Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Oklahoma for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Oklahoma only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Oklahoma (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Vinay Shah (NPI 1013951409)

Field	Value
Entity Type	Individual
Organization	Vinay Shah
Address	9821 S May Ave Ste C
City	Oklahoma City
State	OK
ZIP	73159
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	June 15, 2006

Payer Source	Total Paid
Medicare	$1.7M
Medicaid	$0

Key Findings

Revenue is highly concentrated in intravitreal drug therapy: the provider’s top three Medicare codes (J0178, J2777, 67028) account for 70.6% of total Medicare revenue. J0178 alone represents $896.6K (53.4% of Medicare revenue), while J2777 accounts for $153.1K (9.1%) and 67028 for $136.1K (8.1%), indicating that aflibercept injections are the primary revenue driver. This concentration signals an injection-focused retina practice rather than a general ophthalmology clinic.

The provider’s code mix is consistent with a retina specialist practice that emphasizes frequent anti-VEGF injections and ongoing retinal monitoring. High-volume injection codes (J0178, J2777, J9035) combine with strong utilization of retina imaging (92134, $53.5K) and procedure code 67028 ($136.1K) to show a care pattern centered on medical retina management and serial follow-up. Surgical vitrectomy and retinal repair codes (e.g., 67042, 67036, 67108, 67113) appear at lower volumes and revenue, suggesting occasional surgical intervention layered on a predominantly injection-based practice.

This provider is effectively single-payer in the dataset: total Medicare revenue is $1.7M while there is no Medicaid billing on file. The absence of Medicaid activity suggests reliance on Medicare beneficiaries for billed services and limits insights into payer diversification or Medicaid-dependent service lines. Analysts should treat this profile as Medicare-dominant when modeling revenue or access implications.

Competitive standing is mixed across individual services: for the top revenue drug J0178 the provider ranks #984 of 3204 (69th percentile) which is described as typical and unremarkable national volume for that code, indicating solid but not dominant market position for aflibercept injections. In contrast, bevacizumab (J9035) ranks #72 of 1852 (96th percentile) and retinal imaging 92134 ranks #1049 of 26868 (96th percentile), both marked as above-typical utilization; these placements suggest the practice punches above its weight on imaging and use of bevacizumab relative to peers. Conversely, J2777 ranks in the 28th percentile (#1461 of 2039), reflecting relatively lower use of faricimab compared with national peers.

Several codes are statistical outliers that point to care intensity and procedure focus: 99214 is an extreme outlier (99th percentile, #4543 of 479517) indicating unusually high billing for moderate-complexity established outpatient visits, and 67228 is also an extreme outlier (98th percentile, #11 of 648) for retinal laser photocoagulation. These extreme labels imply the provider bills significantly more E&M time and certain retina procedures than typical peers, consistent with a high-touch chronic retina practice managing complex disease. Such outlier-level E&M and laser activity may reflect either a sicker referral population or a practice style emphasizing frequent face-to-face management and interventional retina care.

Chronic care and longitudinal management services are prominent: chronic care management codes 99426 and 99427 appear with notable volume and are reported at the 95th and 88th percentiles respectively, while 92134 (retinal imaging) is at the 96th percentile. This combination indicates sustained monthly or periodic management for chronic retinal conditions and a practice model built around active monitoring and care coordination. For payers, these codes suggest predictable recurring utilization that drives ongoing revenue and resource needs for care management.

Although this practice performs surgical retina procedures, those codes generate modest share of revenue compared with injections and imaging. Examples include 67042 ($21.8K), 67108 ($18K), and 67036 ($9.7K), which appear at typical national volume levels; this pattern suggests surgeries are part of the service mix but not the dominant revenue stream. Strategically, payers and health systems assessing referral networks should view this provider primarily as a high-volume medical retina and monitoring center with ancillary surgical capability.

