Medicare Enrolled
Dr. Jay Patel, MD
Internal Medicine · San Juan Capistrano, 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. Patel 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. Patel
Dr. Jay Patel is an internal medicine specialist in San Juan Capistrano, CA, with 10 years of NPI registration. Based on federal Medicare data, Dr. Patel performed 2,547 Medicare services across 1,454 unique beneficiaries.
Between the years covered by Open Payments, Dr. Patel received a total of $3,716 from 26 pharmaceutical and/or device companies across 113 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. Patel 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.
✓ 10 years in practice
▲ Top 13% volume in CA
$3,716 industry payments
Medicare Practice Summary
Medicare Utilization ↗2,547
Medicare services
Top 13% in CA for internal medicine
1,454
Unique beneficiaries
$109
Avg. Medicare payment
Medicare patients only (65+ / disabled) · How to read this →
~255 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 |
|---|---|---|---|
| Hospital follow-up visit, high complexity Subsequent hospital inpatient or observation care for an existing patient involving high-level medical decision making, with at least 50 minutes total time on the date of the encounter. |
711 | $99 | $246 |
| Critical care, first 30-74 min Emergency medical care for a critically ill or injured patient lasting between 30 and 74 minutes. This service involves direct patient care and medical decision making to stabilize the patient. |
532 | $175 | $645 |
| Initial hospital admission, high complexity Initial hospital inpatient or observation care for a new patient involving high-level medical decision making, with at least 75 minutes total time on the date of the encounter. |
155 | $147 | $466 |
| Additional 30 minutes of critical care This code represents an additional 30 minutes of critical care services provided beyond the initial critical care time period. |
131 | $87 | $283 |
| 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. |
105 | $108 | $273 |
| Office visit, established patient, complex (40-54 min) An office or outpatient visit for an existing patient lasting between 40 and 54 minutes. This level of service is determined by the total time spent on the date of the encounter. |
88 | $149 | $369 |
| Nursing facility visit, high complexity A follow-up visit by a healthcare provider at a nursing facility for an established patient. The visit involves a high level of medical decision making and takes at least 45 minutes. |
87 | $130 | $327 |
| Pulmonary gas exchange test A test to examine how well the lungs exchange gases. |
82 | $51 | $143 |
| Spirometry test before and after medication A test that measures the amount of air you can exhale and the speed of your breathing before and after taking a medication. |
79 | $33 | $143 |
| New patient office visit, complex (60-74 min) | 70 | $183 | $493 |
| Lung volume test using gas dilution or washout A test that measures the amount of air in your lungs by using a gas dilution or washout method. |
59 | $40 | $110 |
| Breathing device use evaluation An assessment of how a patient uses a breathing device. The provider reviews the patient's technique and device handling. |
57 | $16 | $46 |
| Overnight continuous oxygen level test This test measures oxygen levels in the blood continuously overnight using a device attached to the ear or finger. |
47 | $23 | $40 |
| Hospital discharge management, 30+ min This service covers the care provided by a physician or qualified healthcare professional on the day a patient is discharged from the hospital. It requires more than 30 minutes of total time spent on the day of discharge. |
46 | $95 | $266 |
| Prolonged inpatient or observation care, each additional 15 minutes This code is used for prolonged hospital inpatient or observation care services that extend beyond the total time required for the primary evaluation and management service. It covers each additional 15-minute increment of time spent by the provider. |
46 | $26 | $74 |
| Exercise-induced lung stress test A test performed to evaluate how the lungs function during physical exertion. It helps identify breathing difficulties or lung conditions that occur specifically when exercising. |
43 | $29 | $84 |
| Prolonged office E/M service, first 15 minutes This code is used for additional time spent by a physician beyond the maximum required time of a primary office or outpatient evaluation and management service. It is billed in 15-minute increments based on total time spent on the date of the primary service. |
41 | $27 | $78 |
| New patient office visit (45-59 min) An initial office visit for a new patient lasting between 45 and 59 minutes. This code covers the total time spent by the physician or qualified healthcare professional on the date of the encounter. |
38 | $139 | $395 |
| Airflow rate measurement test A test that measures the rate of airflow. This procedure assesses how quickly air moves. |
32 | $34 | $99 |
| Hospital follow-up visit, moderate complexity Follow-up hospital visit for an existing patient involving moderate medical decision making. The visit requires at least 35 minutes of time spent on the date of service. |
30 | $66 | $217 |
| Lung volume test using sensors A test that measures the amount of air in the lungs using sensors. |
23 | $48 | $140 |
| Advance care planning consultation, first 30 min A session focused on discussing and documenting future healthcare preferences and goals. This service covers the initial 30 minutes of the planning discussion. |
19 | $67 | $188 |
| Sleep study with heart rate and breathing monitoring A sleep study that monitors heart rate, breathing, airflow, and physical effort during sleep. |
14 | $82 | $420 |
| Initial hospital admission, moderate complexity Initial hospital inpatient or observation care for a new patient involving moderate-level medical decision making, with at least 55 minutes total time on the date of the encounter. |
12 | $109 | $305 |
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.
