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

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

Nehal Gandhi (NPI 1295909919)

Field	Value
Entity Type	Individual
Organization	Nehal Gandhi
Address	30 Lacrue Ave Ste 101
City	Glen Mills
State	PA
ZIP	19342
Taxonomy	Rheumatology Physician
NPI Enumerated	April 14, 2008

Payer Source	Total Paid
Medicare	$8M
Medicaid	$0

Key Findings

This provider's Medicare-centric revenue profile is large and concentrated: total Medicare revenue is $8M while there is no Medicaid billing on file, making the practice effectively single-payer (Medicare) in the available claims data. The absence of Medicaid billing suggests the provider either does not enroll in or does not bill state Medicaid programs, or that their patient panel skews heavily to Medicare-aged beneficiaries and commercial payers not shown here.

Revenue concentration is extreme at the procedure level: the precomputed top 3 Medicare codes by revenue account for 65.7% of this provider's total Medicare revenue, driven primarily by J0129 (30.4%), J0717 (25.0%), and J3262 (10.3%). This concentration indicates that a small set of biologic drug administrations dominates the practice's Medicare receipts and therefore its operational focus.

The code mix is consistent with a rheumatology practice that operates an infusion/administration service line: leading codes are biologic injections such as J0129 (abatacept), J0717 (certolizumab pegol), J3262 (tocilizumab), J1745 (infliximab) and J1602 (golimumab), and high-volume administration codes like 96413 and 96401 appear on the roster. Together these codes indicate routine parenteral biologic therapy and chemotherapy/infusion workflows rather than a pure office-only E/M practice.

Competitive standing for key biologics is nationally prominent: J0129 is ranked #2 of 1221 providers (100th percentile; extreme outlier) and J0717 is ranked #2 of 848 providers (100th percentile; extreme outlier), while J3262 ranks #11 of 618 providers (98th percentile; extreme outlier). Several other biologic and infusion codes (for example J1745 at rank #5 of 1352, 100th percentile) also sit at the highest national percentiles, indicating this provider is a major, high-volume national outlier for multiple infusion drugs.

Operational implications from add-on and infusion-duration codes reinforce the presence of an infusion suite: 96415 (add-on infusion time) appears with 612 claims and is ranked #36 of 4959 providers (99th percentile; extreme outlier), and both 96413 and 96401 show high ranks and revenue contributions. High volume on these time-based infusion codes suggests sustained chair-time per patient and the need for staffing, infusion nursing, and drug-handling infrastructure to support prolonged IV biologic administrations.

Clinical mix still includes substantial office-based care and minor procedures: 99214 contributes $193.1K (2.4%) and ranks #1501 of 479517 providers (100th percentile; extreme outlier), indicating significant established-patient outpatient visits accompany infusion services. Procedural codes such as 20610 and smaller joint injection codes are present at volumes described as notably above typical national volume, consistent with combined clinic + procedure workflows common in rheumatology practices.

Financial and payer-risk considerations: because $8M of reported revenue is concentrated in Medicare and no Medicaid billing is reported, the practice's revenue is vulnerable to Medicare policy and drug-pricing/reimbursement changes affecting high-volume biologics. Strategic shifts in Medicare coverage, step-therapy rules, or biosimilar uptake could materially change top-line revenue given the concentration in a few drug-administration codes.

Tenure and market standing support the mature, infusion-focused operation: the NPI was enumerated 2008-04-14 (~18 years ago), indicating long-standing enrollment that aligns with the high cumulative volumes and national-ranking outlier status observed across multiple biologic and infusion codes. Continued high ranks across years of billing suggest an established referral and operational footprint for infusion-based rheumatology care.

Medicare: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0129	Injection, abatacept, 10 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)	72,580	$30	$2.5M
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)	507,600	$1	$2M
J3262	Injection, tocilizumab, 1 mg	166,830	$10	$834.1K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	29,090	$30	$727.3K
J1602	Injection, golimumab, 1 mg, for intravenous use	57,850	$10	$578.5K
J0897	Injection, denosumab, 1 mg	20,040	$20	$360.7K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	2,200	$110	$232.9K
Q5104	Injection, infliximab-abda, biosimilar, (renflexis), 10 mg	6,750	$30	$202.5K
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…	1,930	$100	$193.1K
96401	The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient.	3,090	$60	$191.5K

Showing 1–10 of 22

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Pennsylvania Distribution

Nehal Gandhi — 13 of 22 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. state median

22 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	1	60	7,900	$30	$353.8K
J3262	1	30	45,000	$1	$268K
J0717	1	70	38,610	$1	$223.7K
J1602	2	60	11,780	$10	$181.6K
J3111	17	60	16,590	$10	$176.8K
J1745	1	80	3,630	$30	$115.4K
Q5104	1	10	1,530	$30	$97K
J0897	17	530	2,460	$20	$89.6K
J7329	16	110	3,020	$10	$29.7K
96413	1	300	140	$100	$19.8K

Showing 1–10 of 22

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Natalie Dubchak	PA	Rheumatology Physician	$847.8K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Arum Healthcare Services	PA	Home Health Agency	$0	$12.5M
Barry Jacobson	PA	Obstetrics & Gynecology Physician	$3M	$0
Anthony Rooklin	PA	Allergy & Immunology Physician	$1.3M	$0
David Thomas	PA	Neurology Physician	$477.3K	$0
Eric Smith	PA	Orthopaedic Surgery Physician	$430.7K	$0
Kari Boucher	PA	Dermatology Physician	$312.2K	$0
Sarah Tonelli	PA	Dermatology Physician	$302.6K	$0
Robin Scheiner	PA	Dermatology Physician	$286K	$0
Lisa Carroll	PA	Dermatology Physician	$258.7K	$0
John Luksch	PA	Sports Medicine (Family Medicine) Physician	$239.1K	$0

Nehal Gandhi — Billing Profile & Reimbursement Data

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Nehal Gandhi — 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