patientsComplications and deaths10.1 · 348 casesNoneJul 2023 – Jun 2025
Hybrid Hospital-Wide All-Cause Risk Standardized Mortality RateComplications and deaths3 · 4,502 casesNoneJul 2024 – Jun 2025
Iatrogenic pneumothorax rateComplications and deaths0.24 (0.04 to 0.43) · 9,014 casesNo differentJul 2022 – Jun 2024
In-hospital fall-associated fracture rateComplications and deaths0.34 (0.15 to 0.52) · 9,216 casesNo differentJul 2022 – Jun 2024
Perioperative pulmonary embolism or deep vein thrombosis rateComplications and deaths4.54 (2.51 to 6.58) · 1,421 casesNo differentJul 2022 – Jun 2024
Postoperative acute kidney injury requiring dialysis rateComplications and deaths1.54 (0 to 3.2) · 288 casesNo differentJul 2022 – Jun 2024
Postoperative hemorrhage or hematoma rateComplications and deaths2.11 (0.66 to 3.56) · 1,446 casesNo differentJul 2022 – Jun 2024
Postoperative respiratory failure rateComplications and deaths11.61 (4.09 to 19.14) · 294 casesNo differentJul 2022 – Jun 2024
Postoperative sepsis rateComplications and deaths7.29 (3.39 to 11.2) · 299 casesNo differentJul 2022 – Jun 2024
Postoperative wound dehiscence rateComplications and deaths1.9 (0.45 to 3.36) · 333 casesNo differentJul 2022 – Jun 2024
Pressure ulcer rateComplications and deaths0.23 (0 to 0.78) · 7,538 casesNo differentJul 2022 – Jun 2024
Rate of complications for hip/knee replacement patientsComplications and deaths5.4 · 94 casesNoneApr 2023 – Mar 2025
Catheter Associated Urinary Tract Infections (ICU + select Wards)Infections0.735No differentOct 2024 – Sep 2025
SSI - Abdominal HysterectomyInfections2.573No differentOct 2024 – Sep 2025
Acute Myocardial Infarction (AMI) 30-Day Readmission RateUnplanned return visits14.6 · 185 casesNoneJul 2023 – Jun 2025
Heart failure (HF) 30-Day Readmission RateUnplanned return visits22.1 · 951 casesNoneJul 2023 – Jun 2025
Hospital return days for heart attack patientsUnplanned return visits56.3 · 128 casesNoneJul 2022 – Jun 2025
Hospital return days for heart failure patientsUnplanned return visits6.4 · 644 casesNoneJul 2022 – Jun 2025
Hospital return days for pneumonia patientsUnplanned return visits1.3 · 699 casesNoneJul 2022 – Jun 2025
Pneumonia (PN) 30-Day Readmission RateUnplanned return visits16.3 · 921 casesNoneJul 2023 – Jun 2025
Rate of emergency department (ED) visits for patients receiving outpatient chemotherapyUnplanned return visits5.7 (3.9 to 8.1) · 226 casesNo differentJan 2024 – Dec 2024
Rate of inpatient admissions for patients receiving outpatient chemotherapyUnplanned return visits12.6 (9.4 to 16.5) · 226 casesNo differentJan 2024 – Dec 2024
Rate of readmission after hip/knee replacementUnplanned return visits5.4 · 94 casesNoneJul 2023 – Jun 2025
Rate of readmission for CABGUnplanned return visits11.4 · 54 casesNoneJul 2023 – Jun 2025
Rate of readmission for chronic obstructive pulmonary disease (COPD) patientsUnplanned return visits20.3 · 242 casesNoneJul 2023 – Jun 2025
Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)Unplanned return visits13.2 (9.9 to 17.4) · 702 casesNo differentJan 2022 – Dec 2024
Ratio of unplanned hospital visits after hospital outpatient surgeryUnplanned return visits1 (0.7 to 1.4) · 195 casesNo differentJan 2024 – Dec 2024

What patients said (4,032 patients answered, 29% of those asked)

