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

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

Kishorkumar Desai (NPI 1124005038)

Key Findings

Field	Value
Entity Type	Individual
Organization	Kishorkumar Desai
Address	1830 High St Ste A
City	Hopkinsville
State	KY
ZIP	42240
Taxonomy	Rheumatology Physician
NPI Enumerated	December 30, 2005

Payer Source	Total Paid
Medicare	$1.2M
Medicaid	$0

This provider is effectively a single-payer Medicare practice: lifetime Medicare revenue is $1.2M while Medicaid activity is listed as none (no Medicaid billing on file). The absence of Medicaid billing means analyses of payer mix, access, or state-level Medicaid strategies for this NPI should focus on Medicare-only patterns.

Revenue for this provider is highly concentrated: the precomputed top 3 Medicare codes account for 94.5% of total Medicare revenue. Those top drivers are J0717 ($919.2K, 74.8% of Medicare revenue), 99213 ($122.9K, 10.0%), and J0897 ($119.9K, 9.8%), indicating most dollars come from a very small set of services.

The code mix points to a rheumatology practice built around clinic-administered biologic therapies plus high-volume follow-up visits. J0717 (injection, certolizumab pegol, used when drug is administered under direct supervision) and J0897 (injection, denosumab) together drive the drug-administration side of the business, while 99213 (established patient office visit) is the dominant E/M visit code by claim count. Supporting codes such as 96372 and 96365 for injections and initial IV infusion further support an operational model that includes on-site drug administration.

Competitive standing is strong nationally for the provider’s top services: J0717 ranks #22 of 848 providers nationally (98th percentile; notably above typical national volume for this code), and 99213 ranks #620 of 457151 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code). By contrast J0897 ranks #2007 of 10057 (80th percentile; typical, unremarkable volume), so the provider is especially prominent for certolizumab administration and high-volume established-patient visits.

Several codes are flagged as statistical outliers, which frames utilization risk and operational focus. The provider’s 99213 volume is labeled an “extreme outlier,” and 96372 is also an “extreme outlier,” indicating unusually high utilization of routine office E/M visits and injectable administration relative to peers; J0717 is “notably above typical national volume,” while other procedure codes such as J0897 and 20610 are described as typical or unremarkable. These labels suggest concentrated service-line intensity rather than broad-based procedure diversity.

Operational and financial implications flow from the drug-centric revenue mix: with $919.2K (74.8%) tied to J0717, the practice likely bears the clinical and working-capital responsibilities of clinic-administered biologics (inventory, administration workflows, and payer reimbursement management). That concentration creates sensitivity to changes in coverage, reimbursement policy, and drug pricing for certolizumab pegol in particular, and may influence negotiations or utilization-management priorities with Medicare contractors.

Service-intensity patterns suggest a follow-up-heavy outpatient workflow rather than predominantly high-complexity new consultations. The provider billed 2.2K claims for 99213 (low-level E/M) generating $122.9K (10.0% of Medicare revenue), while higher-complexity code 99214 produced $26.1K (2.1%). This mix is consistent with frequent brief follow-ups typical in chronic disease management, aligning with repeated biologic administration and monitoring.

The provider has long tenure on file, with NPI enumeration dated 2005-12-30 (~21 years ago), which supports the interpretation of an established local practice and may help explain capacity to deliver and bill substantial biologic administration services. Longevity combined with the national ranks for key codes suggests established operational processes for outpatient injection/infusion care that have scaled relative to many peers.

Medicare: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0717	Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	229,800	$1	$919.2K
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…	2,200	$60	$122.9K
J0897	Injection, denosumab, 1 mg	6,660	$20	$119.9K
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…	310	$80	$26.1K
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…	130	$110	$13.5K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	1,320	$10	$13.2K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	170	$50	$7.6K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	100	$40	$4.3K
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	1,410	$1	$1.4K
20605	In this procedure, the provider inserts a needle through the skin of a patient and into an intermediate joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may…	20	$40	$720

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lifeskills, Inc.	KY	Developmentally Disabled Services Day Training Agency	$0	$87.9M
Jennie Stuart Medical Center Inc	KY	General Acute Care Hospital	$0	$50.8M
Pennyrile Area Develpoment District	KY	Supports Brokerage Agency	$0	$24.1M
Hands Of Hope Services, LLC	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$13.5M
Acsr, Inc.	KY	Adult Day Care Clinic/Center	$0	$10.4M
Redeemed And Restored, Inc.	KY	Substance Abuse Rehabilitation Facility	$0	$4.4M
Western Ky Medical, LLC	KY	Methadone Clinic	$82.9K	$4.3M
Fairview Physicians Network LLC	KY	Family Medicine Physician	$0	$4.4M
Pennyrile Home Medical Inc	KY	Oxygen Equipment & Supplies (DME)	$0	$3.7M
Hopkinsville-christian County Ambulance Service	KY	Land Ambulance	$921.8K	$2.3M

Kishorkumar Desai — Billing Profile & Reimbursement Data

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Kishorkumar Desai — 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

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0717	2	30	46,400	$1	$288.1K
J0897	9	80	2,280	$20	$59.6K
99214	1,348	7,230	110	$70	$14.1K
99213	3	7,250	80	$50	$7.7K
20610	178	640	80	$40	$6.6K
96365	35	70	110	$40	$6.4K
99204	174	3,200	30	$100	$4.8K
36415	873	1,040	100	$10	$1.7K
20605	68	100	20	$30	$1.1K
96372	1	1,240	50	$10	$670