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

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

Vishal Verma (NPI 1316131865)

Field	Value
Entity Type	Individual
Organization	Vishal Verma
Address	5187 Us Route 60
City	Huntington
State	WV
ZIP	25705
Taxonomy	Ophthalmology Physician
NPI Enumerated	August 28, 2007

Payer Source	Total Paid
Medicare	$419.8K
Medicaid	$0

Key Findings

This provider is effectively single‑payer within the dataset: total Medicare revenue is $419.8K and there is no Medicaid billing on file. The absence of Medicaid activity indicates the analytics here reflect a Medicare-dominated patient mix rather than a balanced payer portfolio.

Revenue is highly concentrated in a small set of procedures: the precomputed top‑3 codes account for 77.6% of this provider’s Medicare revenue, driven primarily by 66984 which alone represents $221.3K (52.7% of Medicare revenue). This concentration implies that a few high‑value procedures determine the majority of cash flow for this provider.

The code mix points to a cataract‑focused surgical practice supported by office and diagnostic work: 66984 (cataract extraction with IOL insertion), 66821 (YAG capsulotomy for secondary membranous cataract), and 66982 (complex cataract with IOL) are the dominant procedures reported. Supporting services such as biometry and retinal imaging (92136, 92134) and higher‑level E/M visits are present, consistent with a workflow that combines surgery, preoperative diagnostics, and postoperative care.

Office evaluation patterns are notable for unusually high new‑patient visits: 99204 appears with 438 claims and $46.4K in revenue (11.1% of Medicare revenue) and is flagged as an extreme outlier (ranks #316 of 227068, 100th percentile; extreme outlier, far above typical national volume for this code). That elevated new‑patient E/M volume suggests strong referral inflow or a practice configuration that funnels new consults into surgical evaluation.

Diagnostic and measurement services show above‑typical volume that aligns with surgical throughput: 92136 (biometry) accounts for 805 claims and $12.9K (3.1% of Medicare revenue) and ranks in the 98th percentile (notably above typical national volume for this code). High utilization of biometry and imaging supports the high share of intraocular procedures and indicates operational capacity for cataract case planning.

Competitive standing for the core surgical code is above average but not dominant: 66984 ranks #2498 of 15965 providers nationally (84th percentile; typical, unremarkable volume for this code), indicating higher‑than‑median surgical activity but still within the broad range of peers. By contrast, postoperative laser care (66821) ranks #892 of 10087 (91th percentile; typical, unremarkable volume for this code), showing relatively stronger positioning for YAG capsulotomy within the national peer set.

The practice shows consistent surgical depth beyond the single dominant CPT: 66982 (complex cataract) contributes $30K (7.1% of Medicare revenue) and ranks #800 of 4580 (82th percentile; typical, unremarkable volume), reflecting capacity to manage more complex cataract cases in addition to standard extractions. Together with the imaging and E/M mix, this pattern suggests an integrated surgical and clinic model rather than a purely consultative or diagnostic practice.

Operational and payer‑risk observation: because Medicare represents essentially all billed revenue here and top codes are heavily concentrated (top three = 77.6%), the provider’s financial and referral stability may be sensitive to changes in cataract reimbursement or referral sources. The lack of Medicaid billing also means there is little revenue diversification to buffer payer‑specific shocks or local policy shifts.

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
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	650	$340	$221.3K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	200	$290	$58.1K
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…	440	$110	$46.4K
66982	The provider inserts an intraocular lens prosthesis after extracapsular cataract extraction using complex techniques and devices. He may perform this by means of an iris expansion device, providing…	60	$490	$30K
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…	210	$90	$18.1K
92136	The provider uses a noninvasive method to measure the patient’s eye or eyes to get information that the provider then uses to calculate the appropriate power for an intraocular lens (IOL). Selecting…	810	$20	$12.9K
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.	460	$30	$12K
65820	The provider incises the limbus to improve drainage of aqueous humor in the eye. This procedure is typically performed on children, usually to treat congenital glaucoma.	20	$560	$11.2K
92133	The provider performs computerized diagnostic imaging of the optic nerve in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both…	130	$20	$3K
92083	The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for an extended…	50	$40	$2.1K

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.

View: State1 / 2

Claims Volume vs. West Virginia Distribution

Vishal Verma — 2 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. state median

14 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
66984	29	90	210	$70	$60.7K
66982	7	30	30	$400	$17.9K
92014	171	180	120	$70	$16.3K
66821	4	50	50	$190	$16.2K
99214	702	2,740	100	$70	$11.8K
65820	2	10	20	$560	$11.7K
99213	2,695	2,860	80	$50	$7.5K
92136	1	40	160	$20	$6.1K
92134	14	160	60	$30	$5.4K
99204	1	1,220	30	$100	$4.1K

Showing 1–10 of 14

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Pediatric Associates, Inc.	IN	Pediatrics Physician	$0	$98.3M
University Physicians & Surgeons, Inc	WV	Internal Medicine Physician	$0	$58.3M
University Physicians & Surgeons, Inc.	WV	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$9.4M
William Myer	WV	Oral and Maxillofacial Surgery (Dentist)	$0	$774.1K
Robin Arora	WV	Nephrology Physician	$392.5K	$0
Jonathan Cuda	TN	Anatomic Pathology Physician	$326.7K	$0
Rabah Boukhemis	WV	Physical Medicine & Rehabilitation Physician	$210.6K	$0
Matthew Bullock	WV	Adult Reconstructive Orthopaedic Surgery Physician	$207.9K	$0
Cynthia Pinson	WV	Family Medicine Physician	$206.4K	$0
Alexander Caughran	WV	Orthopaedic Surgery Physician	$175.4K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ncgcare Acquisition, LLC	WV	Psychiatry Physician	$0	$40.3M
Prestera Center For Mental Health Services, Inc	WV	Community/Behavioral Health Agency	$0	$18.7M
Radiology Inc	WV	Diagnostic Radiology Physician	$0	$15.2M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$13.2M
Prestera Center For Mental Health Services, Inc	WV	Developmental Disabilities Clinic/Center	$0	$13M
St. Mary's Himg, LLC	WV	Internal Medicine Physician	$0	$2.6M
Associates In Psychology And Therapy, Inc.	WV	Psychologist	$0	$1.5M
Valley Health Systems, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.4M
Ultimate Health Services Inc	WV	Family Medicine Physician	$0	$908.1K
Ahmed Abdelgaber	WV	Family Medicine Physician	$377.5K	$0

Vishal Verma — 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