Physician

Sushil Ghimire, M.D.

According to 2025 Medicare claims, Sushil Ghimire, M.D. (NPI: 1912314840) practices hematology in the Camden, NJ market, with the plurality of this provider's patient population coming from Camden, NJ. This provider's primary affiliated billing organization is CMC DEPARTMENT OF MEDICINE GROUP PA (NPI: 1588796882; TIN: 223266219) and primary practice location at 08043-4637.

Ghimire's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 246 traditional Medicare patients, billed 604 HCPCS/CPT codes, and received $40,882 in Medicare payments. The top billing code was 99205 (New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more). Part D data shows 1,218 prescription claims across 154 beneficiaries totaling $7,222,271 in drug costs, led by Revlimid (Lenalidomide). Open Payments data shows 1 records totaling $17. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing did not follow a clear longitudinal pattern. Concurrently, Part D prescription costs have moved sharply higher in recent years, from $721 to $7,222,271. For DME billing, this provider has fewer than 5 years of reported data, so a reliable trend cannot be assigned.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	N/R	N/R	N/R
2016	N/R	N/R	N/R
2017	169	348	$23,461
2018	168	380	$24,773
2019	N/R	N/R	N/R
2020	N/R	N/R	N/R
2021	70	126	$11,878
2022	195	475	$37,733
2023	217	533	$43,215
2024	246	604	$40,882

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	19	38	$721
2016	20	57	$3,128
2017	66	155	$15,953
2018	54	213	$38,692
2019	N/R	N/R	N/R
2020	N/R	N/R	N/R
2021	53	158	$243,527
2022	99	631	$1,893,083
2023	142	1,103	$5,630,064
2024	154	1,218	$7,222,271

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

No connected DME records

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
99205	New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	19	19	$151
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	172	343	$73
99232	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	26	47	$64
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	28	29	$45
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	61	82	$13

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Revlimid	Lenalidomide	79	2,142	$1,441,245
Calquence	Acalabrutinib Maleate	94	2,820	$1,246,786
Pomalyst	Pomalidomide	52	1,456	$1,140,268
Imbruvica	Ibrutinib	73	2,110	$1,064,440
Jakafi	Ruxolitinib Phosphate	41	1,230	$686,879

Top 5 DME services in 2024

No connected or detailed DME service-level records for 2024.

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	1	$17	Alnylam Pharmaceuticals Inc.
Research Payments	Reported research-related payment or transfer-of-value amount.	0	$0	N/R
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

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FAQ

What Medicare data is available for Sushil Ghimire, M.D.?

Tedicare shows public-source Medicare data for Sushil Ghimire, M.D. (NPI 1912314840), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Sushil Ghimire, M.D. have ACO affiliation data?

No ACO affiliation record is shown in the available Tedicare data for this profile.

What billing organization is linked to Sushil Ghimire, M.D.?

Sushil Ghimire, M.D. is linked to CMC DEPARTMENT OF MEDICINE GROUP PA (billing NPI 1588796882) in the available physician profile data.

Does Sushil Ghimire, M.D. have Open Payments data?

Sushil Ghimire, M.D. has 1 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.