Patient survey stars by topic at Santa Clara Valley Medical Center
Cleanliness3
Nurse communication3
Doctor communication3
Communication about medicines3
Discharge information2
Overall hospital rating3
Quietness2
Recommend hospital4
Share of patients giving the best answer at Santa Clara Valley Medical Center
Room was "always" clean70%
Nurses "always" communicated well73%
Doctors "always" communicated well76%
Staff "always" explained57%
Yes, staff "did" give patients this information82%
Yes, staff "did" give patients information about help after discharge82%
Doctors "always" explained things so they could understand71%
Doctors "always" listened carefully74%
Doctors "always" treated them with courtesy and respect82%
Patients who gave a rating of "9" or "10" (high)67%
Staff "always" explained new medications71%
Nurses "always" explained things so they could understand71%
Nurses "always" listened carefully69%
Nurses "always" treated them with courtesy and respect80%
"Always" quiet at night43%
"YES", patients would definitely recommend the hospital70%
Staff "always" explained possible side effects44%
Yes, staff "did" give patients information about possible symptoms83%

Original Medicare doctor bills

$150,112

Medicare paid this office $150,112 for 320 people.

This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.

Largest Original Medicare bills
Return visit (30+ min)217$60,887$120
Sleep study in sleep lab (6 years or older)38$26,949$657
Sleep study in sleep lab with continuous airway pressure (6 years or older)20$15,366$698
New patient visit (45+ min)102$14,938$146
Critical care, first 30-74 minutes21$4,603$184
See all 13 services
Every Original Medicare service billed
Return visit (30+ min)217$60,887$120
Sleep study in sleep lab (6 years or older)38$26,949$657
Sleep study in sleep lab with continuous airway pressure (6 years or older)20$15,366$698
New patient visit (45+ min)102$14,938$146
Critical care, first 30-74 minutes21$4,603$184
Initial hospital care with moderate level of medical decision making at least 75 minutes26$4,002$154
Test to determine lung volumes using sensors57$3,769$60
Test to measure expiratory airflow and volume changes before and after medication administration77$3,550$40
Test to examine how well the lungs exchange gases47$3,256$61
Long return visit (40+ min)14$2,835$157
Sleep study including heart rate, breathing, and sleep time14$2,593$144
Sleep study including heart rate, breathing, airflow, and effort20$2,082$95
Irrigation and suction of lung airways to obtain cells using an endoscope16$1,526$95

Who their Medicare patients are

320 Original Medicare patients in 2024. Average age 74 · Under 65 11% · 85 and older 14% · Women 45% · Also on Medicaid 57% · Health risk score 1.93. At or below the middle of the specialty; the typical critical care (intensivists) clinician is at 2.58.

Conditions among them: High blood pressure 75% · Diabetes 58% · Chronic kidney disease 41% · Coronary heart disease 39% · COPD 35% · Heart failure 32% · Atrial fibrillation 23% · Depression 23% · Dementia 14% · Cancer 13% · Stroke 10%.

The office billed $360,037, Medicare allowed $193,145 and paid $150,112; for 1,076 services of 30 kinds.

Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.

Year by year

Original Medicare by year
20243201,076741.93$360,037$150,112
20233331,128731.75$366,548$158,505
2022256803741.73$235,146$105,423
2021236879741.70$248,978$124,803
2020217844751.98$213,115$106,320
20192811,498752.25$368,530$182,929
20182671,023722.10$292,160$137,685
20172321,411752.29$362,895$176,814
20162661,448742.57$397,640$168,045
20152491,557742.40$438,185$193,006
20142981,723752.29$538,765$224,113
20133151,459742.57$430,447$194,380

Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.

See the services billed each year

2023: 15 services

Original Medicare services billed in 2023
Return visit (30+ min)247$63,670$118
Sleep study in sleep lab (6 years or older)51$35,018$648
Sleep study in sleep lab with continuous airway pressure (6 years or older)25$19,787$682
New patient visit (45+ min)97$13,794$142
Sleep study including heart rate, breathing, airflow, and effort42$4,776$90
Initial hospital care with moderate level of medical decision making at least 75 minutes27$4,379$156
Test to measure expiratory airflow and volume changes before and after medication administration80$3,290$39
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes16$2,246$107
Long return visit (40+ min)11$2,163$155
Test to examine how well the lungs exchange gases34$1,846$54
Test to determine lung volumes using sensors33$1,703$52
Irrigation and suction of lung airways to obtain cells using an endoscope16$1,533$90
Test to determine lung volumes using sensors19$203$11
Test to measure expiratory airflow and volume changes before and after medication administration19$174$9
Test to examine how well the lungs exchange gases19$150$8