The provider has a long tenure in the Medicare dataset, with NPI enumeration dated 2006-06-15 (~20 years ago), indicating an established practice likely with stable referral relationships and patient panel. Combined with the heavy concentration in injection therapy and high percentiles on imaging and E&M, this tenure supports the interpretation of a mature retina specialty practice that has developed a sustained Medicare-dependent service line profile.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

28 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,310	$690	$896.6K
J2777	Injection, faricimab‑svoa, 0.1 mg	5,470	$30	$153.1K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	1,660	$80	$136.1K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	1,390	$80	$117K
J9035	Injection, bevacizumab, 10 mg	1,110	$60	$62.2K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	1,980	$30	$53.5K
J7999	Compounded drug, not otherwise classified	650	$70	$42.1K
67228	In retinopathy, tiny new vessels grow profusely and fibrous tissue proliferates in between the layers of the retina, which may extend into the optic nerve and vitreous, clear gel that fills the space…	130	$240	$29.7K
99426	Clinical staff members, directed by a physician or other qualified healthcare professional, perform management and care plan services for a patient with a complex chronic condition, expected to last…	610	$40	$26.8K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	260	$90	$22.4K

Showing 1–10 of 28

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 28 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Oklahoma Distribution

Vinay Shah — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oklahoma

Full comparison — all codes billed, vs. state median

28 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	8	30	790	$690	$801.2K
J2777	16	20	23,040	$30	$781.1K
67028	10	40	720	$80	$88.9K
67042	7	10	30	$980	$37.1K
J9035	2	30	330	$50	$23.5K
67113	6	10	20	$1,090	$21.7K
67036	8	10	20	$900	$19.9K
92235	8	20	60	$100	$19.5K
67040	3	10	10	$1,220	$19.5K
67108	3	10	20	$1,020	$19.5K

Showing 1–10 of 28

Related Providers

Other providers that share a Tax Identification Number (TIN) with Vinay Shah, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chickasaw Nation Division Of Health	OK	General Acute Care Hospital	$0	$161.8M
Ou Health Partners, Inc	OK	Multi-Specialty Clinic/Center	$0	$118.5M
Board Of Regents Of The University Of Oklahoma - Ou Physicians	OK	Multi-Specialty Clinic/Center	$0	$96.6M
Chickasaw Nation Division Of Health	OK	Primary Care Clinic/Center	$0	$30.6M
Chickasaw Nation Division Of Health	OK	Primary Care Clinic/Center	$0	$18M
Chickasaw Nation Division Of Health	OK	Primary Care Clinic/Center	$0	$17.8M
Mercy Health System Corporation	WI	Multi-Specialty Clinic/Center	$0	$13.2M
Lance Scott	OK	Ophthalmology Physician	$3.7M	$0
Ravi Pandit	OK	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
Jordan Johnson	OK	Retina Specialist (Ophthalmology) Physician	$2.2M	$0

Nearby Providers

Other providers in the same ZIP code as Vinay Shah, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Little Hands Little Voices	OK	Speech-Language Pathologist	$0	$5.3M
Brandi Kammerer PLLC	OK	Family Nurse Practitioner	$0	$4.8M
Es Speech LLC	OK	Speech-Language Pathologist	$0	$4M
Fountain Of Hope Family Services, Inc.	OK	Community/Behavioral Health Agency	$0	$3M
Community Hospital LLC	OK	General Acute Care Hospital	$0	$2.6M
Weir Asc, LLC	OK	Ambulatory Surgical Clinic/Center	$1.9M	$461.3K
Board Of Regents Of The University Of Oklahoma-ou Physicians	OK	Primary Care Clinic/Center	$0	$2M
Senthil Palaniappun	OK	Vascular & Interventional Radiology Physician	$600K	$0
Danh Pham	OK	Family Medicine Physician	$546.1K	$0
Darryl Robinson	OK	Physical Medicine & Rehabilitation Physician	$222.3K	$0

Vinay Shah — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References