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

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

Sharath Raja (NPI 1417953829)

Field	Value
Entity Type	Individual
Organization	Sharath Raja
Address	2600 N Mayfair Rd
City	Milwaukee
State	WI
ZIP	53226
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	June 22, 2005

Payer Source	Total Paid
Medicare	$3.3M
Medicaid	$0

Key Findings

This provider is effectively single‑payer by scale: total Medicare revenue is $3.3M and there is no Medicaid billing on file, so Medicare accounts for essentially all recorded public-payer activity for this NPI in Milwaukee, WI. Analysts should treat Medicare patterns as representative of the provider’s public-payer business rather than attempting dual‑payer comparisons.

Revenue is highly concentrated in intravitreal drug treatments: the precomputed top 3 Medicare codes by revenue account for 90.9% of this provider's total Medicare revenue, driven by J0178 ($2.1M revenue, 65.0% of this provider's total Medicare revenue), J2777 ($629.9K revenue, 19.4%), and 67028 ($211K revenue, 6.5%). This concentration indicates most Medicare dollars flow from a small set of high-volume injection and injection-procedure services.

The code mix identifies a retina-focused practice model centered on pharmacologic intravitreal therapy and retinal diagnostics: J0178 (aflibercept) and J2777 (faricimab) dominate revenue and 67028 is a common separate intravitreal injection procedure, while 92134 (retinal imaging) appears frequently. Together these codes point to ongoing management of retinal vascular disease (e.g., neovascular AMD and diabetic edema) with repeated injection visits and imaging follow-up.

Competitive standing on key therapeutic codes is strong nationally: J0178 ranks #174 of 3204 providers (95th percentile) and 67028 ranks #207 of 4255 providers (95th percentile), both labeled as "notably above typical national volume," indicating this provider is a major national participant for aflibercept injections and injection procedures. By contrast, J2777 ranks #473 of 2039 providers (77th percentile) and is considered typical for national volume, showing solid but not dominant placement for faricimab.

Imaging and diagnostic throughput is an acute strength: 92134 ranks #335 of 26868 providers (99th percentile) and is labeled an "extreme outlier, far above typical national volume," which suggests unusually high OCT imaging volume relative to peers and supports a workflow with frequent imaging-driven follow-up and treatment decisions. This heavy imaging footprint aligns with high injection volumes that require interval monitoring.

The practice also reports above‑typical office encounter volume for follow-up care: 99213 shows 875 claims with $51.6K revenue and ranks #8792 of 457151 providers (98th percentile), described as "notably above typical national volume." High 99213 volume alongside the injection codes suggests routine, frequent established-patient visits that accompany repeated intravitreal therapies.

Use of alternate anti-VEGF agents is present but less dominant: J9035 (bevacizumab) appears with $52.7K revenue and ranks #82 of 1852 providers (96th percentile) and J2778 (ranibizumab) appears with $61.2K revenue at a 23th percentile rank described as typical. This mix indicates primary reliance on aflibercept and faricimab for revenue while retaining some bevacizumab and ranibizumab use, which could reflect clinical choice, patient mix, or payer preferences.

This NPI shows long tenure: NPI enumerated (registered) on 2005-06-22 (~21 years ago), indicating an established practice presence in the market. Combined with the high ranks on key codes and concentrated Medicare revenue, the provider appears to run a mature, injection-centric retina practice with a sustained Medicare patient panel and limited or no Medicaid participation.

Medicare: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	3,060	$690	$2.1M
J2777	Injection, faricimab‑svoa, 0.1 mg	21,720	$30	$629.9K
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.	2,430	$90	$211K
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.	3,180	$30	$85.8K
J2778	Injection, ranibizumab, 0.1 mg	340	$180	$61.2K
J9035	Injection, bevacizumab, 10 mg	1,000	$50	$52.7K
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…	880	$60	$51.6K
99203	The provider sees a new 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 provider…	190	$70	$13.4K
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…	90	$100	$8.8K
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…	90	$90	$8.4K

Showing 1–10 of 15

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Wisconsin Distribution

Sharath Raja — 6 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. state median

15 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	2	60	440	$690	$488.1K
J2777	3	30	7,290	$30	$332K
J2778	5	10	520	$180	$131.2K
67028	2	110	310	$80	$43.7K
J9035	3	70	110	$50	$14.5K
99214	4,406	9,800	80	$70	$9.2K
67228	4	10	30	$240	$7.3K
92134	2	600	60	$30	$4.7K
99213	23	9,380	60	$50	$4.7K
92235	8	30	50	$70	$4.5K

Showing 1–10 of 15

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nicholas Tosi	WI	Retina Specialist (Ophthalmology) Physician	$4.9M	$0
Retina & Vitreous Consultants Of Wi, Ltd.	WI	Retina Specialist (Ophthalmology) Physician	$0	$3.8M
Lincoln Shaw	WI	Retina Specialist (Ophthalmology) Physician	$832.5K	$0
Razek Georges Coussa	WI	Retina Specialist (Ophthalmology) Physician	$556.7K	$0
Marc Hirsch	WI	Ophthalmology Physician	$248.7K	$0
Rosemarie Brueggeman	WI	Ophthalmology Physician	$178.9K	$0
Chirantan Mukhopadhyay	IL	Ophthalmology Physician	$121.7K	$56K
Charles Yang	WI	Ophthalmology Physician	$145.8K	$0
Jaime Blanchard	WI	Optometrist	$52.5K	$3.6K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital Of Wisconsin, Inc.	WI	Children's Hospital	$0	$262.3M
Froedtert Memorial Lutheran Hospital, Inc.	WI	General Acute Care Hospital	$0	$157.8M
The Medical College Of Wisconsin, Inc.	WI	Internal Medicine Physician	$17.8K	$74.8M
Emergency Medicine Specialists, S.c.	WI	Emergency Medicine Physician	$0	$35.3M
Wisconsin Diagnostic Laboratories LLC	WI	Clinical Medical Laboratory	$2.3M	$22.7M
Childrens Hospital Of Wisconsin, Inc.	WI	Pediatrics Physician	$0	$19M
Children's Hospital And Health System, Inc.	WI	Urgent Care Clinic/Center	$0	$17.7M
Option Care Home Care Inc	WI	Pharmacy	$0	$12.5M
Curative Care Network, Inc.	WI	Rehabilitation Clinic/Center	$0	$12.2M
Children's Specialty Group, Inc.	WI	Pediatrics Physician	$0	$10.4M

Sharath Raja — Billing Profile & Reimbursement Data

Sign up for Sharath Raja — Billing Profile & Reimbursement Data policy alerts

Sharath Raja — Billing Profile & Reimbursement Data

Sign up for Sharath Raja — Billing Profile & Reimbursement Data policy alerts

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