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

Why is the Medicaid comparison limited to New Jersey 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. New Jersey (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.

Kekul Shah (NPI 1467493718)

Field	Value
Entity Type	Individual
Organization	Kekul Shah
Address	4 Princess Rd
City	Lawrenceville
State	NJ
ZIP	08648
Taxonomy	Ophthalmology Physician
NPI Enumerated	June 9, 2006

Payer Source	Total Paid
Medicare	$2.4M
Medicaid	$0

Key Findings

KEKUL SHAH’s Medicare-facing practice is heavily oriented toward intravitreal biologic therapy and associated ophthalmic follow-up: the top three Medicare revenue drivers are J0178 ($1.4M, 55.6%), J2777 ($384.5K, 15.8%), and 92014 ($242.6K, 10.0%), and those three codes together account for 81.4% of the provider’s Medicare revenue. The presence of high-volume biologic drug codes (J0178, J2777) alongside evaluation codes (92014) and imaging (92134) points to a retina-focused, procedure-heavy outpatient ophthalmology operation rather than a primarily elective surgical practice.

Revenue concentration is pronounced: total Medicare revenue is $2.4M and the precomputed top-three share is 81.4%, indicating that a small set of codes—largely anti-VEGF drug administration and related visits—drive the vast majority of billed Medicare dollars for this clinician. That concentration creates both predictable revenue from repeat treatment patterns and exposure if reimbursement or utilization of those specific drugs changes.

Payer mix is effectively single-payer Medicare: the profile shows Total Medicare revenue of $2.4M and “none below” for Medicaid, so there is no Medicaid billing on file. Analysts should treat this provider as Medicare-dependent for public-payer volume and consider commercial payer data (if available) separately.

Competitive standing on the largest drug code is modestly above median: J0178 (aflibercept) shows 2K claims and $691 avg paid/claim for $1.4M in revenue, ranking #557 of 3204 providers nationally (83th percentile; typical, unremarkable volume). This indicates the provider participates at a substantial but not exceptional national level for aflibercept administration.

By contrast, evaluation and imaging volumes are unusually high relative to peers: 92014 has 2.5K claims and $242.6K revenue, ranking #136 of 35415 providers nationally (100th percentile; extreme outlier, far above typical national volume), and 92134 has 2.9K claims and $97.9K revenue, ranking #457 of 26868 providers nationally (98th percentile; extreme outlier). Those ranks suggest very high clinic throughput for established-patient comprehensive exams and retinal imaging compared with the national ophthalmology population.

Some drug codes show atypical claim-count dynamics tied to unit-based billing: J2777 appears as 13.3K claims with a low $29 avg paid/claim but $384.5K revenue (15.8% of Medicare revenue), reflecting the 0.1 mg unit measurement for faricimab and explaining high claim counts despite moderate revenue. Analysts should interpret high claim counts for unit-priced biologics in the context of billing conventions (units per vial/dose) rather than as a direct indicator of patient visit volume.

Operationally, the combination of substantial intravitreal injection revenue (J0178, J2777, J2778) and high-volume diagnostic imaging and follow-up visits (92134, 92014, 92004) is consistent with a practice model centered on chronic retinal disease management (e.g., AMD/diabetic macular edema) with recurring treatment and monitoring cycles. This mix supports predictable recurring revenue but also concentrates dependency on outpatient injection throughput and imaging capacity.

The provider has a long-tenured NPI (enumerated 2006-06-09 (~20 years ago)), indicating two decades of billing history under this NPI. That longevity combined with the extreme-outlier volumes on several evaluation/imaging codes suggests an established referral pattern and sustained clinical throughput rather than a recent expansion artifact.

Medicare: Complete Services Breakdown

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,960	$690	$1.4M
J2777	Injection, faricimab‑svoa, 0.1 mg	13,260	$30	$384.5K
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…	2,450	$100	$242.6K
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.	1,510	$100	$146.5K
J2778	Injection, ranibizumab, 0.1 mg	600	$180	$109.6K
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.	2,880	$30	$97.9K
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.	300	$110	$33.2K
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	420	$70	$30.7K
J9035	Injection, bevacizumab, 10 mg	180	$60	$10.1K
92202	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…	750	$10	$9K

Showing 1–10 of 14

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New Jersey Distribution

Kekul Shah — 3 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

Full comparison — all codes billed, vs. state median

14 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	11	90	880	$690	$693.6K
J2777	16	60	8,820	$30	$319K
J2778	32	40	1,140	$180	$240.8K
67028	20	100	810	$100	$91.1K
92014	12	1,130	160	$100	$34.9K
92012	157	800	140	$70	$18.5K
92235	51	70	60	$120	$17.3K
J9035	17	60	80	$50	$14.2K
92134	11	700	90	$30	$10K
92004	20	900	40	$110	$8K

Showing 1–10 of 14

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Associated Retinal Consultants LLC	DE	Ophthalmology Physician	$0	$25.2M
Rohit Lakhanpal	MD	Retina Specialist (Ophthalmology) Physician	$6.1M	$0
Vinod Voleti	NJ	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Sumit Shah	NJ	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Newman Sund	MD	Ophthalmology Physician	$4M	$0
Eric Suan	MD	Ophthalmology Physician	$3.8M	$0
Matthew Speicher	MD	Ophthalmology Physician	$3.7M	$0
Howard Fine	NJ	Retina Specialist (Ophthalmology) Physician	$3.6M	$0
Timothy Polk	MD	Ophthalmology Physician	$3.5M	$0
Jonathan Prenner	NJ	Retina Specialist (Ophthalmology) Physician	$3.4M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wishing Well Adult Day Health Care, LLC	NJ	Nursing Facility/Intermediate Care Facility	$0	$30.5M
Oaks Integrated Care	NJ	Adult Mental Health Clinic/Center	$0	$7.7M
Darmakusuma Ie	NJ	Ophthalmology Physician	$2M	$0
Medlife Diagnostic Laboratories	NJ	Clinical Medical Laboratory	$500.9K	$1.2M
Joshua Mali	NJ	Retina Specialist (Ophthalmology) Physician	$1.5M	$0
Angana Shah	NJ	Ophthalmology Physician	$1.1M	$0
Kimberly Palangio	NJ	Epilepsy Physician	$641.7K	$0
Edita Surbliene	NJ	Nurse Practitioner	$451.9K	$0
Manuel Vergara	NJ	Epilepsy Physician	$432.5K	$0
Mahmood Siddique	NJ	Internal Medicine Physician	$414.2K	$0

Kekul Shah — 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