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

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

Milan Shah (NPI 1104901644)

Field	Value
Entity Type	Individual
Organization	Milan Shah
Address	11220 Illinois St Ste 120
City	Carmel
State	IN
ZIP	46032
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	October 25, 2006

Payer Source	Total Paid
Medicare	$1.6M
Medicaid	$0

Key Findings

This provider is effectively a single‑payer Medicare operator: Total Medicare revenue: $1.6M and there is no Medicaid billing on file, so the practice’s revenue exposure is concentrated in Medicare rather than a dual Medicare/Medicaid mix. That single‑payer profile reduces direct Medicaid-facing leverage and means payer contracting or coverage decisions will largely hinge on Medicare activity and utilization patterns.

Revenue concentration is extreme: the precomputed top 3 Medicare codes account for 84.2% of this provider's total Medicare revenue, with J0178 alone accounting for $1.1M (71.7% of Medicare revenue). Such concentration around a small set of codes indicates that shifts in treatment patterns, drug pricing, or formulary placement for those services would have outsized impact on this provider’s financials.

The code mix and volumes identify a retina/injection‑centric practice model. High utilization of J0178 (1.7K claims, $689 avg paid/claim) together with notable claim volumes in 67028 (1.6K claims) and intravitreal biologic codes (J2778, J2777) point to routine, high‑frequency intravitreal injections and related retina procedures as the core service line. Supportive diagnostic and imaging activity is present — 92134 has 2.3K claims — consistent with ongoing retinal disease management and monitoring.

Clinical service standing varies by code: for J0178 the provider ranks #715 of 3204 nationally (78th percentile) and is described as typical/unremarkable volume for that drug despite its dominant revenue share, so the provider’s aflibercept usage appears common among peers. By contrast, 92134 (2.3K claims) is an extreme outlier, ranking #786 of 26868 providers nationally (97th percentile), indicating unusually high use of retinal imaging relative to peers and suggesting a practice workflow that heavily emphasizes diagnostic imaging.

Several codes show statistically elevated activity: J3590 (936 claims, $62.7K revenue) ranks #18 of 631 providers nationally (97th percentile) and is labeled notably above typical national volume, and 99213 visits rank in the 97th percentile nationally. These elevated ranks for an unclassified biologic code (J3590) and routine office visits (99213) suggest concentrated billing patterns beyond just the primary injection code and may reflect ancillary services bundled with injection care.

Other high‑cost procedural codes appear but at modest frequency: surgical retinal procedures such as 67041 and 67042 appear with 11 claims each and generate small shares of revenue ($9.1K and $8.5K respectively), indicating the provider performs some surgical retinal work but that surgery is not the primary revenue driver. This reinforces the characterization of the practice as primarily injection‑and‑clinic driven rather than surgery‑focused.

Competitive implication: nationally the provider is a modest to strong participant on select services — typical/unremarkable national volume for the dominant drug J0178, but extreme or notably above‑typical placement for diagnostic imaging and certain ancillary codes. That mixed competitive standing means payers should treat the provider as a high‑volume retina clinic for imaging and injection‑based care, but not necessarily as a top national aflibercept prescriber by raw ranking.

Tenure and stability: the NPI was enumerated on 2006-10-25 (~20 years ago), indicating long‑standing clinical presence. Combined with concentrated Medicare revenue and no Medicaid billing, this suggests an established, Medicare‑focused retina practice whose economics are sensitive to changes in intravitreal biologic utilization, imaging reimbursement, or Medicare policy affecting ophthalmology services.

Medicare: Complete Services Breakdown

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,660	$690	$1.1M
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.	1,620	$80	$136.1K
J3590	Unclassified biologics	940	$70	$62.7K
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.	2,300	$30	$62.1K
J2778	Injection, ranibizumab, 0.1 mg	230	$180	$41.3K
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…	680	$60	$39.5K
J2777	Injection, faricimab‑svoa, 0.1 mg	1,320	$30	$38.3K
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…	280	$90	$25.2K
99204	The provider sees a new 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 provider…	100	$120	$11.2K
67041	In this procedure, the provider removes scar tissue from the retinal membrane that obscures vision. He removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical…	10	$830	$9.1K

Showing 1–10 of 17

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Indiana Distribution

Milan Shah — 2 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. state median

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	17	60	830	$690	$868.8K
J2777	37	40	6,750	$30	$395.6K
J2778	12	10	560	$180	$150K
67028	16	80	550	$80	$78.6K
67042	14	20	20	$1,310	$47K
J3590	5	50	220	$60	$24.5K
67041	14	10	20	$1,000	$22K
92235	17	40	90	$100	$15.8K
99214	2,462	10,540	110	$80	$15.5K
99213	263	10,820	80	$50	$7.6K

Showing 1–10 of 17

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aspire Indiana Inc.	IN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$26.2M
Landmark Recovery Of Carmel LLC	IN	Substance Abuse Rehabilitation Facility	$0	$26.2M
Little Star Center, Inc.	IN	Early Intervention Provider Agency	$0	$22.7M
Arrow Consultation Services, Inc.	IN	Developmentally Disabled Services Day Training Agency	$0	$10.5M
Indiana University Health North Hospital Inc	IN	General Acute Care Hospital	$0	$6.9M
Option Care Enterprises, Inc.	IN	Home Infusion Therapy Pharmacy	$0	$5.2M
Impact Physician Group, Indiana LLC	IN	Internal Medicine Physician	$0	$4.2M
Westmed, LLC	IN	Durable Medical Equipment & Medical Supplies	$0	$4M
Chinthala, PC	IN	Psychiatry Physician	$0	$3.9M
American Health Network Of Indiana, LLC	IN	Clinical Medical Laboratory	$2.2M	$1.6M

Milan Shah — Billing Profile & Reimbursement Data

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Milan 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

Nearby Providers

Frequently Asked Questions

References