Medicare Enrolled
Dr. Ramy Alnahhal, M.D.
Internal Medicine · Delano, CA
Practice pattern: Clinical Cardiology
— Primarily office-based clinical cardiology
Low-engagement
Very High
DATA COVERAGE
Data in 4 of 4 federal sources
Measures public federal data availability — not provider quality
Informational, not a quality rating.
This page presents federal public records about Dr. Alnahhal from CMS (NPPES, Open Payments, Medicare Provider Utilization, PECOS). It is not medical advice, an endorsement, or a judgment of clinical quality. Always consult the provider directly and a licensed clinician for medical decisions. Read methodology →
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What this data tells you about Dr. Alnahhal
Dr. Ramy Alnahhal is an internal medicine specialist in Delano, CA, with 17 years of NPI registration. Based on federal Medicare data, Dr. Alnahhal performed 9,965 Medicare services across 5,777 unique beneficiaries.
Between the years covered by Open Payments, Dr. Alnahhal received a total of $1,145 from 13 pharmaceutical and/or device companies across 35 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common in internal medicine. Most payments are for meals and travel — low-value interactions common across virtually all practicing physicians. Patients may wish to discuss these relationships with their provider.
The Data Coverage level for Dr. Alnahhal is Very High — reflecting how much public federal data is available about this provider. Patients are encouraged to use this data as one of several factors when choosing a healthcare provider.
✓ 17 years in practice
▲ Top 2% volume in CA
$1,145 industry payments
Medicare Practice Summary
Medicare Utilization ↗9,965
Medicare services
Top 2% in CA for internal medicine
5,777
Unique beneficiaries
$27
Avg. Medicare payment
Medicare patients only (65+ / disabled) · How to read this →
~586 Medicare services per year of practice
Top procedures by volume
Ranked by number of services performed for Medicare patients. Avg. submitted charge is what the provider billed; avg. Medicare payment is what CMS paid.
| Procedure | Volume | Avg. paid | Avg. submitted |
|---|---|---|---|
| Office visit, established patient (20-29 min) An office visit for an existing patient lasting between 20 and 29 minutes. The visit involves medical evaluation and management of the patient's condition. |
707 | $63 | $114 |
| Complete blood count (CBC) with differential An automated laboratory test that measures the levels of red blood cells, white blood cells, and platelets in the blood, including a breakdown of the different types of white blood cells. |
667 | $8 | $18 |
| Comprehensive metabolic blood panel A blood test that measures a group of chemicals, including glucose, electrolytes, and kidney and liver function markers. |
655 | $10 | $25 |
| Lipid panel (cholesterol and triglycerides) A blood test that measures cholesterol and triglyceride levels. |
560 | $13 | $25 |
| Allergy blood test (IgE), per allergen A blood test that measures the level of immunoglobulin E (IgE) antibodies produced in response to a specific crude allergen extract. |
555 | $5 | $10 |
| Steroid injection (triamcinolone) A 10 mg injection of triamcinolone acetonide, a corticosteroid medication. This code specifies the drug and dosage administered. |
510 | $1 | $8 |
| Chronic care management, first 20 min/month This service covers the first 20 minutes of clinical staff time directed by a healthcare professional each calendar month to manage chronic conditions. |
440 | $49 | $80 |
| Office visit, established patient (30-39 min) A follow-up office visit for an existing patient lasting between 30 and 39 minutes. The visit involves medical evaluation and management of the patient's condition. |
430 | $88 | $165 |
| Vitamin D level test A blood test to measure the amount of Vitamin D-3 in your body. |
413 | $29 | $60 |
| Thyroid stimulating hormone (TSH) test A blood test that measures the level of thyroid stimulating hormone to evaluate thyroid function. |
399 | $16 | $40 |
| Hemoglobin A1c test (diabetes monitoring) A blood test that measures your average blood sugar levels over the past two to three months. |
342 | $9 | $25 |
| Urinalysis, manual A manual laboratory examination of a urine sample to check for various substances and cells. |
330 | $3 | $8 |
| Uric acid level test A blood test that measures the level of uric acid in your body. Uric acid is a waste product formed when the body breaks down purines. |
268 | $4 | $8 |
| Annual depression screening | 235 | $19 | $47 |
| Annual wellness visit, follow-up A follow-up annual wellness visit that includes a personalized prevention plan of service. |
234 | $132 | $250 |
| Free thyroxine (T4) test A blood test that measures the level of free thyroxine, a thyroid hormone, in the bloodstream. |
195 | $9 | $28 |
