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

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

Sheeba Mathai (NPI 1477988475)

Field	Value
Entity Type	Individual
Organization	Sheeba Mathai
Address	400 Stonebrook Pkwy Unit 201
City	Frisco
State	TX
ZIP	75036
Taxonomy	Family Nurse Practitioner
NPI Enumerated	September 9, 2013

Payer Source	Total Paid
Medicare	$16.2M
Medicaid	$0

Key Findings

This provider’s Medicare revenue is highly concentrated: the precomputed top-3 Medicare codes account for 100.0% of total Medicare revenue, and a single code, K1034, represents $16.5M (99.9% of Medicare revenue). That concentration indicates the practice’s Medicare billing is overwhelmingly driven by one service line rather than a broad mix of evaluation-and-management visits or procedures.

K1034 (provision of COVID-19 nonprescription self-administered tests) dominates the profile — 1.4M claims generating $16.5M and ranking #28 nationally out of 30,143 providers. The dataset labels this volume as an "extreme outlier, far above typical national volume for this code," which positions the provider as an unusually large national supplier for that specific COVID-19 testing item.

Traditional office E/M codes appear only as de minimis Medicare activity: 99214 produced $11.3K from 150 claims and 99213 produced $3.1K from 80 claims. Both codes rank near the national median (99214 at the 60th percentile, 99213 at the 52th percentile) and collectively contribute 0.1% or less of the provider’s Medicare revenue, implying routine outpatient visits are not the core revenue driver.

Other care-management and ancillary codes (99490, 99439, 36415) show small volumes and revenue (each under $3K), with percentiles at or below typical national volumes; these codes suggest the provider offers some chronic care coordination and basic phlebotomy services but at modest scale compared with the dominant K1034 activity.

Payer mix is effectively single-payer in practice: Total Medicare revenue is $16.2M while there is no Medicaid billing on file. The absence of any Medicaid claims indicates the provider operates without a Medicaid revenue stream in the available data, making Medicare the sole recorded public-payer source.

Competitive standing varies sharply by service line. For K1034 the provider ranks in the 100th percentile nationally and is described as an extreme outlier, indicating dominant activity well above peers for that product. For routine office visit codes the provider is a modest, typical participant (99214 at the 60th percentile and 99213 at the 52th percentile), so the provider is not broadly dominant across general primary-care services.

The provider has established tenure in the NPI registry, enumerated since 2013-09-09 (~13 years ago), which indicates prolonged presence in the market; however, the revenue pattern suggests the practice may have shifted operational focus toward high-volume distribution or provisioning of COVID-19 test kits rather than traditional longitudinal primary care.

From a service-line perspective, the code mix (dominance of K1034 with minimal E/M revenue) suggests the operation functions primarily as a high-volume supplier of COVID-19 self-test kits to Medicare beneficiaries rather than a typical family practice generating most revenue from evaluation-and-management encounters. This has implications for payer contracting and utilization management because the provider’s financial footprint is concentrated in a single commodity-like product rather than billed clinical visits.

Medicare: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
K1034	Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count	1,376,910	$10	$16.5M
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…	150	$80	$11.3K
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…	80	$40	$3.1K
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	70	$30	$2.4K
99439	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	40	$20	$940
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	20	$10	$150

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Texas Distribution

Sheeba Mathai — 1 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
K1034	5	2,490	450	$10	$117.8K
99214	13,404	32,500	110	$80	$17.6K
99490	1,139	1,520	180	$40	$16.2K
99213	13,832	29,790	70	$60	$8.4K
99439	593	760	90	$40	$7.4K
36415	5,589	6,270	100	$10	$4.5K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Robert Fresh	LA	Family Medicine Physician	$56.6K	$0
Ameisha Scott	TX	Family Nurse Practitioner	$40.2K	$0
Cynthia Cox	LA	Family Nurse Practitioner	$34.3K	$0
Traci Burks	LA	Psychiatric/Mental Health Nurse Practitioner	$34.3K	$0
Ross Cotton	KY	Anesthesiology Physician	$16.7K	$11.5K
Caitlyn Ludwig	IN	Physician Assistant	$26.4K	$0
Paige Jackson	LA	Physician Assistant	$25.9K	$0
John Stocking	KY	Addiction Medicine (Anesthesiology) Physician	$9.8K	$880
Richard Morris	KY	Anesthesiology Physician	$6.8K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Randolph Torres Ramos	TX	Internal Medicine Physician	$840.6K	$0
Sainath Gaddam	TX	Interventional Cardiology Physician	$251.9K	$538.3K
Lata Pablani	TX	Internal Medicine Physician	$90.5K	$0

Sheeba Mathai — Billing Profile & Reimbursement Data

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Sheeba Mathai — 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