2022: 9 services

Original Medicare services billed in 2022
Return visit (30+ min)192$48,722$117
Sleep study in sleep lab (6 years or older)33$22,104$650
New patient visit (45+ min)107$14,836$139
Sleep study including heart rate, breathing, airflow, and effort25$2,583$86
Test to measure expiratory airflow and volume changes before and after medication administration33$1,363$41
Irrigation and suction of lung airways to obtain cells using an endoscope15$997$66
Test to determine lung volumes using sensors24$274$11
Test to measure expiratory airflow and volume changes before and after medication administration24$234$9
Test to examine how well the lungs exchange gases24$203$8

2021: 11 services

Original Medicare services billed in 2021
Return visit (30+ min)195$52,028$125
Sleep study in sleep lab (6 years or older)34$22,768$670
Sleep study in sleep lab with continuous airway pressure (6 years or older)21$14,010$667
New patient visit (45+ min)82$12,056$147
Test to examine how well the lungs exchange gases70$4,717$65
Test to determine lung volumes using sensors70$4,262$58
Initial hospital care with moderate level of medical decision making at least 75 minutes19$3,706$185
Test to measure expiratory airflow and volume changes before and after medication administration71$3,674$50
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes13$1,816$96
Sleep study including heart rate, breathing, airflow, and effort14$1,566$104
Short return visit (20+ min)13$1,083$77

2020: 11 services

Original Medicare services billed in 2020
Return visit (30+ min)182$40,942$102
Sleep study in sleep lab (6 years or older)31$20,782$649
New patient visit (45+ min)67$9,818$147
Sleep study in sleep lab with continuous airway pressure (6 years or older)11$8,644$665
Test to measure expiratory airflow and volume changes before and after medication administration64$4,211$64
Test to examine how well the lungs exchange gases64$4,062$62
Test to determine lung volumes using sensors64$3,812$58
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes11$3,616$98
Initial hospital care with moderate level of medical decision making at least 75 minutes16$3,435$181
Sleep study including heart rate, breathing, airflow, and effort18$2,551$121
Short return visit (20+ min)21$1,859$69

2019: 12 services

Original Medicare services billed in 2019
Return visit (30+ min)193$47,877$101
Sleep study in sleep lab (6 years or older)44$27,524$626
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes59$22,750$94
Sleep study in sleep lab with continuous airway pressure (6 years or older)32$21,538$653
Initial hospital care with moderate level of medical decision making at least 75 minutes74$16,646$183
New patient visit (45+ min)89$13,348$150
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes59$10,855$66
Test to measure expiratory airflow and volume changes before and after medication administration86$5,278$61
Test to determine lung volumes using sensors85$4,780$56
Test to examine how well the lungs exchange gases80$4,697$58
Short return visit (20+ min)20$1,642$71
Irrigation and suction of lung airways to obtain cells using an endoscope14$1,240$89

2018: 12 services

Original Medicare services billed in 2018
Return visit (30+ min)157$38,559$97
Sleep study in sleep lab (6 years or older)40$25,995$650
Sleep study in sleep lab with continuous airway pressure (6 years or older)30$21,393$648
New patient visit (45+ min)90$12,886$143
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes30$9,549$94
Initial hospital care with moderate level of medical decision making at least 75 minutes44$8,166$181
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes29$4,380$65
Short return visit (20+ min)43$2,708$60
Test to measure expiratory airflow and volume changes before and after medication administration44$2,609$58
Test to determine lung volumes using sensors44$2,360$52
Test to examine how well the lungs exchange gases36$1,976$53
Irrigation and suction of lung airways to obtain cells using an endoscope14$1,473$105

2017: 12 services

Original Medicare services billed in 2017
Return visit (30+ min)144$38,204$99
Sleep study in sleep lab with continuous airway pressure (6 years or older)33$24,380$677
Sleep study in sleep lab (6 years or older)32$21,709$638
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes74$18,042$93
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes73$16,584$65
Initial hospital care with moderate level of medical decision making at least 75 minutes78$16,497$181
New patient visit (45+ min)55$7,407$135
Test to measure expiratory airflow and volume changes before and after medication administration52$3,279$61
Test to determine lung volumes using sensors50$2,719$52
Test to examine how well the lungs exchange gases41$2,407$56
Short return visit (20+ min)16$1,453$69
Irrigation and suction of lung airways to obtain cells using an endoscope17$911$54

