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

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

Asha Shrestha (NPI 1336378405)

Field	Value
Entity Type	Individual
Organization	Asha Shrestha
Address	12 Cromwell Dr
City	Orono
State	ME
ZIP	04473
Taxonomy	Rheumatology Physician
NPI Enumerated	July 9, 2009

Payer Source	Total Paid
Medicare	$545.4K
Medicaid	$0

Key Findings

This provider’s Medicare billing is dominated by biologic drug administration: J0129 (abatacept) accounts for $241.4K of Medicare revenue (43.7% of the provider’s Medicare total) and J3262 (tocilizumab) accounts for $120.4K (21.8%). The concentration on these high-cost injectable biologics, together with billed IV/infusion administration codes such as 96413 and 96365, indicates an on-site drug administration model common to rheumatology infusion practices.

Revenue concentration is very high: the precomputed top-three codes account for 77.3% of this provider’s total Medicare revenue, with J0129 alone representing $241.4K and J3262 $120.4K. That degree of concentration around two biologic drug codes plus a high-level E/M code signals reliance on a small set of services for the majority of Medicare dollars.

This provider is effectively single-payer from the claims available: lifetime Medicare revenue is $545.4K and there is no Medicaid billing on file. Analysts should treat this profile as Medicare-centric when modeling payer mix, network leverage, or access implications in Maine.

Competitive standing differs by service line: for biologic drug codes the provider’s volume is described as "typical, unremarkable" (J0129 ranks #713 of 1221; J3262 ranks #456 of 618), indicating a modest national presence in specialty drug administration. By contrast, office visit E/M work represented by 99214 is reported as "notably above typical national volume" (640 claims, $65.3K revenue), showing above-typical clinical visit volume relative to national peers.

The provider reports elevated volumes for higher‑intensity office visits and new-patient evaluations: 99214 (640 claims, $65.3K, 11.8% of Medicare revenue) is "notably above typical national volume" and 99204 (136 claims, $19.4K, 3.5% of Medicare revenue) likewise shows a "notably above typical" national standing. This suggests the practice manages a relatively large panel of established patients requiring moderate-complexity management and also receives a meaningful flow of new patients.

Routine monitoring and point-of-care services are present and frequently billed: blood draw and lab-related codes such as 36415 (481 claims, $3.8K), 86140 (456 claims, $2.3K), and 85652 (447 claims, $1.3K) appear among top codes and are described as typical volumes for peers. These patterns are consistent with a rheumatology practice that performs in-office lab monitoring for immunomodulatory therapy and chronic disease management.

Tenure is long enough to suggest an established practice footprint: the provider’s NPI was enumerated on 2009-07-09 (~17 years ago). That longevity, coupled with concentrated biologic drug billing and above-typical E/M volume, supports the interpretation of an experienced Rheumatology Physician operating an infusion-capable clinic rather than a transient or early-career billing profile.

Medicare: Complete Services Breakdown

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

37 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)	7,100	$30	$241.4K
J3262	Injection, tocilizumab, 1 mg	24,070	$10	$120.4K
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	$100	$65.3K
J0897	Injection, denosumab, 1 mg	1,560	$20	$29.6K
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…	210	$120	$25.8K
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…	140	$140	$19.4K
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…	140	$80	$10.2K
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…	60	$160	$8.8K
99205	The provider sees a new 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 provider…	30	$190	$5.5K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	90	$50	$4.3K

Showing 1–10 of 37

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 37 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Maine Distribution

Asha Shrestha — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. state median

37 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	2	10	6,880	$30	$207.2K
J3262	1	10	24,070	$1	$113.7K
J0897	15	20	2,730	$20	$86.4K
96413	11	30	170	$100	$20.6K
99214	17	2,500	70	$70	$7.2K
96365	23	30	90	$50	$5.6K
99215	190	780	30	$100	$4.8K
99213	409	2,350	50	$50	$4.3K
99205	90	260	20	$140	$4K
99204	16	810	30	$100	$3.6K

Showing 1–10 of 37

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Optum Medical Care, P.C.	NY	Cardiovascular Disease Physician	$0	$105.1M
Crystal Run Healthcare Physicians LLP	NY	General Practice Physician	$0	$34.1M
Long Island Digestive Endoscopy Center, LLC	NY	Ambulatory Surgical Clinic/Center	$1.6M	$1.4M
Matthew Pomykala	NY	Ophthalmology Physician	$1.7M	$1M
Howard Charles	NY	Ophthalmology Physician	$2.7M	$13.9K
Changping Jia	NY	Nuclear Imaging & Therapy Physician	$2.2M	$58.7K
Eric Fitz	NY	Ophthalmology Physician	$2.2M	$1.3K
Alexandra Pappas	NY	Ophthalmology Physician	$1.8M	$14.4K
Jeffrey Halaas	NY	Hematology & Oncology Physician	$1.6M	$0
Shaya Ansari	NY	Diagnostic Radiology Physician	$1.5M	$1K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Iam-3rivers	ME	Intellectual Disabilities Intermediate Care Facility	$0	$8M
Earth Angels Home Care LLC	ME	In Home Supportive Care Agency	$0	$980.5K
Town Of Orono	ME	Land Ambulance	$117.7K	$468.5K
Orville Hartford	ME	Dermatology Physician	$272.4K	$0
Kristen Whitney	ME	Gerontology Nurse Practitioner	$55.9K	$0
Alana Silverman	ME	Surgical Physician Assistant	$51.7K	$0
Randy Cyr	ME	Physical Therapist	$51.7K	$0
Walter Doerfler	ME	Family Medicine Physician	$41.5K	$0

Asha Shrestha — 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