| Total T3 thyroid hormone test A blood test that measures the total amount of triiodothyronine (T3) hormone in your body. T3 is a thyroid hormone that helps regulate metabolism and energy levels. |
191 | $14 | $32 |
| Vitamin B-12 level test A blood test that measures the amount of vitamin B-12 in your body. |
188 | $15 | $30 |
| Ketorolac injection, per 15 mg An injection of ketorolac tromethamine, a nonsteroidal anti-inflammatory drug, administered in doses measured per 15 mg. |
171 | $0 | $9 |
| EKG interpretation and report A standard electrocardiogram test that records the heart's electrical activity using at least 12 leads. The service includes a professional interpretation of the results and a written report. |
161 | $6 | $80 |
| Drug injection, under skin or into muscle A procedure involving the administration of a medication or substance via injection into the subcutaneous tissue or muscle. |
161 | $11 | $45 |
| Flu vaccine administration This procedure involves the administration of the influenza virus vaccine. It covers the process of delivering the vaccine to the patient. |
153 | $32 | $45 |
| PSA test (complexed) A blood test that measures the level of complexed prostate-specific antigen in the body. |
142 | $18 | $40 |
| C-peptide level test A blood test that measures the amount of C-peptide, a protein produced along with insulin, to help evaluate insulin production and diabetes management. |
123 | $20 | $40 |
| Quadrivalent influenza vaccine, preservative-free A flu shot containing four strains of the influenza virus, formulated without preservatives, administered in a 0.5 ml dose. |
121 | $22 | $45 |
| High-sensitivity C-reactive protein test A blood test that measures high-sensitivity C-reactive protein to detect infection or inflammation. |
118 | $13 | $30 |
| Insulin level test A blood test that measures the total amount of insulin in your body. |
110 | $11 | $20 |
| Urine microalbumin test (kidney screening) A laboratory test that measures the amount of microalbumin, a small protein, in a urine sample. This test is used to detect early signs of kidney damage. |
109 | $6 | $10 |
| Creatinine test (kidney function) A blood test that measures the amount of creatinine to assess kidney function or detect muscle injury. |
109 | $5 | $10 |
| Ceftriaxone antibiotic injection This code represents the administration of ceftriaxone sodium, an antibiotic medication. The charge is calculated for every 250 mg of the drug administered. |
78 | $0 | $30 |
| Chronic care management, additional 20 min/month This service covers an extra 20 minutes of clinical staff time directed by a healthcare professional for managing two or more chronic conditions each calendar month. |
75 | $38 | $80 |
| Electrocardiogram (EKG), 12-lead A standard heart rhythm test using at least 12 leads to record electrical activity. A healthcare provider interprets the results and provides a written report. |
71 | $11 | $58 |
| Basic metabolic blood panel A blood test that measures a group of basic chemicals, including total calcium levels. |
64 | $8 | $25 |
| Remote vital sign monitoring management, each additional 20 minutes This code covers the time spent by a provider managing patient data from remote vital sign monitoring devices. It applies to each additional 20-minute increment beyond the initial monthly service period. |
63 | $32 | $61 |
| Pneumonia vaccine administration This procedure involves the injection of a vaccine to protect against pneumococcal disease. It is administered by a healthcare provider. |
53 | $32 | $45 |
| Remote patient monitoring management, 20 min/month Management based on results from remote vital sign monitoring for the first 20 minutes per calendar month. |
52 | $39 | $70 |
| Bone density scan (DEXA) A test that uses low-dose X-rays to measure bone mineral density in the hip, pelvis, and spine. It helps assess bone strength and risk of fractures. |
51 | $40 | $172 |
| Remote patient monitoring device, 30 days Initial setup of devices for remote monitoring of body functions with daily data transmission or alerts. This service covers the first 30 days of the monitoring period. |
51 | $41 | $75 |
| Transitional care management services, moderate complexity Services provided to coordinate care during the transition from an inpatient or other facility setting back to the community. This includes follow-up and management of a health problem of at least moderate complexity. |
43 | $168 | $240 |
| Iron level test | 41 | $6 | $15 |
| Ultrasound of head and neck blood flow, bilateral An ultrasound exam that uses sound waves to visualize and assess blood flow in the vessels of both the head and the neck. |
41 | $139 | $500 |
| Folic acid level test A blood test that measures the amount of folic acid in the serum. |
38 | $14 | $30 |
| Iron binding capacity test A blood test that measures the amount of iron in the blood and the blood's ability to bind and transport iron. |
38 | $9 | $18 |