2016: 15 services

Original Medicare services billed in 2016
Critical care, first 30-74 minutes29$29,825$195
Return visit (30+ min)118$28,190$95
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes113$21,246$64
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes82$16,687$92
Sleep study in sleep lab (6 years or older)22$14,781$643
Sleep study in sleep lab with continuous airway pressure (6 years or older)19$12,508$658
Initial hospital care with moderate level of medical decision making at least 75 minutes56$11,598$173
New patient visit (45+ min)54$7,365$136
Critical care, each additional 30 minutes20$7,362$98
Sleep study including heart rate, breathing, airflow, and effort21$3,717$169
Test to measure expiratory airflow and volume changes before and after medication administration42$2,750$62
Test to examine how well the lungs exchange gases42$2,478$56
Test to determine lung volumes using sensors42$2,372$54
Short return visit (20+ min)29$2,196$69
Irrigation and suction of lung airways to obtain cells using an endoscope13$1,550$103

2015: 17 services

Original Medicare services billed in 2015
Critical care, first 30-74 minutes35$31,380$196
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes95$30,785$93
Return visit (30+ min)115$27,655$99
Sleep study in sleep lab with continuous airway pressure (6 years or older)30$20,835$672
Sleep study in sleep lab (6 years or older)29$19,800$639
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes72$14,033$65
Initial hospital care with moderate level of medical decision making at least 75 minutes62$12,375$179
Critical care, each additional 30 minutes26$12,073$98
New patient visit (45+ min)43$6,177$144
Long return visit (40+ min)16$2,711$129
Test to measure expiratory airflow and volume changes before and after medication administration36$2,107$59
Test to examine how well the lungs exchange gases37$2,083$56
Test to determine lung volumes using sensors37$1,917$52
Short return visit (20+ min)11$687$62
Test to determine lung volumes using sensors14$166$11
Test to measure expiratory airflow and volume changes before and after medication administration13$165$12
Test to examine how well the lungs exchange gases14$123$8

2014: 21 services

Original Medicare services billed in 2014
Critical care, first 30-74 minutes49$34,359$194
Sleep study in sleep lab with continuous airway pressure (6 years or older)47$32,418$648
Sleep study in sleep lab (6 years or older)43$27,494$625
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes104$25,177$90
Return visit (30+ min)106$22,308$97
Initial hospital care with moderate level of medical decision making at least 75 minutes103$18,859$175
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes101$15,900$62
Critical care, each additional 30 minutes35$12,518$98
New patient visit (45+ min)40$5,611$140
Short return visit (20+ min)40$4,019$66
Test to measure expiratory airflow and volume changes before and after medication administration57$3,472$60
Test to examine how well the lungs exchange gases54$3,047$55
Test to determine lung volumes using sensors52$2,784$53
Insertion of non-tunneled central venous tube for infusion (5 years or older)20$2,668$107
Long return visit (40+ min)15$2,339$130
Irrigation and suction of lung airways to obtain cells using an endoscope16$2,206$116
Initial hospital care with straightforward or low-level medical decision making at least 55 minutes14$1,704$122
Emergent insertion of breathing tube into windpipe using an endoscope12$1,242$96
Test to measure expiratory airflow and volume changes before and after medication administration15$176$12
Test to determine lung volumes using sensors14$155$11
Test to examine how well the lungs exchange gases14$114$8

2013: 14 services

Original Medicare services billed in 2013
Critical care, first 30-74 minutes63$35,846$190
Sleep study in sleep lab (6 years or older)54$34,909$646
Sleep study in sleep lab with continuous airway pressure (6 years or older)38$26,585$682
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes133$21,368$61
Return visit (30+ min)81$14,312$97
Critical care, each additional 30 minutes35$11,784$96
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes73$11,631$88
Initial hospital care with moderate level of medical decision making at least 75 minutes63$11,032$172
Short return visit (20+ min)71$8,792$63
New patient visit (45+ min)40$5,954$149
Irrigation and suction of lung airways to obtain cells using an endoscope14$1,070$76
Test to determine lung volumes using sensors16$174$11
Test to measure expiratory airflow and volume changes before and after medication administration15$173$12
Test to examine how well the lungs exchange gases16$127$8

Medicaid work

$9,660 in 2024

Medicaid paid $9,660 for 713 billed services this clinician did in 2024, up to 50 people in a month for one service.

Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.

