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

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

Rohit Adyanthaya (NPI 1710023411)

Field	Value
Entity Type	Individual
Organization	Rohit Adyanthaya
Address	241 Corporate Blvd
City	Norfolk
State	VA
ZIP	23502
Taxonomy	Ophthalmology Physician
NPI Enumerated	January 29, 2007

Payer Source	Total Paid
Medicare	$4.1M
Medicaid	$0

Key Findings

This provider is effectively single‑payer in the available data: total Medicare revenue is $4.1M while Medicaid revenue is listed as none, indicating no Medicaid billing on file. The absence of Medicaid activity means payer-mix analysis and benchmarking should focus on Medicare (and likely commercial, if available elsewhere) rather than dual‑payer dynamics.

Revenue is heavily concentrated in a very small set of Medicare codes: the precomputed top 3 codes account for 83.3% of the provider's total Medicare revenue, led by J0178 at $2.9M (71.5%), followed by 67028 at $248.9K (6.1%) and J3490 at $231.7K (5.7%). This concentration indicates the provider’s Medicare book of business is dominated by a few high-revenue services, so changes in utilization or reimbursement for those codes would materially affect total revenue.

The code mix and volumes point to a retina‑focused ophthalmology operation that delivers high volumes of intravitreal pharmacotherapy and associated follow-up care: J0178 (aflibercept) shows 4.3K claims at $680 avg paid/claim and $2.9M revenue, while 67028 (intravitreal injection) shows 2.5K claims and $248.9K revenue. High counts for imaging and follow-up codes — 92134 (2.7K claims, $79.6K revenue) and 99214 (2.2K claims, $202.1K revenue) — support a workflow that couples frequent in‑office injections with diagnostic imaging and frequent E&M visits.

On national competitive standing, the provider is a pronounced high-volume outlier for several services: J0178 ranks #48 of 3204 providers nationally (99th percentile; extreme outlier), 99214 ranks #888 of 479517 (100th percentile; extreme outlier), and 92134 ranks #580 of 26868 (98th percentile; extreme outlier). 67028 also ranks notably above peers at #181 of 4255 (96th percentile; notably above typical national volume), which collectively signals nationally significant throughput for intravitreal therapy and associated management.

Operational and revenue implications of the dominant drug exposure are material: J0178’s $680 avg paid/claim and its $2.9M contribution (71.5% of Medicare revenue) make the provider highly dependent on aflibercept utilization and reimbursement. High unit payments for select unclassified/other drug codes (for example, J3490: 86 claims at $2694 avg paid/claim generating $231.7K) also indicate occasional high-dollar drug billing events that disproportionately impact overall Medicare revenue.

Although several codes are extreme outliers, the profile also includes many services with typical or unremarkable volumes, indicating a mixed footprint across procedure types: for example, J2781 (1.2K claims, $142.2K revenue) is described as typical/unremarkable (83th percentile), J7312 (336 claims, $53.4K) is typical (73th percentile), and J9035 (866 claims, $47.6K) is typical (94th percentile). This suggests the practice combines a few very high‑volume/high‑revenue therapies with a broader set of standard ophthalmology services.

The provider’s NPI tenure is long-standing — enumerated on 2007-01-29 (~19 years ago) — which supports interpretation of high volumes as the output of an established practice rather than a recent surge. Long tenure combined with extreme national rankings for several codes suggests entrenched referral flows, clinical capacity, or a focused service model in retinal treatments.

From a risk and contracting perspective, the lack of Medicaid billing (none) and heavy reliance on a single high-cost biologic (J0178 at $2.9M) concentrate both reimbursement exposure and negotiating leverage toward Medicare and commercial payers; any policy or formulary shifts affecting J0178 utilization or payment could disproportionately affect this provider’s revenue base. Analysts evaluating capacity, supply procurement, or payer negotiations should prioritize J0178 utilization trends and monitoring of intravitreal injection volumes (67028) alongside E&M and imaging follow-up activity.

Medicare: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	4,290	$680	$2.9M
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.	2,490	$100	$248.9K
J3490	Unclassified drugs	90	$2,690	$231.7K
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…	2,220	$90	$202.1K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	1,190	$120	$142.2K
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.	2,650	$30	$79.6K
67210	The provider destroys a lesion of the retina using a laser beam that heats up the tissue.	140	$400	$53.9K
J7312	Injection, dexamethasone, intravitreal implant, 0.1 mg	340	$160	$53.4K
J9035	Injection, bevacizumab, 10 mg	870	$60	$47.6K
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…	500	$90	$42.3K

Showing 1–10 of 20

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Virginia Distribution

Rohit Adyanthaya — 4 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. state median

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	3	80	1,400	$690	$1.1M
67028	8	90	1,000	$90	$107.1K
J2781	3	20	560	$120	$86.6K
J7312	6	20	240	$160	$42.5K
92014	195	870	170	$80	$32.8K
67041	6	20	20	$1,110	$23.3K
66821	208	230	60	$210	$23K
99214	23	12,890	140	$80	$21K
J3490	26	110	60	$280	$20.5K
J9035	7	60	170	$50	$19.9K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mark Le	FL	Diagnostic Radiology Physician	$10.7M	$0
Virginia Eye Consultants Inc	VA	Ophthalmology Physician	$0	$8.3M
April Lopez	TX	Family Nurse Practitioner	$6.7M	$0
John O'keefe	VA	Ophthalmology Physician	$4.8M	$0
Juan Astruc	VA	Ophthalmology Physician	$4.7M	$0
Ricky Alaniz	TX	Optometrist	$77.9K	$3.7M
Jeremiah Brown	TX	Retina Specialist (Ophthalmology) Physician	$3.7M	$0
Bryan Schwent	VA	Ophthalmology Physician	$3.7M	$0
Joseph Khawly	TX	Ophthalmology Physician	$3.2M	$0
Howard Martin	TX	Dermatopathology (Pathology) Physician	$3M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sentara Hospitals	VA	General Acute Care Hospital	$0	$79.7M
Tremont Road Dental Super, P.C.	VA	General Practice Dentistry	$0	$63.5M
Sentara Medical Group	VA	Family Medicine Physician	$0	$48.7M
Emergency Physicians Of Tidewater	VA	Emergency Medicine Physician	$0	$47.9M
Community Alternative Inc	VA	Community/Behavioral Health Agency	$0	$44.3M
Life's Journey	VA	Adult Mental Health Clinic/Center	$0	$24.4M
Keys To Success Family & Developmental Services	VA	Community/Behavioral Health Agency	$0	$16.1M
Advantage Home Care, LLC	VA	Home Health Agency	$0	$15.7M
National Counseling Group, Inc	VA	Mental Health Counselor	$0	$14.5M
Childrens Medical Group Inc	VA	Pediatrics Physician	$0	$9.1M

Rohit Adyanthaya — 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