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NPI 1356482020 · Reno, NV · Hematology & Oncology Physician
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Sowjanya Reganti is a hematology & oncology physician provider located in Reno, Nevada. This profile covers 50 Medicare and 1 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Sowjanya Reganti |
| Address | 5423 Reno Corporate Dr. |
| City | Reno |
| State | NV |
| ZIP | 89511 |
| Taxonomy | Hematology & Oncology Physician |
| NPI Enumerated | February 8, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.3M |
| Medicaid | $5.3K |
Provider billing is heavily Medicare-centered: total Medicare revenue is $1.3M compared with total Medicaid revenue of $5.3K, so Medicare composes the vast majority of reported reimbursements and the provider functions effectively as a Medicare-focused oncology clinician. The Medicaid footprint is minimal in dollar terms and is limited to a small number of office visits rather than drug or infusion billing.
Revenue concentration on a few high-cost drug codes is pronounced: the precomputed top 3 Medicare codes account for 75.0% of this provider's total Medicare revenue, driven by J9271 ($430K, 33.3% of Medicare revenue), J9299 ($325.4K, 25.2% of Medicare revenue), and J0897 ($212.8K, 16.5% of Medicare revenue). This concentration indicates that reimbursement is dominated by oncology drug administration rather than a broad mix of nondrug services.
The mix of billed services is consistent with an infusion-based hematology/oncology practice: high-revenue immunotherapy codes J9271 and J9299 appear alongside chemotherapy administration codes such as 96413 and add-on infusion code 96417, and infusion-related services 96365/96375. Frequent lab and venipuncture codes (85025, 80053, 36415) further support the presence of on-site phlebotomy and monitoring capabilities typical of an oncology infusion setting.
National competitive standing for the top drug codes is modest to mixed. J9271 ranks #1186 of 1841 providers nationally (35th percentile) and is described as typical, unremarkable volume; J9299 ranks #285 of 505 nationally (44th percentile) and is likewise typical and unremarkable; by contrast J0897 ranks #858 of 10057 providers nationally (91th percentile) but is still labeled typical, unremarkable in the dataset, indicating the provider is not a dominant national player on pembrolizumab or nivolumab but shows relatively higher relative activity on denosumab within the larger peer set.
Evaluation-and-management billing is an important secondary revenue source and shows above-typical intensity for some E/M levels: 99214 contributed $99.7K (1.1K claims) and 99215 contributed $72.5K (545 claims) to Medicare revenue. Those codes rank highly nationally—99214 at #9876 of 479517 (98th percentile, noted as notably above typical national volume) and 99215 at #1561 of 145531 (99th percentile, labeled an extreme outlier)—which suggests this clinician documents and bills a high volume of moderate- and high-complexity office visits relative to peers.
The provider’s Medicaid billing is concentrated entirely in a single E/M code: 99214 accounts for 100.0% of Medicaid revenue (68 claims, $5.3K) and ranks #1724 of 2254 providers in-state (23th percentile, typical, unremarkable volume). This pattern indicates virtually no Medicaid drug or infusion billing and a small Medicaid patient base handled primarily through established-patient office visits.
Operational and payer-risk implications follow from the concentration in high-cost oncology drugs and Medicare dependence: with J9271, J9299, and J0897 driving a large share of Medicare revenue, any changes in reimbursement, prior authorization, or utilization management for these agents would materially affect revenue. The small Medicaid footprint reduces diversification across payers and means payer-policy shifts at Medicare carry outsized financial impact for this provider.
The provider has long-standing enrollment in the NPI registry (NPI enumerated: 2007-02-08 (~19 years ago)), indicating practice stability and tenure in the market; combined with the billing profile—infusion-oriented drug revenue plus high-complexity E/M volume—this points to an established hematology/oncology practice with an infusion center and substantial Medicare-dominant case flow.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
50 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J9271 | Injection, pembrolizumab, 1 mg | 10,000 | $40 | $430K |
| J9299 | Injection, nivolumab, 1 mg | 13,560 | $20 | $325.4K |
| J0897 | Injection, denosumab, 1 mg | 11,820 | $20 | $212.8K |
| 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… | 1,060 | $90 | $99.7K |
| 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… | 550 | $130 | $72.5K |
| Q5111 | Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg | 320 | $110 | $34.7K |
| 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… | 280 | $100 | $29.5K |
| J9395 | Injection, fulvestrant, 25 mg | 1,380 | $10 | $11K |
| 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… | 60 | $180 | $11K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 880 | $10 | $7K |
Showing 1–10 of 50
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 50 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
50 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J9271 | 27 | 40 | 13,000 | $40 | $625.8K |
| J9299 | 7 | 10 | 14,400 | $20 | $362K |
| J0897 | 6 | 70 | 3,630 | $20 | $94.6K |
| Q5111 | 6 | 10 | 400 | $110 | $46.4K |
| 99233 | 796 | 1,150 | 150 | $90 | $26.8K |
| 96413 | 25 | 70 | 210 | $100 | $23.7K |
| 84443 | 53 | 80 | 50 | $20 | $22.7K |
| 80053 | 39 | 100 | 160 | $10 | $22.2K |
| 99214 | 103 | 3,610 | 110 | $80 | $19K |
| 99223 | 1,165 | 1,280 | 60 | $130 | $13.7K |
Showing 1–10 of 50
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
1 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… | 70 | $80 | $5.3K |
How this provider's Medicaid billing volume and revenue compare to other Nevada providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Nevada median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 1,724 | 2,250 | 290 | $60 | $138K |
Other providers in the same ZIP code as Sowjanya Reganti, ranked by combined Medicare and Medicaid revenue.
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