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

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

Amol Kulkarni (NPI 1093754723)

Field	Value
Entity Type	Individual
Organization	Amol Kulkarni
Address	1025 Regent St
City	Madison
State	WI
ZIP	53715
Taxonomy	Ophthalmology Physician
NPI Enumerated	June 6, 2006

Payer Source	Total Paid
Medicare	$2.1M
Medicaid	$0

Key Findings

AMOL KULKARNI’s Medicare billing is heavily weighted toward intravitreal anti‑VEGF therapy and retina services: J0178 (aflibercept) accounts for $1.3M revenue (62.0% of Medicare revenue) with 1.9K claims, J2777 (faricimab) accounts for $210.7K (10.1%) with 7.3K claims, and 67028 (isolated intravitreal injection) accounts for $157.8K (7.5%) with 1.8K claims. These three codes together make up 79.6% of the provider’s Medicare revenue, indicating a practice model concentrated on recurring injection-based treatment and associated retinal care.

The provider’s overall Medicare scale is $2.1M in lifetime revenue while there is no Medicaid billing on file, so the provider is effectively single‑payer (Medicare) in the available claims data. The absence of Medicaid activity means analyses of payer mix, access for low‑income populations, or state Medicaid benchmarking cannot be performed for this provider.

Competitive standing by code is mixed: for the high‑revenue drug code J0178 the provider ranks #591 of 3204 (82th percentile) and is described as typical, unremarkable volume for this code, while J2777 ranks #1248 of 2039 (39th percentile) and is also labeled typical, unremarkable. The retinal procedure 67028 ranks #558 of 4255 (87th percentile) and is likewise labeled typical, unremarkable — together these positions suggest solid national presence in routine injection and retinal procedure volumes but not dominant market share for these specific services.

Several codes show unusually high relative volume compared with national peers: 99214 (office E/M) is labeled an extreme outlier, ranking #2642 of 479517 (99th percentile) with $147.9K revenue and 1.7K claims, and 92134 (retinal OCT imaging) is labeled an extreme outlier, ranking #550 of 26868 (98th percentile) with $72.8K revenue and 2.7K claims. These elevated E/M and imaging volumes indicate heavy visit and monitoring activity that supports frequent injection management and follow‑up care.

Other procedure and drug codes corroborate a retina/surgical retina practice mix: J9035 (bevacizumab) appears with $61.4K revenue and ranks #71 of 1852 (96th percentile) but is described as typical, unremarkable volume for that code; surgical retina procedures such as 67042 ($31.4K, 37 claims, 82th percentile) and 67108 ($14K, 16 claims, 45th percentile) are present at lower volumes. The presence of both operative and nonoperative retinal procedure codes indicates the provider offers a mix of injection management, diagnostic imaging, and occasional retina surgery.

The high concentration of revenue in a small number of drug and injection codes (top three = 79.6% of Medicare revenue) creates operational and cost implications: a majority of Medicare dollars are tied to high‑cost biologic therapies, primarily J0178 at $1.3M, so payer impact or utilization reviews of anti‑VEGF prescribing patterns could materially affect this provider’s Medicare revenue stream. From a contracting and network perspective, this profile looks like a specialized retinal injection center that depends on recurrent, drug‑driven encounters.

Tenure and stability are notable: the NPI was enumerated on 2006-06-06 (~20 years ago), indicating a long‑established practice presence in Madison, WI. That longevity combined with concentrated injection volume and high percentile imaging/E/M activity suggests an experienced retinal clinician with a stable referral and follow‑up population.

For payer/analyst monitoring, key signals to track include sustained dominance of J0178 in revenue share ($1.3M, 62.0%), persistent high E/M and OCT imaging volumes (99214 and 92134 labeled extreme outliers), and the absence of Medicaid billing. These specific, data‑backed patterns define the provider as an established Medicare‑focused retina practice whose utilization profile is driven by repeat injectable therapies and intensive monitoring rather than broad multispecialty ambulatory billing.

Medicare: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,880	$690	$1.3M
J2777	Injection, faricimab‑svoa, 0.1 mg	7,270	$30	$210.7K
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.	1,750	$90	$157.8K
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…	1,660	$90	$147.9K
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.	2,700	$30	$72.8K
J9035	Injection, bevacizumab, 10 mg	1,120	$60	$61.4K
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…	730	$60	$43.6K
67042	In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina…	40	$850	$31.4K
65800	In this procedure, the provider drains fluid from the anterior chamber of the eye and also removes thin, watery fluid that fills the space between the cornea and the iris, known as the aqueous.…	230	$90	$21.1K
67108	The provider repairs a detached retina using heat produced by a laser beam or by freezing the tissues. He may attach a scleral buckle to simplify the passage of fluid through and behind the retina or…	20	$880	$14K

Showing 1–10 of 19

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Wisconsin Distribution

Amol Kulkarni — 8 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. state median

19 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	3	60	440	$690	$488.1K
J2777	14	30	7,290	$30	$332K
67028	5	110	310	$80	$43.7K
67042	4	20	20	$870	$20.8K
67108	5	10	20	$960	$17.3K
J9035	2	70	110	$50	$14.5K
65800	1	10	140	$100	$13.3K
99214	6	9,800	80	$70	$9.2K
92134	4	600	60	$30	$4.7K
99213	45	9,380	60	$50	$4.7K

Showing 1–10 of 19

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dean Health Systems, Inc	WI	Allergy & Immunology Physician	$0	$26.3M
Dean Health Systems, Inc.	WI	Ambulatory Surgical Clinic/Center	$2M	$856.3K
Infinity Healthcare Physicians, S.c.	WI	Emergency Medicine Physician	$0	$2.5M
Dean Health Systems, Inc.	WI	Ambulatory Surgical Clinic/Center	$1.8M	$750K
Mitchell Wolf	WI	Ophthalmology Physician	$1.6M	$0
James Bell	WI	Ophthalmology Physician	$1.4M	$0
Shannon O'mahar	WI	Hematology & Oncology Physician	$1.1M	$0
Shadi Latta	IL	Hematology & Oncology Physician	$897.4K	$990
Ki Hassler	FL	Cardiovascular Disease Physician	$858.6K	$0
Joanna Zurko	WI	Internal Medicine Physician	$667.9K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Meriter Hospital, Inc.	WI	General Acute Care Hospital	$0	$25.5M
Ssm Health Care Of Wisconsin, Inc.	WI	General Acute Care Hospital	$0	$14.7M
Ssm Health Care Of Wisconsin, Inc	WI	Clinical Medical Laboratory	$0	$6.4M
Madison Surgery Center, Inc.	WI	Ambulatory Surgical Clinic/Center	$3.6M	$549.2K
Ryan Bros Ambulance LLC	WI	Land Ambulance	$1.5M	$2.3M
Madison Emergency Physicians, Sc	WI	Emergency Medicine Physician	$0	$3.2M
Emergency Medicine Associates Of Madison, Sc	WI	Emergency Medicine Physician	$0	$2.1M
Meriter Health Enterprises Inc.	WI	Clinical Medical Laboratory	$680.6K	$1M
Michelle Lakner	WI	Nurse Practitioner	$660.9K	$0
Lisa Lepeak	WI	Hematology & Oncology Physician	$488.3K	$0

Amol Kulkarni — 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