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.

Chirag Shah (NPI 1487872412)

Field	Value
Entity Type	Individual
Organization	Chirag Shah
Address	50 Staniford St
City	Boston
State	MA
ZIP	02114
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	April 23, 2007

Payer Source	Total Paid
Medicare	$5M
Medicaid	$0

Key Findings

CHIRAG SHAH is a retina specialist (Ophthalmology) physician based in BOSTON, MA with an NPI enumerated on 2007-04-23 (~19 years ago), indicating long tenure in Medicare billing and clinical practice. This multi-decade enrollment supports a mature outpatient retinal practice profile rather than a newly established clinic.

This provider’s Medicare revenue totals $5M while there is no Medicaid billing on file (no Medicaid billing on file), making the practice effectively single-payer at scale and heavily Medicare-dependent for revenue. Analysts should treat Medicaid as absent when modeling payer mix or risk exposure.

Revenue is highly concentrated: the top 3 Medicare codes by revenue account for 76.4% of this provider's total Medicare revenue. Those codes are J0178 ($2.9M; 58.8%), J2777 ($522K; 10.4%), and 67028 ($357.6K; 7.2%), which together dominate the payer-side revenue picture.

The code mix and descriptions indicate a high-volume intravitreal injection and retina diagnostic operation: J0178 (aflibercept injection), J2777 (faricimab injection) and procedure code 67028 (intravitreal injection as an isolated procedure) are the primary revenue drivers, and the provider also bills high volumes for retinal imaging and exams such as 92134 and 92014. This pattern is consistent with a practice focused on medical retina management (frequent injectable therapeutics plus OCT/diagnostic follow-up) rather than cataract or general ophthalmology as the primary service line.

On competitive standing, the provider ranks well above peers for several high-impact codes: J0178 ranks #51 of 3204 providers nationally (98th percentile; notably above typical national volume) and 67028 ranks #64 of 4255 (99th percentile; extreme outlier). Additional diagnostic codes 92014 (ranks #47 of 35415; 100th percentile; extreme outlier) and 92134 (ranks #16 of 26868; 100th percentile; extreme outlier) further signal national-level intensity in both injection throughput and retina imaging.

Not all drug codes show the same relative intensity: J2777 is billed at scale (18K claims, $29 avg paid/claim, $522K revenue) but ranks #594 of 2039 (71th percentile; typical, unremarkable volume), while Q5124 (ranibizumab biosimilar) shows concentrated use relative to a smaller national cohort (1.8K claims, $158 avg paid/claim, $284.4K revenue; ranks #13 of 122 providers nationally, 90th percentile; typical, unremarkable volume). This mixed profile suggests the practice uses multiple anti-VEGF agents with different utilization patterns rather than exclusive reliance on a single product.

From a payer operational perspective, injectable therapeutics drive both claim volume and spend here: J0178 carries a high average payment ($692 avg paid/claim) and represents 58.8% of Medicare revenue, so utilization or formulary shifts for aflibercept would materially affect reimbursements. Payers and contracting teams should prioritize utilization management, drug mix monitoring, and site-of-service considerations for high-impact injectables when engaging this provider.

Several codes are flagged as statistical outliers or notably above typical national volume (67028 described as an extreme outlier; J0178 as notably above typical; 92014 and 92134 as extreme outliers), so payers may want focused peer-comparison reviews on procedure mix and visit flow to confirm clinical alignment with expected retina practice patterns. These observations support targeted utilization review and benchmarking rather than any presumption of improper behavior—useful next steps include case-mix review and comparison to other high-volume retina specialists in Massachusetts and nationally.

Medicare: Complete Services Breakdown

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

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	4,250	$690	$2.9M
J2777	Injection, faricimab‑svoa, 0.1 mg	18,000	$30	$522K
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.	3,340	$110	$357.6K
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…	3,130	$100	$313.4K
Q5124	Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg	1,800	$160	$284.4K
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.	5,890	$30	$200.2K
J2778	Injection, ranibizumab, 0.1 mg	950	$190	$179.2K
J9035	Injection, bevacizumab, 10 mg	1,260	$60	$69.4K
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…	400	$80	$30.5K
99204	The provider sees a new 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 provider…	130	$130	$17.4K

Showing 1–10 of 25

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 25 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Massachusetts Distribution

Chirag Shah — 4 of 25 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

25 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	4	90	790	$690	$826.5K
J2777	13	50	7,080	$30	$343.1K
J2778	7	30	560	$180	$200.7K
Q5124	2	10	800	$160	$186K
67028	4	120	570	$100	$80.7K
92014	3	1,070	160	$90	$30.1K
67042	19	30	20	$1,170	$25.7K
J9035	5	80	250	$50	$19.7K
67039	2	10	20	$1,150	$19.5K
66821	215	240	40	$210	$17.4K

Showing 1–10 of 25

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The General Hospital Corporation	MA	General Acute Care Hospital	$0	$438M
Community Physicians Of Indiana Inc	IN	Family Medicine Physician	$0	$185M
Massachusetts General Physicians Organization Inc	MA	Dermatology Physician	$0	$60.2M
Boston Emergency Physician Foundation, Inc.	MA	Emergency Medicine Physician	$0	$24.3M
Colorado Permanente Medical Group, P.C.	CO	Internal Medicine Physician	$0	$23.2M
Alok Bansal	CA	Ophthalmology Physician	$3M	$4.7M
David Reed	MA	Retina Specialist (Ophthalmology) Physician	$7.7M	$0
Torsten Wiegand	MA	Retina Specialist (Ophthalmology) Physician	$7.6M	$0
Omesh Gupta	PA	Ophthalmology Physician	$7.1M	$80
Mitchell Fineman	PA	Ophthalmology Physician	$7M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Massachusetts Eye And Ear Infirmary	MA	General Acute Care Hospital	$0	$68.1M
Bay Cove Human Services, Inc	MA	Community/Behavioral Health Agency	$630.5K	$36.4M
Jewish Family & Children's Service	MA	Case Management Agency	$0	$12.5M
Commonwealth Of Massachusetts	MA	Case Management Agency	$0	$10.4M
Massachusetts Eye And Ear Associates, Inc.	MA	Ophthalmology Physician	$0	$6.6M
Miriam Englander-paschalis Ilios	MA	Retina Specialist (Ophthalmology) Physician	$4.5M	$0
Jeffrey Heier	MA	Retina Specialist (Ophthalmology) Physician	$3.6M	$0
Adam Chin	MA	Ophthalmology Physician	$3.4M	$870
Tina Cleary	MA	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
Boston Eye Surgery & Laser Center Trust	MA	Ambulatory Surgical Clinic/Center	$2.1M	$415.8K

Chirag 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