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

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

Dimple Modi (NPI 1205032844)

Field	Value
Entity Type	Individual
Organization	Dimple Modi
Address	550 Redmond Rd Nw
City	Rome
State	GA
ZIP	30165
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	June 21, 2007

Payer Source	Total Paid
Medicare	$2.7M
Medicaid	$0

Key Findings

This provider is effectively a Medicare-only biller at scale: lifetime Medicare revenue is $2.7M while there is no Medicaid billing on file, so payer mix is concentrated entirely in Medicare for the available data. The NPI has been enumerated since 2007-06-21 (approximately 19 years), indicating a long-tenured presence in the market.

Revenue is highly concentrated in a small set of procedure codes: the precomputed top 3 Medicare codes by revenue account for 91.3% of this provider's total Medicare revenue, led by J0178 at $1.9M (69.4% of Medicare revenue), followed by J2777 at $457.6K (16.6%) and 67028 at $144.8K (5.3%). This degree of concentration means the practice’s financial performance is driven almost entirely by intravitreal drug administration and the separate-service vitreous injection code.

The code mix and dollar distribution identify a procedure-first retina practice: J0178 (aflibercept) and J2777 (faricimab) dominate revenue, and 67028 (vitreous injection as an isolated/separate procedure) is the third-largest contributor. These codes reflect high-volume intravitreal anti-VEGF and related injection services typical of retina specialists treating retinal vascular disease and highlight a service-line built around repeat, in-office injections.

Competitive standing is uneven across services: J0178 ranks #206 of 3204 providers nationally (94th percentile) and is described as notably above typical national volume for this code, making the provider a strong national-level participant for aflibercept administration. By contrast, J2777 ranks #674 of 2039 (67th percentile) and 67028 ranks #534 of 4255 (87th percentile), both labeled as typical or unremarkable volumes, indicating leadership on aflibercept specifically but more modest positioning for other injection and newer drug codes.

Clinical support services align with a high-throughput injection workflow: retinal imaging codes such as 92134 ($31.9K; 1.2% of Medicare revenue) and 92250 ($27.6K; 1.0% of Medicare revenue) rank in the 93th and 99th percentiles respectively, with 92250 called an extreme outlier. High relative volume of fundus photography and retinal imaging suggests in-house diagnostic capacity to monitor chronic retinal disease and support frequent treatment visits.

Evaluation-and-management billing patterns show unusually high established-visit activity: 99214 generated $131.8K (4.8% of Medicare revenue) and ranks #3736 of 479517 providers nationally (99th percentile; described as an extreme outlier), while 99213 also ranks highly at the 97th percentile. These extreme/high percentiles for E/M codes indicate the practice records substantially more moderate-complexity established-office visits than most peers, consistent with frequent follow-up visits related to ongoing injection therapy.

Use of alternative injectable agents and new-patient comprehensive exams is low relative to national peers: J9035 (bevacizumab) accounts for only $1.9K and ranks in the 17th percentile, and new-patient comprehensive codes (92004, 92014, 99203/99204) appear at very low ranks and revenues. This pattern reinforces that the practice is focused on treating established retinal patients with in-office pharmacologic therapy rather than on new-patient intake or bevacizumab-based treatment pathways.

From a payer and utilization-management perspective, the practice’s financial exposure is concentrated: with 91.3% of Medicare revenue tied to J0178, J2777, and 67028, changes in drug selection, reimbursement, or clinical pathways for intravitreal injections could materially affect revenue. Given the provider’s high national percentile for J0178 and elevated E/M and imaging volumes, payers evaluating this profile should consider that most encounters are treatment- and monitoring-focused rather than diversified across broader ophthalmology services.

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	2,860	$670	$1.9M
J2777	Injection, faricimab‑svoa, 0.1 mg	15,780	$30	$457.6K
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.	1,790	$80	$144.8K
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…	1,480	$90	$131.8K
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…	700	$60	$41.4K
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.	1,140	$30	$31.9K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	1,060	$30	$27.6K
J9035	Injection, bevacizumab, 10 mg	40	$50	$1.9K
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…	20	$80	$1.5K
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…	10	$100	$1K

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. Georgia Distribution

Dimple Modi — 4 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. state median

13 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	3	70	970	$680	$700.6K
J2777	19	40	14,100	$30	$524.3K
67028	7	80	720	$90	$71.9K
92014	772	850	130	$80	$19.7K
99214	90	13,640	120	$80	$17.8K
J9035	63	70	120	$50	$10.3K
99213	414	13,360	80	$60	$9.2K
92134	42	620	70	$30	$7.1K
92004	587	640	40	$90	$5.9K
99204	6,980	7,260	30	$110	$5.1K

Showing 1–10 of 13

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gregory Harris	GA	Hematology & Oncology Physician	$2M	$0
Melissa Dillmon	GA	Hematology & Oncology Physician	$2M	$0
Dilawar Khan	GA	Hematology & Oncology Physician	$1.9M	$0
Jeffrey Peller	GA	Rheumatology Physician	$1.1M	$0
Harbin Clinic, LLC	GA	Ambulatory Surgical Clinic/Center	$754.6K	$0
Matthew Mumber	GA	Radiation Oncology Physician	$636.9K	$0
Rahul Garg	GA	Cardiovascular Disease Physician	$605K	$0
John Abdou	GA	Radiation Oncology Physician	$601.9K	$0
Charles Baggett	GA	Cardiovascular Disease Physician	$470.3K	$0
Nzeadibenma Uzochukwu	IL	Diagnostic Radiology Physician	$84K	$360.8K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dr. Miniyars Pediatrics, P.C.	GA	Pediatrics Physician	$0	$18.8M
Floyd Physicians, LLC	GA	Neonatal-Perinatal Medicine Physician	$0	$2.6M
Ear,nose,& Throat Of Northwest Georgia	GA	Otolaryngology Physician	$0	$2M
Amtran Medical Transport Inc	GA	Land Ambulance	$1.8M	$1.7K
Floyd Healthcare Management Inc	GA	Family Medicine Physician	$0	$1.3M
Travis Whitehead	GA	Emergency Medicine Physician	$70.8K	$702.1K
Kathrine Whitehead	GA	Emergency Medicine Physician	$59.8K	$626.1K
Surgery Center Of Rome, LP	GA	Ambulatory Surgical Clinic/Center	$681.8K	$0
Jason Smith	GA	Procedural Dermatology Physician	$445K	$0
Scott Mcdaniel	GA	Professional Counselor	$0	$423.4K

Dimple Modi — 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