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NPI 1528324662 · Nashville, TN · Retina Specialist (Ophthalmology) Physician
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Akshay Thomas is a retina specialist (ophthalmology) physician provider located in Nashville, Tennessee. This profile covers 18 Medicare and 5 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Akshay Thomas |
| Address | 345 23rd Ave N Ste 350 |
| City | Nashville |
| State | TN |
| ZIP | 37203 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | April 3, 2012 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.2M |
| Medicaid | $52K |
AKSHAY THOMAS is a retina specialist in Nashville, TN with an NPI enumerated on 2012-04-03 (~14 years ago). Lifetime Medicare revenue on file is $3.2M versus $52K in Medicaid, indicating Medicare is the overwhelmingly dominant payer for this provider's billed services.
Medicare revenue is highly concentrated: the precomputed top three Medicare codes account for 78.1% of Medicare revenue, driven by J0178 (51.6% of Medicare revenue, $1.6M) and J2777 (20.9% of Medicare revenue, $661.2K), with 92014 contributing 5.6% ($175.5K). This mix shows the practice’s financial model is largely built on high-volume intravitreal injections supplemented by office-based comprehensive eye exams.
Medicaid revenue is likewise concentrated: the precomputed top three Medicaid codes make up 83.1% of Medicaid revenue, with 67028 at 37.9% ($19.7K), 92134 at 34.4% ($17.9K), and 99214 at 10.8% ($5.6K). For Medicaid patients the provider’s activity centers on injection procedures and retinal imaging, mirroring the clinical focus seen in Medicare.
On national competitive standing for key Medicare injectable agents, the provider reports substantial but not unique volume: J0178 ranks #366 of 3204 providers (89th percentile) and J2777 ranks #445 of 2039 providers (78th percentile), both described in the source as typical, unremarkable volume despite being above the median. In contrast, 92014 is an extreme outlier nationally (rank #208 of 35415, 99th percentile), indicating an unusually large share of comprehensive established-patient visits relative to peers.
Within Medicaid (in-state) competitive context the provider’s injection volume for 67028 is modest—rank #28 of 37 providers (25th percentile)—while 92134 retinal imaging sits near typical statewide levels (rank #36 of 81, 56th percentile). This suggests the provider is not a dominant Medicaid injector in Tennessee but maintains routine imaging volume among state peers.
The code mix shows active use of multiple anti-VEGF agents and biosimilars: Q5124 ($137.5K, 4.3% of Medicare revenue) and Q5128 ($130.3K, 4.1%) appear alongside J2778 and J9035, indicating the practice administers a portfolio of biologic options rather than a single agent. High volumes of retinal diagnostics (92134 at 2.2% of Medicare revenue and 617 Medicaid claims) and some procedure throughput (67028 and 67036 present at lower volumes) align with a retina-focused outpatient practice that performs injections and imaging more than surgery.
Several codes are statistical outliers reflecting unusually high visit and imaging throughput: 92014 is labeled an "extreme outlier, far above typical national volume" (99th percentile) and 92134 is also an "extreme outlier, far above typical national volume" (98th percentile). Additionally, 99204 appears as an extreme outlier for new-patient moderate-complexity visits (rank #2206 of 227068, 99th percentile), pointing to above-typical new patient intake or high-complexity consults relative to national peers.
Because the provider’s revenue is concentrated in a few high-revenue biologic injection codes (top 3 Medicare codes = 78.1% of Medicare revenue) and a similar top-three concentration for Medicaid (83.1%), the practice’s financial performance is sensitive to changes in drug utilization, reimbursement, or formulary placement. This concentration also creates potential leverage for payer negotiations around injection-related reimbursement but also exposes the provider to downside if access to those specific agents changes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
18 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2,380 | $690 | $1.6M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 22,800 | $30 | $661.2K |
| 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… | 2,120 | $80 | $175.5K |
| 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. | 1,770 | $90 | $152.4K |
| Q5124 | Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg | 790 | $170 | $137.5K |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 610 | $220 | $130.3K |
| J2778 | Injection, ranibizumab, 0.1 mg | 510 | $180 | $90.6K |
| 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. | 2,510 | $30 | $70.3K |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 200 | $160 | $32.3K |
| 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… | 260 | $110 | $28K |
Showing 1–10 of 18
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
18 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 10 | 80 | 790 | $680 | $769.8K |
| J2777 | 16 | 50 | 15,060 | $30 | $592.1K |
| Q5128 | 16 | 20 | 1,190 | $210 | $394K |
| J2778 | 33 | 40 | 1,340 | $180 | $370.2K |
| Q5124 | 4 | 10 | 690 | $180 | $137.8K |
| 67028 | 22 | 80 | 1,130 | $90 | $98.5K |
| J7312 | 8 | 10 | 210 | $150 | $45.8K |
| 67042 | 35 | 40 | 20 | $1,020 | $34.5K |
| 67036 | 15 | 20 | 20 | $940 | $24.4K |
| J3590 | 10 | 10 | 50 | $300 | $21.7K |
Showing 1–10 of 18
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 140 | $150 | $19.7K |
| 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. | 620 | $30 | $17.9K |
| 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 | $60 | $5.6K |
| J9035 | Injection, bevacizumab, 10 mg | 90 | $60 | $5.3K |
| 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… | 120 | $30 | $3.5K |
How this provider's Medicaid billing volume and revenue compare to other Tennessee providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Tennessee median
5 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 2,933 | 3,760 | 610 | $40 | $202.3K |
| 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. | 28 | 40 | 760 | $50 | $193K |
| 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… | 3,031 | 4,050 | 620 | $30 | $183.9K |
| J9035 | Injection, bevacizumab, 10 mg | 27 | 30 | 780 | $20 | $65.7K |
| 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. | 36 | 80 | 440 | $10 | $29.6K |
Other providers in the same ZIP code as Akshay Thomas, ranked by combined Medicare and Medicaid revenue.
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