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

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

Sanjay Jain (NPI 1730130105)

Field	Value
Entity Type	Individual
Organization	Sanjay Jain
Address	200 W Arbor Dr
City	San Diego
State	CA
ZIP	92103
Taxonomy	Diagnostic Radiology Physician
NPI Enumerated	May 12, 2006

Payer Source	Total Paid
Medicare	$354.1K
Medicaid	$0

Key Findings

This profile is effectively single-payer on file: lifetime Medicare revenue is $354.1K and there is no Medicaid billing on file, so all observed claims and revenue in our dataset derive from Medicare patients. That concentration means payer-strategy or network-access questions should focus on Medicare contracting and referral sources rather than Medicaid participation.

Revenue is concentrated in abdominal cross-sectional imaging: the top three Medicare codes 74177 (15.8%), 74176 (11.0%), and 74178 (7.2%) together account for 34.0% of this provider's total Medicare revenue. Those three CT abdomen/pelvis codes are the single largest revenue drivers, indicating a service-line emphasis where bowel/abdominal imaging is a primary revenue source.

The code mix and claim volumes point to a high-throughput diagnostic radiology practice with broad multi‑modality capability. High claim counts for cross-sectional studies (74177: 353 claims, 74176: 344 claims), large ultrasound volumes (76770: 440 claims; 76700: 383 claims; 76705: 235 claims), and thousands of chest radiographs (71046: 1.6K claims; 71045: 1.2K claims) suggest the provider operates in a setting that delivers frequent, lower-reimbursement studies alongside higher-reimbursement CT and MRI exams.

Competitive standing on Medicare is strong for several procedures: the provider ranks highly versus national peers for key abdominal and ultrasound codes (for example 74176 ranks #358 of 22168 providers nationally at the 98th percentile, and 76770 ranks #149 of 18942 providers nationally at the 99th percentile). Multiple top codes are described as “notably above typical” or sit in the upper percentiles nationally, indicating this clinician is a major national-volume performer for a subset of imaging services rather than a low-volume or incidental provider.

Several CPTs are flagged as statistical outliers in national comparisons, highlighting unusually high throughput in specific modalities. Notably, retroperitoneal and abdominal ultrasound codes such as 76770, 76700, 76705, and 76706 are described as extreme outlier/99th‑percentile volumes, and other exams like 76830 and 72110 also sit at 99th‑percentile levels; these patterns point to concentrated operational capacity in abdominal ultrasound and spine imaging.

The reimbursement mix shows a combination of many low‑unit‑price, high‑volume studies and a smaller set of higher‑paid cross-sectional exams. For example, chest radiograph 71046 generated 1.6K claims at a $13 avg paid/claim for $20.4K revenue, while MRI/CT items such as 74183 paid at $212 avg paid/claim for $14.6K revenue—this profile is consistent with a throughput-oriented imaging practice that balances high-volume plain films and ultrasound with episodic higher-fee CT/MRI procedures.

The provider has a long-enumerated NPI (2006-05-12, approximately 20 years ago), indicating sustained presence in the market. That tenure, combined with repeated high national ranks on multiple imaging CPTs, suggests established referral relationships and a stable service footprint in Diagnostic Radiology rather than a recently entered or transient operation.

Medicare: Complete Services Breakdown

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

65 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	350	$140	$48.4K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	340	$100	$33.7K
74178	The provider performs computed tomography of the abdomen and pelvis without contrast material in one or both body regions followed by contrast material in one or both body regions and additional…	110	$200	$22K
76770	A retroperitoneal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e.Kidneys, urinary bladder, and aorta). This particular code is used when the ultrasound is…	440	$50	$21.1K
76700	An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code…	380	$60	$21.1K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	1,570	$10	$20.4K
71250	In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the thorax without using contrast material.	300	$50	$15.8K
74183	The provider performs magnetic resonance imaging of the structures and organs of the abdomen, initially without control and then with additional sequences after injection of contrast.	70	$210	$14.6K
71271	The provider performs a low–dose computed tomography (LDCT), with low–dose ionizing radiation, for examination of the thorax without using contrast material to screen for lung cancer.	90	$120	$10.5K
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	180	$50	$9.4K

Showing 1–10 of 65

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 65 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. California Distribution

Sanjay Jain — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. state median

65 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
74177	10	2,090	90	$100	$12.9K
72148	38	1,350	60	$110	$11.5K
74183	10	690	30	$160	$9.5K
74178	2	1,060	30	$190	$8.8K
74176	2	1,950	70	$80	$7.2K
70450	24	2,040	150	$30	$7K
71250	7	1,890	70	$60	$6.7K
76700	1	1,820	40	$70	$5.5K
71275	21	1,580	50	$80	$5.3K
71260	10	1,710	50	$60	$4.6K

Showing 1–10 of 65

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Orlando Health, Inc.	FL	General Acute Care Hospital	$0	$105.5M
Mcv Associated Physicians	VA	Anesthesiology Physician	$0	$99M
Ohiohealth Corporation	OH	Family Medicine Physician	$0	$89.1M
University Of Virginia Physicians Group	VA	Sports Medicine (Neuromusculoskeletal Medicine) Physician	$0	$84.6M
Orlando Health Medical Group Inc	FL	Internal Medicine Physician	$0	$57.6M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Kings Physician Services, PC	NY	Diagnostic Radiology Physician	$0	$47.3M
Usc Care Medical Group, Inc	CA	General Practice Physician	$0	$39.1M
Jefferson University Physicians	PA	General Practice Physician	$0	$30.8M
Riverside Radiology And Interventional Associates Inc	OH	Diagnostic Radiology Physician	$0	$30.3M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Regents Of The University Of California	CA	General Acute Care Hospital	$0	$264.9M
Family Health Centers Of San Diego Inc	CA	Federally Qualified Health Center (FQHC)	$0	$95.2M
Scripps Health	CA	General Acute Care Hospital	$0	$64.2M
Ihs Radiology Medical Group, Inc.	CA	Diagnostic Radiology Physician	$0	$59.1M
New Alternatives, Inc.	CA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$32M
Mark Schechter	CA	Diagnostic Radiology Physician	$1.7M	$270
Harrison Wang	CA	Diagnostic Radiology Physician	$1.3M	$0
Scripps Mercy Ambulatory Surgery Center, LP	CA	Ambulatory Surgical Clinic/Center	$723.3K	$551.3K
Randy Fanous	CA	Diagnostic Radiology Physician	$339.6K	$911.3K
Michael Booker	CA	Diagnostic Radiology Physician	$1.2M	$0

Sanjay Jain — 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