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

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

Shilpa Gulati (NPI 1417375577)

Field	Value
Entity Type	Individual
Organization	Shilpa Gulati
Address	3640 Main St Ste 201
City	Springfield
State	MA
ZIP	01107
Taxonomy	Ophthalmology Physician
NPI Enumerated	April 4, 2014

Payer Source	Total Paid
Medicare	$2.4M
Medicaid	$0

Key Findings

This provider’s Medicare footprint is concentrated: lifetime Medicare revenue is $2.4M and there is no Medicaid billing on file (listed as none (no Medicaid billing on file)), making the practice effectively single‑payer with Medicare representing the entirety of reported public payor activity. Analysts should treat Medicaid-based network impact as nil when assessing payer mix or state Medicaid strategy for this NPI.

Revenue is highly concentrated in intravitreal drug codes: the precomputed top 3 Medicare codes by revenue account for 88.8% of this provider's total Medicare revenue, led by J0178 at $1.5M (62.0%), followed by J2777 at $501.1K (20.8%) and 67028 at $144.1K (6.0%). This indicates that a small set of procedure/drug codes dominate reimbursement and should be the focus of utilization reviews and contract discussions.

The code mix points to a retina-focused interventional practice: large volumes and revenues for J0178 (injection, aflibercept) and J2777 (injection, faricimab) together with elevated imaging (92134) suggest routine management of medical retinal disease with repeated intravitreal injections supported by advanced retinal imaging. Office E/M and comprehensive exam codes (e.g., 92014, 99213, 92004) appear in the portfolio but contribute much smaller shares of revenue, consistent with a procedure-centric retina service line.

On competitive standing for the highest-revenue drug, J0178 is billed at a scale above many peers but not dominant: the provider ranks #453 of 3204 nationally (86th percentile; typical, unremarkable volume for this code). That percentile places the clinician in the upper quartile of national billers for this drug class, indicating above‑average throughput of aflibercept injections relative to peers.

J2777 and 67028 show different national positions that refine the competitive view: J2777 ranks #623 of 2039 (69th percentile; typical, unremarkable volume), indicating modestly above-median use of faricimab relative to billed peers, while 67028 ranks #760 of 4255 (82th percentile; typical, unremarkable volume), suggesting relatively high utilization of isolated intravitreal injection procedure coding compared with national ophthalmologists. These rank/percentile signals support classifying the provider as a solid regional contributor rather than a national outlier for injection procedures.

There are notable statistical outliers in ancillary services that reinforce a retina practice focus: 92134 (computerized retinal imaging) shows 2.3K claims and $70.7K revenue and is labeled an "extreme outlier, far above typical national volume" at the 97th percentile, and 92004 (new patient comprehensive ophthalmological evaluation) is at the 97th percentile and described as "notably above typical national volume" with 228 claims and $25.8K revenue. High 92134 imaging volume in particular supports frequent monitoring of retinal disease and justifies contracting attention on imaging capacity and reimbursement.

Procedural diversity beyond injections exists but at much smaller scale: surgical codes such as 67042 (16 claims, $14.6K) and vitreoretinal-related procedures like 67145 (29 claims, $5.7K) are present but constitute minor portions of revenue. This mix suggests the practice performs occasional surgical or more invasive retinal interventions but is primarily structured around recurring, high-volume intravitreal pharmacologic treatment and imaging.

The provider’s NPI tenure (enumerated 2014-04-04 (~12 years ago)) indicates a stable enrollment period long enough to produce multi-year billing patterns; combined with $2.4M lifetime Medicare revenue and the heavy concentration in a few high-revenue drug codes, payers should treat this clinician as an established retina-focused Medicare provider with predictable injection and imaging utilization when modeling cost and network impact.

Medicare: Complete Services Breakdown

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,170	$690	$1.5M
J2777	Injection, faricimab‑svoa, 0.1 mg	17,280	$30	$501.1K
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.	1,530	$90	$144.1K
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.	2,280	$30	$70.7K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	720	$90	$68K
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…	470	$60	$30K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	230	$110	$25.8K
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…	240	$100	$24K
J9035	Injection, bevacizumab, 10 mg	340	$60	$18.5K
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…	20	$910	$14.6K

Showing 1–10 of 17

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Massachusetts Distribution

Shilpa Gulati — 2 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. state median

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	13	90	790	$690	$826.5K
J2777	15	50	7,080	$30	$343.1K
67028	24	120	570	$100	$80.7K
92014	146	1,070	160	$90	$30.1K
67042	15	30	20	$1,170	$25.7K
J9035	29	80	250	$50	$19.7K
99214	3,880	15,410	110	$80	$15.6K
92012	384	560	90	$70	$12.4K
92134	25	670	70	$30	$10.6K
99213	815	13,700	70	$60	$8.8K

Showing 1–10 of 17

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
David Lally	MA	Ophthalmology Physician	$3.2M	$670
Rebecca Soares	MA	Retina Specialist (Ophthalmology) Physician	$3M	$9.1K
Andrew Lam	MA	Ophthalmology Physician	$1.4M	$0
Hari Mylvaganam	MA	Ophthalmology Physician	$1.3M	$5.1K
Ronald Gailun	MA	Ophthalmology Physician	$467.8K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Center For Human Development, Inc.	MA	Community/Behavioral Health Agency	$0	$97.1M
Viecare Corp	MA	Foster Care Agency	$0	$35.5M
Andventure, LLC	MA	Home Health Agency	$0	$14.6M
Baystate Mri & Imaging Center, LLC	MA	Magnetic Resonance Imaging (MRI) Clinic/Center	$2.6M	$6.7M
Radiology & Imaging, Inc.	MA	Diagnostic Radiology Physician	$0	$5.8M
Pioneer Valley Surgicenter LLC	MA	Ambulatory Surgical Clinic/Center	$429.2K	$614.8K
Sidney Kahn Iv	MA	Vascular & Interventional Radiology Physician	$945K	$0
Michael Loosemore	MA	MOHS-Micrographic Surgery Physician	$908.7K	$0
Greater Springfield Surgery Center, LLC	MA	Ambulatory Surgical Clinic/Center	$650.7K	$114.4K
Scott Halista	MA	Rheumatology Physician	$679.1K	$15.5K

Shilpa Gulati — 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