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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

Ashok Reddy (NPI 1225028228)

Field	Value
Entity Type	Individual
Organization	Ashok Reddy
Address	806 Dr Martin Luther King Jr Ave Ne
City	Albuquerque
State	NM
ZIP	87102
Taxonomy	Ophthalmology Physician
NPI Enumerated	October 21, 2005

Payer Source	Total Paid
Medicare	$3.2M
Medicaid	$0

Key Findings

This Albuquerque-based Ophthalmology Physician reports $3.2M in lifetime Medicare revenue and no Medicaid billing on file (“none below”), making the practice effectively Medicare-dependent. The provider’s NPI has been enumerated since 2005-10-21 (~21 years ago), indicating long tenure in the market.

Revenue is highly concentrated: the precomputed top three Medicare codes (J0178, J2777, J2778) account for 84.3% of this provider’s total Medicare revenue. Those three codes individually represent 55.0% (J0178), 22.5% (J2777), and 6.8% (J2778) of Medicare revenue, signaling dependence on a few high-revenue therapies.

The code mix and volumes point to a retina-focused, injection-heavy ambulatory practice: J0178 (aflibercept) shows 2.5K claims, $683 avg paid/claim, $1.7M revenue (55.0% of Medicare revenue), while J2777 (faricimab) shows 24.5K claims, $29 avg paid/claim, $709.9K revenue (22.5%). Complementary retinal services such as 67028 (1.9K claims, $90 avg, $171.8K) and 92134 (1.5K claims, $26 avg, $38.3K) further support a service-line built around intravitreal injections and retinal imaging.

Competitive standing on the top drugs is solid but not dominant: J0178 ranks #307 of 3204 providers nationally (90th percentile; typical, unremarkable volume for this code) and J2777 ranks #401 of 2039 (80th percentile; typical, unremarkable volume). J2778 ranks #368 of 1208 (70th percentile; typical, unremarkable volume), indicating the provider is a relatively high-volume injector nationally but not an extreme outlier.

Clinical intensity and diagnostic utilization are notable: 99214 appears with 871 claims, $84 avg paid/claim and $73.2K revenue (2.3% of Medicare revenue) and ranks #16012 of 479517 providers nationally (97th percentile; notably above typical national volume), while 92134 ranks #1548 of 26868 (94th percentile; notably above typical national volume). This suggests above-typical E/M coding intensity and frequent use of retinal imaging compared with peers.

Surgical retina capability exists but at modest scale: vitrectomy codes 67042 and 67041 each show 24 claims with revenues of $20.9K and $20.3K respectively, and retinal detachment repair codes 67108 and 67113 show small counts and revenue. These entries indicate the provider performs some operative retina procedures but that surgical volume is a minor portion of overall Medicare revenue.

Use of ancillary biologics and compounding is present but limited in share: J3590 (unclassified biologics) accounts for $89K (40 claims, $2226 avg) and ranks #460 of 631 providers nationally (27th percentile; typical, unremarkable volume), while J7999 (compounded drug) accounts for $27K (429 claims, $63 avg) and ranks #202 of 1333 (85th percentile; typical, unremarkable volume). Together these codes contribute small proportions of revenue and suggest occasional use of non-standard or compounded therapies alongside the primary anti-VEGF portfolio.

From a payer and network-planning perspective the absence of Medicaid activity (“none below”) combined with concentrated Medicare revenue exposes the practice to Medicare payment dynamics and specialty drug utilization patterns. Contracting or utilization-management strategies should therefore be framed around high-volume intravitreal biologics (J0178, J2777, J2778) and robust imaging/E/M activity rather than Medicaid-focused reimbursement considerations.

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	2,550	$680	$1.7M
J2777	Injection, faricimab‑svoa, 0.1 mg	24,480	$30	$709.9K
J2778	Injection, ranibizumab, 0.1 mg	1,200	$180	$214.1K
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.	1,910	$90	$171.8K
J3590	Unclassified biologics	40	$2,230	$89K
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…	870	$80	$73.2K
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.	1,470	$30	$38.3K
J7999	Compounded drug, not otherwise classified	430	$60	$27K
67042	In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina…	20	$870	$20.9K
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…	20	$840	$20.3K

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. New Mexico Distribution

Ashok Reddy — 2 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. state median

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	3	20	1,100	$690	$816.1K
J2777	5	20	17,340	$30	$653.4K
J2778	5	10	720	$180	$247.3K
J3590	3	10	30	$1,420	$97.9K
67028	4	30	390	$90	$71.6K
67041	2	10	20	$1,200	$44.5K
67042	5	10	30	$980	$31.3K
67108	2	10	10	$1,160	$23.1K
J7999	4	10	320	$60	$18.6K
92014	116	180	130	$70	$18.5K

Showing 1–10 of 17

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eye Associates Of New Mexico Ltd	NM	Ophthalmology Physician	$0	$46.9M
Jason Ysasaga	TX	Ophthalmology Physician	$9.9M	$0
Ryan Rush	TX	Ophthalmology Physician	$9.7M	$0
Christopher Fisher	OK	Internal Medicine Physician	$7.6M	$0
Antonio Aragon	TX	Ophthalmology Physician	$7.3M	$0
John Pitcher	NM	Ophthalmology Physician	$5.1M	$0
Brian Phelps	OK	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Mark Chiu	NM	Ophthalmology Physician	$3.8M	$0
Christopher Roybal	NM	Ophthalmology Physician	$3.8M	$0
Christopher Fuller	TX	Ophthalmology Physician	$3.6M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tricore Reference Laboratories	NM	Clinical Medical Laboratory	$0	$64.8M
Bright Horizons, Inc.	NM	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$46.9M
Lovelace Health System LLC	NM	General Acute Care Hospital	$0	$45.2M
Tricore Inc.	NM	Clinical Medical Laboratory	$7M	$35.8M
App Of New Mexico Ed PLLC	NM	Emergency Medicine Physician	$0	$42M
Duke City Recovery Toolbox LLC	NM	Community/Behavioral Health Agency	$108.4K	$28M
Metro Treatment Of New Mexico LP	NM	Methadone Clinic	$220.4K	$27.9M
Enchanted Care Solutions, LLC	NM	Home Health Agency	$0	$25.8M
Open Skies Healthcare	NM	Community/Behavioral Health Agency	$0	$23.8M
Krossroads Integrative Health And Recovery Solutions Inc	NM	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$16.7M

Ashok Reddy — 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