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

Why is the Medicaid comparison limited to Unspecified Location 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. Unspecified Location (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.

Viren Shah (NPI 1306903265)

Field	Value
Entity Type	Individual
Organization	Viren Shah
Address	1235 Lakepoint Pkwy Suite 101
City	Sugarland
State	XX (Unspecified Location)
ZIP	77478
Taxonomy	Internal Medicine Physician
NPI Enumerated	January 2, 2007

Payer Source	Total Paid
Medicare	$136.8K
Medicaid	$0

Key Findings

This provider is effectively a single-payer Medicare practitioner: lifetime Medicare revenue is $136.8K and there is no Medicaid billing on file. The NPI was enumerated 2007-01-02 (~19 years ago), so despite long tenure the overall Medicare billing footprint is relatively modest in scale compared with many peers.

Revenue is highly concentrated in a few office-based evaluation and management and preventive codes: the precomputed top 3 Medicare codes account for 76.1% of this provider's total Medicare revenue. Specifically, 99214 alone represents $52.9K (38.6% of Medicare revenue), while G0439 accounts for $26K (19.0%) and 99213 $25.4K (18.5%), signaling dependence on established-patient visits and annual wellness visits.

The code mix and volumes point to a primary care / internal medicine practice model focused on longitudinal chronic care and prevention. High counts for 99214 (637 claims) and 99213 (403 claims), together with 217 claims for G0439 (annual wellness visits), indicate routine management of established patients and a steady delivery of AWVs and prevention planning.

On competitive standing, 99214 ranks #31723 of 479517 providers nationally (93th percentile; notably above typical national volume for this code), which suggests this provider has unusually strong national-level volume for moderate-complexity established visits. By contrast, both G0439 (rank #9783 of 105855, 91th percentile; typical, unremarkable volume for this code) and 99213 (rank #38580 of 457151, 92th percentile; typical, unremarkable volume for this code) are high-percentile but described as typical volumes, indicating solid activity without being extreme outliers for those services.

Clinical services beyond routine E/M appear in the mix: 99497 (227 claims, $12.5K, 9.1% of Medicare revenue) shows substantial use of advance care planning, and 99495 (29 claims, $4.4K, 3.2%) indicates some transitional care management activity. Behavioral counseling and prevention codes such as G0447 (220 claims, $5.3K, 3.9%) and 99407 (54 claims, $1.4K, 1.0%) further show a practice offering structured counseling (obesity and tobacco) alongside primary care visits.

The provider shows limited billing for the highest-intensity office visits: 99215 has only 21 claims and $2.8K in revenue (2.0% of Medicare revenue) and ranks #105503 of 145531 providers nationally (26th percentile; typical, unremarkable volume for this code). This suggests most visits are moderate rather than high complexity, reinforcing a steady primary care panel rather than a high-acuity specialty role.

Preventive and routine services are a consistent part of the business profile: vaccination and screening codes such as 90674 (51 claims, $1.7K, 1.2%), G0008 (52 claims, $1.6K, 1.2%), and G0444 (58 claims, $986, 0.7%) indicate the practice incorporates immunization and depression screening into its workflow. These counts support the interpretation that AWVs and preventive workflows are meaningful revenue and service drivers alongside chronic care E/M.

From a payer-mix and strategic risk perspective, the absence of Medicaid billing means this provider’s commercial or Medicare Advantage exposure (not shown) would determine non-Medicare volume, but based on available data the practice is heavily weighted toward Medicare and to a concentrated set of E/M and preventive codes. That concentration (top 3 = 76.1%) heightens sensitivity of total revenue to changes in utilization or reimbursement for those specific services.

Medicare: Complete Services Breakdown

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	640	$80	$52.9K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	220	$120	$26K
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…	400	$60	$25.4K
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	230	$60	$12.5K
G0447	Face-to-face behavioral counseling for obesity, 15 minutes	220	$20	$5.3K
99495	The provider manages the care of a patient during the transition to home care after discharge from a healthcare facility. The patient’s care requires at least moderate medical decision making,…	30	$150	$4.4K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	20	$130	$2.8K
90674	This code represents a flu vaccine product that protects against four strains of influenza. It is derived from cell cultures, contains no preservatives or antibiotics, and is administered as a 0.5 mL…	50	$30	$1.7K
G0008	Administration of influenza virus vaccine	50	$30	$1.6K
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	$120	$1.5K

Showing 1–10 of 14

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes. Note: this provider's state, "XX," is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; the State panel below benchmarks against other providers coded under the same designation.

View: State1 / 2

Claims Volume vs. Unspecified Location Distribution

Viren Shah — 3 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Unspecified Location

Full comparison — all codes billed, vs. state median

14 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0439	1	10	160	$130	$20.5K
99213	4	10	140	$60	$18.8K
99214	1	10	80	$90	$15.8K
99215	3	10	60	$110	$13.3K
99497	1	10	230	$50	$12.5K
G0447	1	10	220	$20	$5.2K
99495	2	10	30	$140	$4.4K
99204	6	10	20	$120	$2.8K
90674	1	10	50	$30	$1.7K
99407	1	10	50	$30	$1.4K

Showing 1–10 of 14

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Miracle Hands Healthcare Services	TX	Home Health Agency	$0	$65.9M
Night-light After Hours Pediatrics PLLC	TX	Urgent Care Clinic/Center	$0	$35.1M
Incarnation Home Health Services,inc,	TX	Home Health Agency	$0	$32.3M
Med-source Healthcare Services, Inc	TX	Home Health Agency	$0	$28.4M
D & D Care Homes, Inc.	TX	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$14.6M
Quintessence Healthcare, Inc	TX	Home Health Agency	$0	$11.9M
Ncj Health System Inc	TX	Home Health Agency	$0	$11.8M
K2 Holistic Healthcare Services, Inc.	TX	Home Health Agency	$0	$11.1M
Immunogenomics LLC	TX	Clinical Medical Laboratory	$227.7K	$5.6M
Topblood LLC	TX	Clinical Medical Laboratory	$4.7M	$630

Viren Shah — Billing Profile & Reimbursement Data

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Viren Shah — 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