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    v1.0.28
    OpenPayerNPI Medicare & MedicaidSetu Patel
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    Setu Patel — Billing Profile & Reimbursement Data

    NPI 1801259361 · Phoenix, AZ · Retina Specialist (Ophthalmology) Physician

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    Setu Patel is a retina specialist (ophthalmology) physician provider located in Phoenix, Arizona. This profile covers 18 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationSetu Patel
    Address1750 E Glendale Ave
    CityPhoenix
    StateAZ
    ZIP85020
    TaxonomyRetina Specialist (Ophthalmology) Physician
    NPI EnumeratedApril 1, 2016

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$633.7K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    18 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J0178Injection, aflibercept, 1 mg330$670$221.1K
    J2777Injection, faricimab‑svoa, 0.1 mg2,580$30$74.8K
    67028The 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.680$90$59.5K
    92134The 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.1,470$30$41.3K
    J7312Injection, dexamethasone, intravitreal implant, 0.1 mg240$150$35.7K
    J7999Compounded drug, not otherwise classified500$70$35.6K
    67042In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina…40$840$34.4K
    J2778Injection, ranibizumab, 0.1 mg190$180$33.7K
    92014An 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…340$90$29K
    92012For 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$70$26.3K

    Showing 1–10 of 18

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    18 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J01784050780$690$734.8K
    J277744509,000$30$525.8K
    J27782630550$180$198K
    6702839601,240$90$119K
    J73121520270$160$48.9K
    J79992350490$70$46.8K
    67042114030$1,160$46.5K
    67113102020$1,190$40.3K
    92014173650140$80$21.5K
    992149,64910,410120$80$20.6K

    Showing 1–10 of 18

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    District Medical Group, IncAZInternal Medicine Physician$0$130.6M
    Associated Retina Consultants, Ltd.AZRetina Specialist (Ophthalmology) Physician$0$6.2M
    Stephen DesouzaAZRetina Specialist (Ophthalmology) Physician$2.5M$0
    Matthew WelchAZRetina Specialist (Ophthalmology) Physician$2.2M$0
    Benjamin BakallAZRetina Specialist (Ophthalmology) Physician$2M$0
    Joseph BryanAZRetina Specialist (Ophthalmology) Physician$1.9M$0
    Rima PatelAZRetina Specialist (Ophthalmology) Physician$1.8M$0
    Henry KwongAZRetina Specialist (Ophthalmology) Physician$1.7M$0
    Alan GordonAZRetina Specialist (Ophthalmology) Physician$1.6M$0
    Anthony DebeusCARetina Specialist (Ophthalmology) Physician$1.6M$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    HonorhealthAZGeneral Acute Care Hospital$0$107.2M
    All Valley Home Health Care & Nursing IncAZHome Health Agency$0$55.7M
    Bowie Investment Group IncAZHome Health Agency$0$31.9M
    Gina PalaciosAZNurse Practitioner$27M$0
    Affiliated Hospitalists, PlcAZHospitalist Physician$0$21M
    Neighborhood Outreach Access To HealthAZFederally Qualified Health Center (FQHC)$0$19.6M
    Avista Senior Living Desert Springs, LLCAZAssisted Living Facility$0$17.6M
    Unomed LLCAZCritical Care Medicine (Internal Medicine) Physician$0$15.4M
    Bayada Home Health Care, Inc.AZHome Health Agency$0$10.7M
    Emcare - Pnx Emergency Physicians LLCAZEmergency Medicine Physician$0$9.6M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Arizona Distribution
    Setu Patel — 0 of 18 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Arizona