| Complete ultrasound of retroperitoneum An ultrasound examination of the structures located behind the abdominal cavity. |
37 | $76 | $160 |
| Ferritin level test (iron stores) A blood test that measures the level of ferritin, a protein that stores iron in the body. |
36 | $13 | $30 |
| Prothrombin time test (blood clotting) A laboratory test that measures how long it takes for blood to clot. This procedure evaluates the body's coagulation process. |
36 | $4 | $10 |
| Pneumococcal vaccine, 23-valent A vaccine that protects against 23 types of pneumococcal bacteria. It is used to prevent infections caused by these bacteria. |
33 | $131 | $178 |
| Quadrivalent influenza vaccine, cell culture-derived A flu shot that protects against four strains of the influenza virus. It is produced using cell culture technology rather than traditional egg-based methods. |
32 | $32 | $65 |
| Telephone medical discussion, 11-20 minutes A phone conversation with a physician lasting between 11 and 20 minutes. |
27 | $69 | $110 |
| Chest X-ray, 2 views An X-ray imaging test of the chest that captures two different angles to visualize the lungs, heart, and chest wall. |
26 | $24 | $60 |
| COVID-19 immunoassay detection test A laboratory test that uses an immunoassay method to detect the presence of severe acute respiratory syndrome coronavirus 2 (COVID-19) through direct visual observation. |
26 | $41 | $60 |
| Echocardiogram, transthoracic An ultrasound of the heart that uses color to show blood flow, rate, direction, and valve function. |
22 | $144 | $350 |
| Stool test for blood to screen for colon tumors A test that analyzes a stool sample to detect hidden blood, which is used to screen for colon tumors. |
20 | $4 | $10 |
| Pneumococcal conjugate vaccine (PCV15) An intramuscular injection of the 15-valent pneumococcal conjugate vaccine. This vaccine protects against 15 types of pneumococcal bacteria. |
20 | $241 | $275 |
| Joint injection, major joint Removal of fluid from a large joint and/or injection of medication into the joint space. |
17 | $56 | $122 |
| Blood glucose test using hand-held instrument A test that measures the level of sugar in the blood using a portable device. The result helps monitor blood glucose levels. |
17 | $3 | $10 |
| Shoulder X-ray, 2+ views An X-ray imaging test of the shoulder joint using at least two different angles to visualize the bones and surrounding structures. |
14 | $29 | $50 |
| Knee X-ray, 1-2 views An X-ray imaging test of the knee joint using one to two different angles to visualize the bones and surrounding structures. |
13 | $25 | $50 |
| X-ray of lower and sacral spine, 2-3 views An X-ray imaging test that captures 2 to 3 views of the lower back and sacral spine to visualize the bones and joints in this area. |
11 | $29 | $60 |
| Ultrasound of head and neck soft tissue This procedure uses sound waves to create images of the soft tissues in the head and neck area. It allows for the visualization of structures beneath the skin without using radiation. |
11 | $88 | $170 |
| Initial preventive physical examination, new Medicare beneficiary A comprehensive preventive health visit for new Medicare beneficiaries during their first 12 months of enrollment. The service is conducted as a face-to-face visit and is limited to preventive care. |
11 | $170 | $250 |
How to read this data: This reflects Medicare patients only (typically 65+). Payment amounts are what Medicare paid the provider, not your out-of-pocket cost. A higher procedure volume generally indicates more experience with that procedure.
0.2% high complexity
10.3% medium
89.5% routine
Industry Payment Transparency
Open Payments through 2023 ↗$1,145
Total received (2018-2023)
Avg $191/year across 6 years
Top 33% in CA for internal medicine
A higher payment rank reflects disclosed industry relationships (consulting, research, speaking) common among subspecialists — not wrongdoing.
13
Companies
35
Individual payments
All payments are legal and publicly reported · Not evidence of wrongdoing · How to interpret →
Payment profile
Industry payments classified by relationship type. Not all payments are equal — research and consulting reflect different relationships than speaking programs or meals.
Meals & Travel
Food, beverages, travel, and lodging — typically low-value
$1,145 (100.0%)
Payment trend by year
Annual totals from pharmaceutical and medical device companies.
2023
$89
2022
$137
2021
$104
2020
$64
2019
$300
2018
$451
Payments by company (2023)
Consulting
Speaking
Meals & Travel
Research
Bayer Healthcare Pharmaceuticals Inc.
$89
Top 3 companies account for 100.0% of 2023 payments
All-time payments by company (2018-2023) ›
Boehringer Ingelheim Pharmaceuticals, Inc.
$237
Medtronic Vascular, Inc.
$150
Allergan Inc.
$134
Horizon Therapeutics plc
$125
Nestle HealthCare Nutrition Inc.
$116
Merck Sharp & Dohme Corporation
$112
Bayer Healthcare Pharmaceuticals Inc.
