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

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

Himanshu Banda (NPI 1205179496)

Field	Value
Entity Type	Individual
Organization	Himanshu Banda
Address	2245 S 19th St # 200
City	Tacoma
State	WA
ZIP	98405
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	April 5, 2013

Payer Source	Total Paid
Medicare	$5.1M
Medicaid	$0

Key Findings

This provider’s billing is effectively single‑payer: reported lifetime Medicare revenue is $5.1M and there is no Medicaid billing on file. The absence of any Medicaid claims means the practice’s patient mix and revenue exposure are concentrated in Medicare beneficiaries.

Revenue is highly concentrated in a handful of intravitreal drug and injection codes: the precomputed top‑3 Medicare codes account for 81.6% of total Medicare revenue, led by J0178 ($2M, 38.6%) and J2777 ($1.9M, 37.9%), with 67028 contributing $261.2K (5.2%). This concentration indicates that a small set of procedures and drugs drive the vast majority of billed revenue and therefore performance is sensitive to utilization or reimbursement changes for these codes.

Clinical mix and service line: the code set is characteristic of a retina specialist focused on high-volume intravitreal pharmacotherapy and retina imaging. High‑revenue drug codes (J0178, J2777, J0179, J2781, J2778) together with substantial imaging codes (92134, 92250) and select retinal surgeries (67028, 67042, 67113) indicate a practice model centered on recurring injections and diagnostic follow‑up rather than large volumes of non‑retinal ophthalmology office visits.

Competitive standing for leading drug codes is strong nationally: J0178 ranks #207 of 3204 providers (94th percentile; notably above typical national volume) and J2777 ranks #59 of 2039 providers (97th percentile; notably above typical national volume). These rankings position the provider as a major national participant for aflibercept and faricimab administration, implying above‑average injection volume relative to peers.

Imaging and diagnostics are also an outlier strength: 92134 shows 2.6K claims and ranks #628 of 26868 providers (98th percentile; extreme outlier, far above typical national volume), and 92250 ranks in the 98th percentile as well. This combination of extreme imaging volume alongside high injection volume suggests robust follow‑up and monitoring capacity that supports ongoing medical retina care pathways.

Surgical and procedure volume exists but represents a much smaller share of revenue: 67028 accounts for $261.2K (5.2% of Medicare revenue) and ranks #155 of 4255 providers (96th percentile; notably above typical national volume), while vitrectomy and other retinal surgeries (67042, 67113, 67108) appear at low claim counts and single‑digit percentage shares. The practice therefore performs retinal surgery but derives the majority of Medicare revenue from injections and imaging rather than operative caseload.

Drug mix details point to reliance on newer, higher‑priced agents: aflibercept (J0178) and faricimab (J2777) together make up the majority of drug revenue, with smaller contributions from brolucizumab (J0179, $199.1K, 3.9%) and bevacizumab (J9035, $2.3K, 0.0%). For payers and procurement teams, this concentration in branded intravitreal biologics will be relevant to utilization management, contracting, and formulary strategy.

Tenure and market position: the NPI was enumerated on 2013-04-05 (~13 years ago), indicating an established practice footprint. Combined with high national percentiles on key retina injection and imaging codes, the provider likely has sustained referral streams and negotiating visibility within the Medicare market, but remains exposed to shifts in injection utilization or reimbursement due to the heavy revenue concentration.

Medicare: Complete Services Breakdown

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

27 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,850	$680	$2M
J2777	Injection, faricimab‑svoa, 0.1 mg	66,120	$30	$1.9M
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.	2,590	$100	$261.2K
J0179	Injection, brolucizumab-dbll, 1 mg	820	$240	$199.1K
J3490	Unclassified drugs	90	$1,750	$150.5K
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…	1,060	$100	$103K
J7312	Injection, dexamethasone, intravitreal implant, 0.1 mg	540	$160	$83.9K
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.	2,570	$30	$82.4K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	560	$120	$66.6K
J2778	Injection, ranibizumab, 0.1 mg	330	$180	$59.6K

Showing 1–10 of 27

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 27 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Washington Distribution

Himanshu Banda — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. state median

27 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2777	3	50	12,780	$30	$599.7K
J0178	2	90	470	$680	$597.2K
J0179	1	10	660	$240	$165.8K
J2778	20	30	510	$180	$117.1K
J2781	8	10	650	$120	$88.6K
67028	2	110	550	$90	$72.9K
J3490	24	70	70	$50	$51.2K
J7312	1	20	270	$160	$46K
67042	13	40	30	$1,190	$39.2K
67113	5	10	20	$1,240	$32.2K

Showing 1–10 of 27

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sound Retina Ps	WA	Specialist	$0	$7.4M
Mark Nelson	WA	Ophthalmology Physician	$4.3M	$0
Anthony Truxal	WA	Ophthalmology Physician	$3.7M	$0
Matthew Asano	CO	Ophthalmology Physician	$2M	$0
Kenneth Fung	WA	Ophthalmology Physician	$1.6M	$0
Barton Blackorby	MO	Retina Specialist (Ophthalmology) Physician	$1.1M	$0
Jay Haynie	WA	Optometrist	$394.5K	$0
Jacob Light	WA	Ophthalmology Physician	$166.8K	$230

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Multicare Health System	WA	General Acute Care Hospital	$0	$162.2M
Multicare Health System	WA	Children's Hospital	$0	$108.4M
Franciscan Medical Group	WA	Family Medicine Physician	$0	$92.6M
Multicare Health System	WA	Family Medicine Physician	$0	$75M
Franciscan Health System	WA	General Acute Care Hospital	$0	$44.6M
Multicare Health System	WA	Pediatrics Physician	$0	$29.4M
Western Psychological And Counseling Services LLC	WA	Clinical Psychologist	$0	$20.8M
Sound Health Medical Supply	WA	Customized Equipment (DME)	$0	$20.7M
Tra-minw P S	WA	Radiology Clinic/Center	$0	$14.5M
Advanced Lifeline Services	WA	SNF/Subacute Care Certified Respiratory Therapist	$0	$12.5M

Himanshu Banda — 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