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 Oregon for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Oregon 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. Oregon (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.

Apurva Patel (NPI 1073770707)

Field	Value
Entity Type	Individual
Organization	Apurva Patel
Address	5440 Sw Westgate Dr Ste 217
City	Portland
State	OR
ZIP	97221
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	May 20, 2008

Payer Source	Total Paid
Medicare	$1.2M
Medicaid	$0

Key Findings

This provider is a Retina Specialist whose Medicare billing is heavily weighted toward intravitreal drug therapy and related procedures. The single highest-revenue code is J0178 (aflibercept) with $606.2K revenue (50.9% of the provider's total Medicare revenue), followed by J2777 with $214K (18.0%) and 67028 with $109.3K (9.2%); the top 3 codes together account for 78.0% of this provider's total Medicare revenue, indicating a clinic model centered on repeated in-office injections and drug administration.

The overall Medicare footprint is $1.2M in lifetime revenue while there is no Medicaid billing on file, so the provider effectively operates as a Medicare-focused practice for public payers. That payer mix concentration means analyses of state Medicaid penetration or dual-eligible exposure will find no direct Medicaid billing to evaluate for this NPI.

Code-level patterns reinforce an injection-centric practice. J0178 shows 876 claims at $692 avg paid/claim for $606.2K revenue and ranks #1416 of 3204 providers nationally (56th percentile; typical, unremarkable volume for this code), while 67028 shows 1.1K claims at $98 avg paid/claim for $109.3K revenue and ranks #1242 of 4255 providers nationally (71th percentile; typical, unremarkable volume for this code), together signaling routine intravitreal procedures as a primary service line.

J2777 (faricimab) presents an unusual claims profile with 7.4K claims at $29 avg paid/claim generating $214K revenue (18.0% of Medicare revenue) and ranks #1234 of 2039 providers nationally (39th percentile; typical, unremarkable volume for this code). The combination of a high claim count and a low per-claim average is consistent with frequent, low-unit-price billing for a high-volume injectable therapy, reinforcing a drug-administration workflow.

Several non-drug codes show above-typical national utilization that complements the injection workflow. 92134 (retinal imaging) produced $43.9K (3.7% of Medicare revenue) and ranks #1625 of 26868 providers nationally (94th percentile; notably above typical national volume for this code), and 99213 (established office visits) produced $40.4K (3.4%) and ranks #18198 of 457151 providers nationally (96th percentile; notably above typical national volume for this code), indicating the practice pairs frequent injections with retinal imaging and routine follow-up visits at rates above most peers.

There is also meaningful revenue from other injectable/drug-related codes and compounding: J2778 (ranibizumab) generated $96.3K (8.1%) and ranks #699 of 1208 providers nationally (42th percentile; typical, unremarkable volume), while J7999 (compounded drug) generated $51.7K (4.3%) and ranks #85 of 1333 providers nationally (94th percentile; typical, unremarkable volume). The presence of J7999 at a high national rank suggests comparatively elevated use of compounded or miscellaneous drug billing in this practice relative to peers.

From a competitive-standing perspective, the provider is not a national outlier for the highest-revenue anti-VEGF code: J0178 sits at the 56th percentile nationally (rank #1416 of 3204) and J2777 is at the 39th percentile (rank #1234 of 2039), which together indicate a modest, regionally typical participation in anti-VEGF administration rather than market leadership on those drugs. At the same time, imaging and routine E&M volumes (92134 and 99213) are well above typical national volumes, suggesting the provider captures more diagnostic and follow-up activity per injection than many peers.

The NPI was enumerated on 2008-05-20 (~18 years ago), indicating a long-established billing history. Combined with a concentrated $1.2M Medicare lifetime revenue and no Medicaid billing on file, this tenure likely reflects a stable, Medicare-centered referral and service pattern that should be considered when assessing network fit or when modeling incremental Medicaid revenue opportunities for this clinician.

Medicare: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	880	$690	$606.2K
J2777	Injection, faricimab‑svoa, 0.1 mg	7,380	$30	$214K
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.	1,120	$100	$109.3K
J2778	Injection, ranibizumab, 0.1 mg	540	$180	$96.3K
J7999	Compounded drug, not otherwise classified	710	$70	$51.7K
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.	1,420	$30	$43.9K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	620	$70	$40.4K
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…	90	$100	$8.6K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	60	$100	$6K
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…	60	$90	$5.5K

Showing 1–10 of 13

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Oregon Distribution

Apurva Patel — 1 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. state median

13 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	30	60	840	$680	$623.7K
J2777	26	30	10,050	$30	$527.6K
J2778	7	20	400	$180	$87.8K
67028	21	70	580	$90	$72.3K
J7999	8	50	270	$70	$23.4K
92014	281	440	110	$80	$16K
92235	23	30	60	$100	$11.1K
99214	2,853	6,070	80	$70	$10.3K
92134	28	390	80	$30	$8.1K
99213	92	5,480	60	$50	$5.7K

Showing 1–10 of 13

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
New York Eye & Ear Infirmary	NY	Special Hospital	$0	$38.9M
Jonathan Feistmann	NY	Ophthalmology Physician	$2.7M	$3.1M
Brian Campolattaro	NY	Pediatric Ophthalmology and Strabismus Specialist Physician Physician	$122.7K	$4.2M
Brooke Nesmith	KS	Retina Specialist (Ophthalmology) Physician	$3.7M	$0
Llewelyn Rao	OH	Retina Specialist (Ophthalmology) Physician	$3.7M	$0
Juan Romero	NY	Ophthalmology Physician	$3.1M	$441.8K
Vatsal Doshi	NJ	Retina Specialist (Ophthalmology) Physician	$2.2M	$130
Eric Fitz	NY	Ophthalmology Physician	$2.2M	$1.3K
Jessica Lee	NY	Ophthalmology Physician	$1.9M	$120.9K
Retina Northwest P.C.	OR	Ophthalmology Physician	$0	$1.8M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lifeworks Nw	OR	Mental Health Counselor	$0	$57.6M
Lifeworks Northwest	OR	Addiction (Substance Use Disorder) Counselor	$0	$14.4M
Michael Lee	OR	Retina Specialist (Ophthalmology) Physician	$1.7M	$0
Wenlan Zhang	OR	Retina Specialist (Ophthalmology) Physician	$1.5M	$0
Harpal Sandhu	OR	Retina Specialist (Ophthalmology) Physician	$1.4M	$4.5K
Paul Tlucek	OR	Retina Specialist (Ophthalmology) Physician	$1.2M	$0
Janani Singaravelu	OR	Ophthalmology Physician	$35.1K	$0

Apurva Patel — 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