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

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

Sumit Nanda (NPI 1407840515)

Field	Value
Entity Type	Individual
Organization	Sumit Nanda
Address	3366 Nw Expressway
City	Oklahoma City
State	OK
ZIP	73112
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	September 2, 2005

Payer Source	Total Paid
Medicare	$4.2M
Medicaid	$0

Key Findings

Practice revenue concentration is heavily weighted toward three Medicare line items: J2777 ($2.7M, 65.7% of Medicare revenue), J0178 ($480.8K, 11.5%), and 67028 ($178.5K, 4.3%); these top three codes account for 81.5% of this provider's total Medicare revenue, indicating a narrow set of services drive the bulk of billings. This concentration suggests the financial profile is highly dependent on intravitreal drug administration and associated retinal procedures.

Clinical/service-line implications point to a retina-focused, injection-centric practice: the dominant code J2777 (faricimab injection) plus J0178 (aflibercept injection) and 67028 (isolated intravitreal injection) together imply routine, high-volume in-office anti-VEGF/anti-complement/injectable therapies and related retina follow-up. Supporting codes such as 92134 (retinal imaging) and 92235 (fluorescein angiography) further indicate integrated diagnostic imaging and procedural workflows typical of retina subspecialty care.

Payer mix is effectively single-payer Medicare: lifetime Medicare revenue is $4.2M while there is no Medicaid billing on file, so Medicaid does not meaningfully contribute to this provider's documented revenue streams. For contracting and risk-transfer considerations, this profile means payer negotiations and utilization patterns should be analyzed primarily within a Medicare context.

Competitive standing on J2777 is nationally exceptional: the provider ranks #23 of 2039 for J2777 (99th percentile) and is flagged as an "extreme outlier," marking this clinician as a major national-volume deliverer of faricimab relative to peers. By contrast, J0178 is mid-pack (rank #1583 of 3204, 51th percentile) and described as typical, while 67028 is notably above typical (rank #336 of 4255, 92th percentile), indicating a mix of both dominant and routine positions across top codes.

Multiple diagnostic and evaluation codes also show above-typical or outlier volumes, reinforcing the high-touch retina practice model: 99214 ($158.4K; ranks #1987 of 479517, 100th percentile, extreme outlier) and 92134 ($90.3K; ranks #320 of 26868, 99th percentile, extreme outlier) are substantial contributors to Medicare revenue and reflect frequent office visits and retinal imaging in the care pathway. These elevated E/M and imaging volumes are consistent with ongoing management of chronic retinal conditions requiring repeated visits and monitoring.

Surgical and ancillary services exist but comprise a smaller share of revenue: 67042 (vitrectomy with ILM peel) accounts for $51.7K and ranks #69 of 1087 (93th percentile), indicating some operative retina work is performed but it is not the primary revenue driver. Additional codes for angiography (92242), laser (67210), and fundus photography (92250) appear at modest revenue levels, suggesting a practice that combines injections, diagnostics, and occasional procedures.

The provider's national rank pattern is mixed across codes, with several extreme outlier or notably above-typical flags (J2777, 99214, 92134, 92201) that identify areas of dominant activity, and many other codes ranked in typical ranges; this profile signals a specialized, high-volume retina center for certain drugs and services while remaining conventional for others. Analysts should interpret competitive risk and referral dynamics with attention to the extreme concentration around faricimab administration.

Tenure and stability are long-standing: the NPI has been enumerated since 2005-09-02 (~21 years ago), which supports interpretation of these billing patterns as established practice behavior rather than a short-term or newly emergent billing profile. Longevity combined with high-volume J2777 activity suggests entrenched operational capacity for intravitreal drug delivery and associated chronic retinal care workflows.

Medicare: Complete Services Breakdown

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

27 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2777	Injection, faricimab‑svoa, 0.1 mg	94,620	$30	$2.7M
J0178	Injection, aflibercept, 1 mg	730	$660	$480.8K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	2,130	$80	$178.5K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	1,350	$120	$162K
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…	1,800	$90	$158.4K
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.	3,220	$30	$90.3K
J3490	Unclassified drugs	40	$1,770	$65.4K
92235	The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken…	560	$100	$52.7K
67042	In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina…	60	$850	$51.7K
92201	The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece…	2,410	$20	$43.3K

Showing 1–10 of 27

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 27 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Oklahoma Distribution

Sumit Nanda — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oklahoma

Full comparison — all codes billed, vs. state median

27 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	16	30	790	$690	$801.2K
J2777	1	20	23,040	$30	$781.1K
67028	8	40	720	$80	$88.9K
J2781	1	10	380	$120	$67.4K
67042	2	10	30	$980	$37.1K
J3490	18	30	70	$320	$24.6K
92235	2	20	60	$100	$19.5K
99214	29	5,560	130	$70	$18.4K
66821	137	220	40	$210	$15.2K
67210	1	10	30	$350	$13.1K

Showing 1–10 of 27

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Brad Simons	FL	Ophthalmology Physician	$262.6K	$4M
Rebecca Kurzon	FL	Ophthalmology Physician	$597.5K	$0
John Beneke	FL	Ophthalmology Physician	$396.3K	$17.8K
Staci Walters	FL	Optometrist	$291.2K	$0
Frank Fischer	FL	Ophthalmology Physician	$287.6K	$0
Kimberly Wise	OK	Ophthalmology Physician	$201.9K	$0
David Mills	FL	Ophthalmology Physician	$167.8K	$0
Carl Sylvester	OK	Ophthalmology Physician	$167.1K	$0
Deena Sylvester	OK	Ophthalmology Physician	$135K	$0
Maria Artigas	FL	Ophthalmology Physician	$14.1K	$2.9K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Integris Baptist Medical Center Inc	OK	General Acute Care Hospital	$0	$30.7M
Variety Care, Inc	OK	Federally Qualified Health Center (FQHC)	$0	$14.3M
Smiling Faces Pediatric Dentistry Inc	OK	General Practice Dentistry	$0	$14M
Pediatrix Medical Group Of Oklahoma, P.C.	OK	Neonatal-Perinatal Medicine Physician	$0	$11.2M
Variety Care, Inc.	OK	Federally Qualified Health Center (FQHC)	$0	$9.7M
North Oklahoma County Mental Health Center	OK	Mental Health Counselor	$0	$6.3M
Concepts In Counseling, LLC	OK	Community/Behavioral Health Agency	$0	$5.8M
Oklahoma Emergency Physicians LLC	OK	Emergency Medicine Physician	$0	$5.2M
Osu Center For Health Sciences	OK	Clinic/Center	$0	$4.8M
Your Key To Change, LLC	OK	Community/Behavioral Health Agency	$0	$4.8M

Sumit Nanda — 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