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NPI 1619181260 · Gilbert, AZ · Retina Specialist (Ophthalmology) Physician
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Sachin Mehta is a retina specialist (ophthalmology) physician provider located in Gilbert, Arizona. This profile covers 24 Medicare and 3 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 | Sachin Mehta |
| Address | 3303 E Baseline Rd Ste 108 |
| City | Gilbert |
| State | AZ |
| ZIP | 85234 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | May 10, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $4.4M |
| Medicaid | $11.8K |
This provider’s billing is heavily Medicare‑weighted: Total Medicare revenue is $4.4M versus Total Medicaid revenue of $11.8K, indicating Medicare is the dominant payer by a large margin and the practice operates effectively as a Medicare-focused retina practice. Medicaid activity is present but immaterial to overall revenue.
Medicare revenue is highly concentrated in intravitreal drug injections: the precomputed top 3 Medicare codes (J0178, J2777, J2778) account for 80.5% of the provider’s Medicare revenue, with J0178 at 35.4%, J2777 at 33.6%, and J2778 at 11.5%. On the Medicaid side, the precomputed top 3 codes account for 100.0% of Medicaid revenue, led by 92134 (41.4%), 67028 (36.3%), and J9035 (22.3%).
The code mix signals a retina/surgical retina practice structured around frequent intravitreal anti‑VEGF injections and retinal imaging: high‑revenue Medicare codes J0178, J2777, and J2778 correspond to aflibercept, faricimab, and ranibizumab injections respectively, while high claim counts for 92134 and 67028 support intensive retinal imaging and standalone intravitreal injection throughput. This pattern is consistent with a clinic model focused on chronic retinal disease management rather than primary care or broad multispecialty outpatient services.
Competitive standing is mixed by drug: J2777 (faricimab) shows especially strong national presence, ranking #102 of 2039 providers nationally (95th percentile; notably above typical national volume), indicating the provider is a high‑volume national participant for that agent. By contrast, J0178 ranks #417 of 3204 (87th percentile; typical, unremarkable volume) and J2778 ranks #132 of 1208 (89th percentile; typical, unremarkable volume), which portray standard-to-moderately high participation for those agents rather than dominance.
Diagnostic imaging footprint is an outlier: 92134 appears as a high-volume imaging code with 3.8K claims and $102.6K revenue and ranks #161 of 26868 providers nationally (99th percentile; extreme outlier, far above typical national volume). This suggests substantially higher OCT or posterior‑segment imaging throughput compared with most peers, supporting a workflow that pairs frequent injections with routine imaging follow-up.
Standalone intravitreal injection procedure volume is also elevated: 67028 records 2.8K claims and $252.7K revenue and ranks #115 of 4255 providers nationally (97th percentile; notably above typical national volume), reinforcing that a large share of clinical activity is procedure‑based injections rather than only evaluation & management visits. Major surgical vitrectomy and retinal repair codes (e.g., 67042, 67036, 67113) are present but represent a small fraction of revenue, indicating some surgical capability but a primary emphasis on office‑based injection care.
Medicaid competitive position is limited in-state: 92134 ranks #39 of 65 providers in-state (41th percentile), 67028 ranks #20 of 31 (37th percentile), and J9035 ranks #19 of 22 (14th percentile), showing the provider is a modest participant on Arizona Medicaid with relatively low state market share across the top Medicaid codes. Coupled with Total Medicaid revenue of $11.8K, Medicaid does not appear to be a strategic revenue driver.
NPI tenure is long‑standing: NPI enumerated 2007-05-10 (~19 years ago), which aligns with an established practice likely to have an enduring referral network and operational processes optimized for high-volume injection and imaging workflows. This longevity supports the observed sustained high volumes for select retinal treatments and diagnostics.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
24 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2,240 | $690 | $1.6M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 50,940 | $30 | $1.5M |
| J2778 | Injection, ranibizumab, 0.1 mg | 2,780 | $180 | $506.5K |
| 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. | 2,840 | $90 | $252.7K |
| 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. | 3,800 | $30 | $102.6K |
| 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… | 940 | $80 | $78.4K |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 360 | $210 | $76K |
| J7999 | Compounded drug, not otherwise classified | 810 | $70 | $57.5K |
| 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… | 840 | $60 | $50.5K |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 300 | $150 | $44.8K |
Showing 1–10 of 24
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 24 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
24 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 7 | 50 | 780 | $690 | $734.8K |
| J2777 | 2 | 50 | 9,000 | $30 | $525.8K |
| Q5128 | 9 | 20 | 520 | $220 | $207.5K |
| J2778 | 3 | 30 | 550 | $180 | $198K |
| 67028 | 4 | 60 | 1,240 | $90 | $119K |
| J7312 | 11 | 20 | 270 | $160 | $48.9K |
| J7999 | 15 | 50 | 490 | $70 | $46.8K |
| 67042 | 19 | 40 | 30 | $1,160 | $46.5K |
| 67113 | 15 | 20 | 20 | $1,190 | $40.3K |
| 67036 | 13 | 30 | 30 | $1,030 | $37.9K |
Showing 1–10 of 24
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 210 | $20 | $4.8K |
| 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. | 100 | $40 | $4.2K |
| J9035 | Injection, bevacizumab, 10 mg | 80 | $30 | $2.6K |
How this provider's Medicaid billing volume and revenue compare to other Arizona providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Arizona median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| J9035 | Injection, bevacizumab, 10 mg | 19 | 20 | 530 | $160 | $369.7K |
| 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. | 20 | 30 | 380 | $70 | $266.2K |
| 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. | 39 | 70 | 300 | $20 | $98.9K |
Other providers in the same ZIP code as Sachin Mehta, ranked by combined Medicare and Medicaid revenue.
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