Largest Medicaid services in 2024
Return visit (30+ min)637$8,570
New patient visit (45+ min)63$983
EVALUATION OF WHEEZING13$107
Medicaid work by year
2024713350$9,660
20231,041574$11,557
2022894559$7,364
2021869753$5,421
2020672758$926
2019723856$743
2018559444$4,548
See the largest Medicaid services in earlier years

2023

Largest Medicaid services in 2023
Return visit (30+ min)695$7,660
New patient visit (45+ min)168$3,014
EVALUATION OF WHEEZING144$877
Plethysmography for determination of lung volumes and, when performed, airway resistance17$4
Diffusing capacity17$2

2022

Largest Medicaid services in 2022
Return visit (30+ min)500$4,229
New patient visit (45+ min)93$2,679
EVALUATION OF WHEEZING74$456
Advance Care Planning discussed and documented in the medical record, patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan (DEM) (GER, Pall Cr)32$0
Patient screened for tobacco use and identified as a tobacco non-user195$0

2021

Largest Medicaid services in 2021
Return visit (30+ min)526$3,567
New patient visit (45+ min)71$1,417
Diffusing capacity41$163
Plethysmography for determination of lung volumes and, when performed, airway resistance41$148
EVALUATION OF WHEEZING41$127
Patient not eligible due to active diagnosis of hypertension47$0
Patient screened for tobacco use and identified as a tobacco non-user102$0

2020

Largest Medicaid services in 2020
Return visit (30+ min)448$734
New patient visit (45+ min)48$193
EVALUATION OF WHEEZING45$0
Plethysmography for determination of lung volumes and, when performed, airway resistance45$0
Diffusing capacity45$0
Short return visit (20+ min)13$0
Patient screened for tobacco use and identified as a tobacco non-user28$0

2019

Largest Medicaid services in 2019
Return visit (30+ min)478$519
1ST HOSP IP/OBS HIGH 7528$80
Diffusing capacity15$72
Plethysmography for determination of lung volumes and, when performed, airway resistance16$70
EVALUATION OF WHEEZING15$2
New patient visit (45+ min)52$0
Patient not eligible due to active diagnosis of hypertension29$0
Patient screened for tobacco use and identified as a tobacco non-user90$0

2018

Largest Medicaid services in 2018
Return visit (30+ min)435$2,478
Short return visit (20+ min)30$1,413
New patient visit (45+ min)38$657
Patient screened for tobacco use and identified as a tobacco non-user56$0

Drugs they prescribed that Part D paid

$805,158

Pharmacies billed $805,158 in 2024.

This is pharmacy cost, not the office bill, and not what patients paid.

Opioids were 0% of their Part D prescriptions (0 of 1,675) in 2024. At or below the middle of the specialty; the typical critical care (intensivists) clinician is at 0%.

674 generic and 1,001 brand-name prescriptions · $805,158 in drug cost · 103 antibiotic prescriptions to 56 people.

Part D prescriptions only. The opioid rate is opioid prescriptions as a share of all this clinician's Part D prescriptions; surgeons and pain specialists run higher than others, so it is shown against the same specialty.

Largest Part D drug costs
Ofev32$412,290$12,884
Trelegy Ellipta195$132,775$681
Breo Ellipta144$52,896$367
Arnuity Ellipta128$33,913$265
Spiriva Respimat39$24,251$622
See all 30 drugs
Every Part D drug this clinician prescribed
Ofev32$412,290$12,884
Trelegy Ellipta195$132,775$681
Breo Ellipta144$52,896$367
Arnuity Ellipta128$33,913$265
Spiriva Respimat39$24,251$622
Advair Hfa45$17,167$381
Fluticasone Propionate Hfa63$15,595$248
Budesonide-Formoterol87$12,510$144
Incruse Ellipta27$11,154$413
Fluticasone-Salmeterol69$8,779$127
Breyna72$8,526$118
Symbicort23$6,772$294
Dulera15$5,042$336
Albuterol Sulfate Hfa159$3,868$24
Wixela Inhub30$3,411$114
Roflumilast26$2,216$85
Pantoprazole139$1,179$8
Clarithromycin12$840$70
Ethambutol16$762$48
Ventolin Hfa11$594$54
Famotidine13$283$22
Gabapentin30$211$7
Montelukast22$187$8
Amoxicillin-Clavulanate Potass19$183$10
Isoniazid36$165$5
Levofloxacin26$158$6
Ropinirole11$142$13
Azithromycin36$123$3
Pramipexole Dihydrochloride19$101$5
Prednisone13$84$6

Year by year

Part D prescribing by year
20241,6753150% (0)60%$805,158
20231,6813200% (0)66%$938,633
20221,7573060% (0)65%$837,524
20212,0463260% (0)65%$723,588
20201,9922670% (0)64%$515,227
20191,6372560% (0)64%$517,988
20181,177204None56%$307,755
20171,139161None52%$241,653
20166691454% (25)43%$133,322
20155341232% (12)51%$131,605
201434493None47%$53,320
201328180None22%$15,392

Part D prescriptions only. A drug prescribed to fewer than 11 people in a year is hidden.