$89
Janssen Pharmaceuticals, Inc
$77
PFIZER INC.
$34
AstraZeneca Pharmaceuticals LP
$30
Novo Nordisk Inc
$15
Amgen Inc.
$14
Lilly USA, LLC
$12
Top 3 companies account for 45.5% of all-time payments
Associated products mentioned in payments ›
ClosureFast · EMGALITY · FARXIGA · HawkOne · JANUVIA · JARDIANCE · KRYSTEXXA · Kerendia · PREVNAR - 13 · PREVNAR 13 · Repatha · TRADJENTA · Tresiba · VIBERZI · VRAYLAR · XARELTO · ZENPEP
Should you be concerned? Payments from pharmaceutical and device companies are legal and common — 57% of U.S. physicians receive at least one. They often reflect legitimate consulting, research, or education. What matters is whether a recommended drug or device appears in your doctor's payment records. If so, consider asking your doctor about it. How to interpret this data →
Most payments (100%) are for meals and travel — low-value interactions that are common across virtually all practicing physicians.
Geographic Context
Internal medicine physicians within 10 mi
58
Per 100K population
6.4
County median income
$67,660
Nearest hospital
ADVENTIST HEALTH DELANO
0.0 mi
0.0 mi
Data Sources
| Provider Registry | ✓ NPPES | Weekly updates |
| Medicare Enrollment | ✓ PECOS | Monthly updates |
| Practice Data | ✓ Medicare Util. | Annual (CY lag) |
| Industry Payments | ✓ Open Payments | CY 2023 |
| Disciplinary History | — Not public | N/A |
This provider has data in 4 of 4 available federal datasets, with a Data Coverage level of Very High. This reflects how much public data is available about a provider. How we calculate this →
Summary
Dr. Alnahhal is a clinical cardiology specialist, with above-average Medicare volume (top 2% in CA), with low-engagement industry engagement, with 17 years of NPI registration.
This summary is auto-generated from federal data, describing data availability and patterns. Read our methodology →
Frequently Asked Questions
Is Dr. Alnahhal experienced with office visit, established patient (20-29 min)?
Based on Medicare claims data, Dr. Alnahhal performed 707 office visit, established patient (20-29 min) services. Research suggests that higher procedure volume is often associated with better outcomes, particularly for complex procedures. Note that Medicare data only captures patients aged 65 and older, so the total practice volume across all patients is likely higher.
Does Dr. Alnahhal receive payments from pharmaceutical companies?
Yes. Dr. Alnahhal received a total of $1,145 from 13 companies across 35 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common among physicians — 57% of all U.S. physicians receive at least one industry payment. Patients may wish to ask their doctor about these relationships, especially if a recommended drug or device appears in the payment records.
How do Dr. Alnahhal's costs compare to other internal medicine physicians in Delano?
Dr. Alnahhal's average Medicare payment per service is $27. Note that these figures represent what Medicare pays, not your out-of-pocket cost, which depends on your specific insurance plan and deductible. Procedure-level data above shows both what was submitted and what Medicare paid for each service type.
What does Data Coverage mean?
Data Coverage (currently Very High for Dr. Alnahhal) measures how much public federal data is available about a provider. It is not a quality rating. A "Very High" or "High" level means the provider has data across multiple federal sources (NPPES, PECOS, Medicare Utilization, Open Payments), indicating a long track record of practice, Medicare participation, and industry disclosure. A "Low" or "Moderate" level may simply mean the provider is newer, does not see Medicare patients, or has not received any industry payments — none of which are inherently negative. Read our full methodology →
Is this data up to date?
Each data source has its own update cycle. Provider registry data (NPPES) is updated weekly. Medicare enrollment (PECOS) is updated monthly. Medicare practice data has a ~2 year lag — the most recent available is typically 2 years prior. Industry payment data (Open Payments) is published annually, usually in June, covering the prior calendar year. We display the data date prominently on each section so you always know how current it is. See our data freshness policy →
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About this page
All data on this page is sourced verbatim from public federal records published by the U.S. Centers for Medicare & Medicaid Services (CMS): NPPES ↗, Open Payments ↗, Medicare Provider Utilization ↗, and PECOS. Publication is mandated by the Physician Payments Sunshine Act (§6002 ACA, 42 U.S.C. §1320a-7h) and the Freedom of Information Act.
This page is not medical advice, an endorsement, a recommendation, or a quality rating. Data Coverage reflects data completeness — how much federal information exists for this provider — not clinical performance, patient outcomes, or quality of care. Always verify information directly with the provider and consult a licensed clinician before making medical decisions.
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