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

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

Heather Shah (NPI 1093767493)

Field	Value
Entity Type	Individual
Organization	Heather Shah
Address	1107 14th Ave Se Ste 200
City	Decatur
State	AL
ZIP	35601
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	May 16, 2006

Payer Source	Total Paid
Medicare	$1.8M
Medicaid	$0

Key Findings

HEATHER SHAH is effectively a Medicare-focused Hematology & Oncology physician with $1.8M in lifetime Medicare revenue and no Medicaid billing on file, indicating a single-payer footprint in the available data rather than a mixed Medicaid/Medicare practice presence. The provider’s NPI was enumerated on 2006-05-16 (about 20 years ago), signaling long tenure and likely established referral relationships or practice operations in DECATUR, AL.

Revenue concentration is high: the precomputed top 3 Medicare codes by revenue account for 62.0% of this provider’s total Medicare revenue, which signals dependence on a small set of infusions and specialty injections for the majority of billings. Those top codes include J9271 (pembrolizumab), J0897 (denosumab), and Q5127 (pegfilgrastim biosimilar), reflecting a narrow set of high-value oncology/ supportive-care therapies driving receipts.

The code mix is consistent with an oncology infusion practice: J9271 (injection, pembrolizumab) is the single largest revenue contributor at $520.8K (31.0% of Medicare revenue) and J0897 (denosumab) contributes $328.3K (19.6%). Combined with Q5127 (pegfilgrastim-fpgk) at $191.9K (11.4%), the portfolio points to routine administration of checkpoint inhibitors, bone-support agents, and growth-factor supportive care rather than a primary emphasis on high-volume E/M office visits.

Competitive standing varies by code. For J0897 the provider ranks #347 of 10057 nationally (97th percentile), described as notably above typical national volume, indicating local or niche specialization in denosumab administration relative to peers. By contrast, J9271 ranks #910 of 1841 (50th percentile) and is characterized as typical/ unremarkable volume nationally, so while pembrolizumab is the top revenue driver here, the provider’s volume on that drug is not exceptional versus peers.

Several add-on and administration codes show elevated national percentiles that reflect active infusion throughput: 96375 ranks in the 97th percentile and 96411 ranks in the 96th percentile (both noted as notably above typical national volume), supporting the interpretation that this practice delivers many additional IV pushes and add-on chemotherapy administrations beyond primary doses. G0498 (infusion initiation with home pump continuation) also ranks in the 95th percentile, reinforcing a pattern of office-based infusion services with continuity into community/home settings.

Routine E/M and lab codes are present but not dominant: 99214 and 99215 together represent moderate office visit revenue ($95K and $18.5K respectively) with 99214 at the 98th percentile for national volume (notably above typical), suggesting the provider documents a substantial number of moderate-complexity established-patient visits relative to peers. Laboratory panels and basic labs (80053, 36415, 85025) appear as small revenue contributors but with high national percentile ranks (many in the mid-to-high 90s), consistent with high testing volume tied to an active infusion clinic.

The provider’s portfolio includes multiple formulations of injectable supportive and specialty agents with relatively low per-claim payments but very large claim counts for some products (e.g., J0642 shows 95.6K claims for $95.6K revenue, and J0897 and J9271 have very large claim counts), indicating operational focus on high-frequency, low-unit-price billing lines as well as several high-dollar-per-claim biologics. This mixed profile suggests a practice model that combines routine supportive injections and labs with intermittent high-cost oncology biologics.

Medicare: Complete Services Breakdown

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

80 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	12,400	$40	$520.8K
J0897	Injection, denosumab, 1 mg	18,240	$20	$328.3K
Q5127	Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg	710	$270	$191.9K
J0642	Injection, levoleucovorin (khapzory), 0.5 mg	95,560	$1	$95.6K
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…	1,040	$90	$95K
J1437	Injection, ferric derisomaltose, 10 mg	5,300	$20	$90.1K
J1568	Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg	2,470	$30	$76.6K
J1454	Injection, fosnetupitant 235 mg and palonosetron 0.25 mg	130	$340	$44K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	450	$90	$42K
G0498	Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community…	130	$180	$22.7K

Showing 1–10 of 80

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 80 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Alabama Distribution

Heather Shah — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. state median

80 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	24	30	19,900	$40	$827.2K
J1568	30	30	5,180	$30	$316.2K
Q5127	6	20	590	$270	$165.7K
J0897	10	200	3,120	$20	$97.7K
J0642	3	10	81,310	$1	$81.3K
J1437	6	40	3,000	$20	$59.1K
J1454	6	20	90	$340	$33.7K
J0881	15	30	7,720	$1	$24.1K
96413	26	150	150	$90	$20.2K
99214	148	7,330	120	$80	$16.8K

Showing 1–10 of 80

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
John Waples	AL	Medical Oncology Physician	$9.6M	$0
Marshall Schreeder	AL	Medical Oncology Physician	$3.5M	$0
Heather Brody	AL	Hematology & Oncology Physician	$3.1M	$0
Jorge Diaz	AL	Hematology & Oncology Physician	$2.6M	$0
Naveen Lobo	AL	Medical Oncology Physician	$2.4M	$0
Ali Hachem	AL	Hematology & Oncology Physician	$2.3M	$0
Daniel Schreeder	AL	Hematology & Oncology Physician	$2.3M	$0
Robert Conry	AL	Hematology & Oncology Physician	$2.1M	$0
Lakshmikanth Katragadda	AL	Hematology & Oncology Physician	$2.1M	$0
Oncology Specialties, P.C.	AL	Hematology & Oncology Physician	$0	$2M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hawkins Mccaghren Partnership	AL	General Practice Dentistry	$0	$13.5M
Encore Rehabilitation, Inc	AL	Physical Therapy Clinic/Center	$0	$8.3M
Sunbridge Home Health Care, Inc.	AL	In Home Supportive Care Agency	$0	$7.8M
H H Health System-morgan LLC	AL	General Acute Care Hospital	$0	$6.9M
Decatur Morgan Pediatrics	AL	Pediatrics Physician	$0	$3.6M
Riverside Family Health LLC	AL	Family Nurse Practitioner	$0	$3.3M
Decatur Morgan Emergency Medicine	AL	Emergency Medicine Physician	$0	$2.9M
Encore Rehabilitation, Inc.	AL	Physical Therapy Clinic/Center	$0	$2.6M
Hh Health System - Dmh Ambulance LLC	AL	Land Ambulance	$1.1M	$1.4M
Family Support Services, LLC	AL	Clinical Social Worker	$0	$1.8M

Heather Shah — Billing Profile & Reimbursement Data

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Heather 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