See the drugs prescribed each year

2023: 31 drugs

Part D drugs prescribed in 2023
Ofev24$341,069$14,211
Trelegy Ellipta204$165,205$810
Breo Ellipta173$80,286$464
Symbicort129$56,888$441
Advair Hfa72$39,364$547
Flovent Hfa86$30,218$351
Arnuity Ellipta109$29,808$273
Spiriva Respimat37$27,232$736
Advair Diskus35$20,335$581
Spiriva Handihaler13$17,075$1,313
Incruse Ellipta39$16,027$411
Wixela Inhub40$13,083$327
Daliresp12$6,269$522
Roflumilast22$4,916$223
Fluticasone-Vilanterol12$3,999$333
Fluticasone Propionate Hfa17$3,857$227
Budesonide-Formoterol15$3,782$252
Albuterol Sulfate Hfa86$2,938$34
Qvar Redihaler11$2,821$256
Ventolin Hfa21$2,217$106
Fluticasone-Salmeterol12$1,826$152
Pantoprazole147$1,578$11
Rifampin15$1,046$70
Montelukast52$716$14
Pramipexole Dihydrochloride30$445$15
Azithromycin33$434$13
Prednisone17$238$14
Amoxicillin-Clavulanate Potass12$176$15
Levofloxacin20$144$7
Gabapentin26$109$4
Citalopram Hbr19$54$3

2022: 27 drugs

Part D drugs prescribed in 2022
Ofev21$256,052$12,193
Trelegy Ellipta204$144,188$707
Breo Ellipta281$121,973$434
Spiriva Respimat84$52,987$631
Symbicort92$43,503$473
Advair Hfa47$32,481$691
Daliresp45$28,366$630
Spiriva Handihaler44$27,436$624
Arnuity Ellipta87$24,761$285
Flovent Hfa39$12,644$324
Wixela Inhub50$11,301$226
Albuterol Sulfate Hfa128$6,898$54
Incruse Ellipta17$6,409$377
Advair Diskus11$5,860$533
Flovent Diskus17$4,820$284
Rifampin41$2,799$68
Clarithromycin37$2,398$65
Ethambutol41$1,730$42
Pantoprazole167$1,502$9
Moxifloxacin12$1,077$90
Azithromycin25$788$32
Montelukast38$658$17
Pramipexole Dihydrochloride52$479$9
Amoxicillin-Clavulanate Potass12$288$24
Famotidine11$200$18
Levofloxacin25$120$5
Citalopram Hbr15$79$5

2021: 33 drugs

Part D drugs prescribed in 2021
Breo Ellipta360$144,668$402
Ofev13$141,758$10,904
Trelegy Ellipta116$71,694$618
Spiriva94$55,393$589
Spiriva Respimat104$53,485$514
Symbicort58$33,123$571
Advair Hfa41$32,304$788
Daliresp55$31,716$577
Arnuity Ellipta118$27,708$235
Incruse Ellipta60$24,260$404
Advair Diskus34$18,694$550
Wixela Inhub72$16,946$235
Flovent Hfa32$10,877$340
Anoro Ellipta18$8,268$459
Xarelto14$7,094$507
Albuterol Sulfate Hfa124$6,318$51
Fluticasone-Salmeterol20$5,392$270
Budesonide-Formoterol16$4,800$300
Rifampin52$3,107$60
Clarithromycin40$2,228$56
Pantoprazole187$1,850$10
Alvesco14$1,801$129
Ethambutol38$1,715$45
Ventolin Hfa23$1,657$72
Montelukast65$777$12
Pramipexole Dihydrochloride58$369$6
Bupropion Xl21$326$16
Levothyroxine12$206$17
Amoxicillin-Clavulanate Potass18$178$10
Isoniazid13$82$6
Citalopram Hbr16$80$5
Gabapentin11$60$5
Levofloxacin17$49$3