Industry Payment Transparency
Open Payments through 2024 ↗$3,716
Total received (2019-2024)
Avg $929/year across 4 years
Top 19% in CA for internal medicine
A higher payment rank reflects disclosed industry relationships (consulting, research, speaking) common among subspecialists — not wrongdoing.
26
Companies
113
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
$3,716 (100.0%)
Payment trend by year
Annual totals from pharmaceutical and medical device companies.
2024
$1,459
2023
$1,279
2022
$728
2019
$250
Payments by company (2024)
Consulting
Speaking
Meals & Travel
Research
GlaxoSmithKline, LLC.
$397
Shionogi Inc
$245
Pulmonx Corporation
$179
GENZYME CORPORATION
$102
Boehringer Ingelheim Pharmaceuticals, Inc.
$93
Mylan Specialty L.P.
$77
Amgen Inc.
$59
AstraZeneca Pharmaceuticals LP
$57
Actelion Pharmaceuticals US, Inc.
$56
Takeda Pharmaceuticals U.S.A., Inc.
$39
Regeneron Healthcare Solutions, Inc.
$39
Axsome Therapeutics, Inc.
$31
Lilly USA, LLC
$28
Paratek Pharmaceuticals, Inc.
$24
Janssen Pharmaceuticals, Inc
$18
Philips North America LLC
$16
Top 3 companies account for 56.3% of 2024 payments
All-time payments by company (2019-2024) ›
GlaxoSmithKline, LLC.
$1,143
AstraZeneca Pharmaceuticals LP
$419
Takeda Pharmaceuticals U.S.A., Inc.
$315
Shionogi Inc
$245
GENZYME CORPORATION
$193
Boehringer Ingelheim Pharmaceuticals, Inc.
$180
Pulmonx Corporation
$179
Grifols USA, LLC
$149
Gilead Sciences, Inc.
$125
JAZZ PHARMACEUTICALS INC.
$119
Mylan Specialty L.P.
$103
Intuitive Surgical, Inc.
$78
Actelion Pharmaceuticals US, Inc.
$73
Amgen Inc.
$59
Regeneron Healthcare Solutions, Inc.
$39
Janssen Pharmaceuticals, Inc
$38
Novo Nordisk Inc
$36
Covis Pharma GmBH
$32
Axsome Therapeutics, Inc.
$31
Almatica Pharma LLC
$31
Lilly USA, LLC
$28
United Therapeutics Corporation
$27
Paratek Pharmaceuticals, Inc.
$24
Salix Pharmaceuticals, a division of Bausch Health US, LLC
$19
Insmed, Inc.
$17
Philips North America LLC
$16
Top 3 companies account for 50.5% of all-time payments
Associated products mentioned in payments ›
(AK6) Vest Therapy · AIRSUPRA · ALVESCO · Arikayce · BREZTRI · CHARTIS CATHETER · CUVITRU · DUPIXENT · Da Vinci Surgical System · Epclusa · FASENRA · Fetroja · GLASSIA · HYQVIA · IMFINZI · LOREEV XR · NUCALA · NUZYRA · OFEV · Prolastin-C Liquid · STIOLTO RESPIMAT · Saxenda · Sunosi · TAVNEOS · TEZSPIRE · TRELEGY ELLIPTA · TRINTELLIX · TRULICITY · TYVASO · UPTRAVI · XARELTO · XIFAXAN · XYWAV · YUPELRI
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
1,151
Per 100K population
36.4
County median income
$113,702
Nearest hospital
ALISO RIDGE BEHAVIORAL HEALTH, LLC
6.8 mi
6.8 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 2024 |
| 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. Patel is a clinical cardiology specialist, with above-average Medicare volume (top 13% in CA), with low-engagement industry engagement in the top 19% of CA peers.
This summary is auto-generated from federal data, describing data availability and patterns. Read our methodology →
Frequently Asked Questions
Is Dr. Patel experienced with hospital follow-up visit, high complexity?
Based on Medicare claims data, Dr. Patel performed 711 hospital follow-up visit, high complexity 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. Patel receive payments from pharmaceutical companies?
Yes. Dr. Patel received a total of $3,716 from 26 companies across 113 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. Patel's costs compare to other internal medicine physicians in San Juan Capistrano?
Dr. Patel's average Medicare payment per service is $109. 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. Patel) 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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