2020: 34 drugs

Part D drugs prescribed in 2020
Breo Ellipta414$165,084$399
Spiriva122$61,231$502
Advair Diskus72$46,140$641
Incruse Ellipta89$34,223$385
Advair Hfa50$28,166$563
Arnuity Ellipta116$25,393$219
Trelegy Ellipta40$22,253$556
Spiriva Respimat32$16,983$531
Symbicort39$16,091$413
Wixela Inhub41$13,260$323
Daliresp27$12,850$476
Fluticasone-Salmeterol27$7,694$285
Anoro Ellipta17$7,351$432
Flovent Hfa16$5,902$369
Ventolin Hfa64$5,339$83
Albuterol Sulfate Hfa102$5,324$52
Dulera13$4,186$322
Clarithromycin15$1,680$112
Pantoprazole241$1,453$6
Proair Respiclick12$1,091$91
Ethambutol13$1,065$82
Rifampin20$1,019$51
Montelukast55$524$10
Prednisone29$384$13
Pramipexole Dihydrochloride65$362$6
Bupropion Xl16$351$22
Amoxicillin-Clavulanate Potass26$291$11
Azithromycin12$262$22
Levothyroxine12$206$17
Levofloxacin31$140$5
Isoniazid18$131$7
Furosemide13$78$6
Citalopram Hbr21$77$4
Famotidine12$53$4

2019: 28 drugs

Part D drugs prescribed in 2019
Breo Ellipta294$107,900$367
Spiriva100$43,771$438
Advair Diskus60$34,039$567
Incruse Ellipta94$33,979$361
Advair Hfa57$26,209$460
Symbicort68$25,690$378
Arnuity Ellipta86$19,751$230
Spiriva Respimat30$15,844$528
Trelegy Ellipta28$15,229$544
Rifabutin12$14,176$1,181
Anoro Ellipta26$10,599$408
Flovent Hfa22$10,306$468
Daliresp14$7,717$551
Dulera20$6,101$305
Qvar Redihaler24$5,420$226
Wixela Inhub20$4,488$224
Clarithromycin15$2,638$176
Ventolin Hfa34$2,196$65
Pantoprazole224$1,602$7
Albuterol Sulfate Hfa15$639$43
Pramipexole Dihydrochloride70$560$8
Montelukast27$402$15
Amoxicillin-Clavulanate Potass25$334$13
Levofloxacin25$153$6
Citalopram Hbr17$120$7
Famotidine17$96$6
Prednisone11$79$7
Furosemide14$41$3

2018: 20 drugs

Part D drugs prescribed in 2018
Breo Ellipta194$69,777$360
Spiriva58$26,690$460
Symbicort60$23,007$383
Advair Diskus34$17,585$517
Anoro Ellipta36$14,416$400
Incruse Ellipta41$13,851$338
Spiriva Respimat31$13,143$424
Advair Hfa26$11,173$430
Arnuity Ellipta53$11,145$210
Budesonide11$5,534$503
Qvar Redihaler14$2,991$214
Ventolin Hfa31$1,922$62
Pantoprazole153$1,263$8
Proair Hfa15$1,112$74
Pramipexole Dihydrochloride79$601$8
Amoxicillin-Clavulanate Potass23$593$26
Montelukast20$168$8
Levothyroxine14$142$10
Levofloxacin19$119$6
Gabapentin13$90$7

2017: 33 drugs

Part D drugs prescribed in 2017
Spiriva83$39,599$477
Advair Diskus60$28,232$471
Breo Ellipta72$24,990$347
Symbicort78$22,599$290
Incruse Ellipta23$7,594$330
Advair Hfa13$4,865$374
Spiriva Respimat13$4,782$368
Dulera15$4,658$311
Flovent Hfa17$4,355$256
Qvar18$4,056$225
Pulmicort Flexhaler14$2,488$178
Eliquis20$2,121$106
Ventolin Hfa29$2,024$70
Proair Hfa15$1,071$71
Pantoprazole94$794$8
Amoxicillin-Clavulanate Potass16$387$24
Atorvastatin26$377$14
Omeprazole26$244$9
Donepezil25$221$9
Risperidone15$207$14
Pramipexole Dihydrochloride27$206$8
Sertraline29$196$7
Furosemide33$184$6
Potassium Chloride16$171$11
Montelukast16$124$8
Finasteride11$116$11
Clopidogrel11$109$10
Levothyroxine11$100$9
Gabapentin14$95$7
Lisinopril14$88$6
Atenolol15$74$5
Levofloxacin17$69$4
Amlodipine Besylate11$43$4

2016: 18 drugs

Part D drugs prescribed in 2016
Spiriva45$16,228$361
Dulera51$13,079$256
Symbicort44$12,533$285
Advair Diskus18$7,356$409
Dexilant11$3,668$333
Qvar16$3,235$202
Clarithromycin14$2,057$147
Ventolin Hfa19$1,485$78
Ethambutol15$1,149$77
Proair Hfa15$1,140$76
Amoxicillin-Clavulanate Potass15$610$41
Tamsulosin12$376$31
Pantoprazole38$348$9
Pramipexole Dihydrochloride45$309$7
Atorvastatin13$146$11
Doxepin11$124$11
Omeprazole12$119$10
Gabapentin12$94$8

2015: 14 drugs

Part D drugs prescribed in 2015
Rifabutin14$15,465$1,105
Advair Diskus41$14,328$349
Spiriva44$14,085$320
Dulera46$10,773$234
Symbicort33$8,763$266
Qvar13$2,384$183
Proair Hfa23$2,130$93
Ethambutol14$1,343$96
Pantoprazole47$553$12
Pramipexole Dihydrochloride37$531$14
Amoxicillin-Clavulanate Potass17$447$26
Azithromycin13$234$18
Omeprazole12$102$8
Isoniazid15$101$7

2014: 7 drugs

Part D drugs prescribed in 2014
Advair Diskus30$10,059$335
Spiriva24$7,194$300
Dulera15$3,209$214
Symbicort12$2,746$229
Proair Hfa31$2,385$77
Pramipexole Dihydrochloride47$1,082$23
Pantoprazole45$421$9

2013: 5 drugs

Part D drugs prescribed in 2013
Symbicort12$3,282$274
Pramipexole Dihydrochloride54$1,094$20
Proair Hfa14$828$59
Amox Tr-Potassium Clavulanate14$386$28
Pantoprazole30$298$10

Money from drug and device companies

$55 in 2025

Industry payments by year
202511None$55
202455None$188
202222None$162

Paid work is consulting, speaking, honoraria and royalties, as opposed to meals and travel.

A payment is not proof that care is biased.

Payments by company
Inspire Medical SystemsInspire$55
1 payment
  • Meals for Inspire · 2025-01-17 · $55
See the published payment
Every published payment
Inspire Medical SystemsMeals · 2025-01-17Inspire$55
See earlier years (2024, 2022)

2024: $188

Payments by company in 2024
Inspire Medical SystemsInspire$86
1 payment
  • Meals for Inspire · 2024-08-22 · $86
Idorsia Pharmaceuticals USQuviviq$48
1 payment
  • Meals for Quviviq · 2024-01-22 · $48
Aimmune TherapeuticsVowst$21
1 payment
  • Meals for Vowst · 2024-10-22 · $21
Philips North America(6299) Dreamwear$20
1 payment
  • Meals for (6299) Dreamwear · 2024-08-08 · $20
CapsoVisionCapsocam Plus$13
1 payment
  • Meals for Capsocam Plus · 2024-06-24 · $13

2022: $162

Payments by company in 2022
Boehringer Ingelheim PharmaceuticalsOfev$145
1 payment
  • Meals for Ofev · 2022-05-15 · $145
ResmedAir 11$17
1 payment
  • Meals for Air 11 · 2022-04-06 · $17

Checkups this office reported

2023

Medicare did not publish checkup rates for this clinician.

Medicare’s overall office score
65.7 / 100
Scores the office’s reporting and systems. It is not a grade for how the doctor treats you.

What the office says it does

Boxes the office ticked on its Medicare worksheet for 2023. Nobody checks these.

  • Offers telehealth visits
  • Records advance care plans
  • Tobacco use

Professional record

NPI
1477523249
Licence
CA A104257, OR MD184939, WA MD00047235California A104257: Current · expires 2027-10-31Washington MD.MD.00047235: Expired
Video visits
Lists video visits
Gender
Male
More record details
Sole proprietor
No
Taxonomy
Federal specialty code 207RS0012X (207RS0012X); Federal specialty code 207RC0200X (207RC0200X); Federal specialty code 207RP1001X (207RP1001X)
Mailing address
201 16th Ave E, Seattle, WA, 98112
NPI first listed
2006-01-25
NPI last updated
2022-01-26
NPI record certified
2022-01-26

This is when the NPI record was last certified, not a medical board exam.

Extra NPI addresses: 888 Swift Blvd, Richland, WA, 99352

This office lists an electronic records connection.