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

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

Rohan Shah (NPI 1811139470)

Field	Value
Entity Type	Individual
Organization	Rohan Shah
Address	1605 Williams Rd
City	Hixson
State	TN
ZIP	37343
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	March 29, 2009

Payer Source	Total Paid
Medicare	$2.9M
Medicaid	$0

Key Findings

This provider’s Medicare footprint is the material revenue driver: Total Medicare revenue is $2.9M while there is no Medicaid billing on file, so the practice is effectively single‑payer (Medicare) in scale and exposure. The absence of Medicaid billing suggests limited involvement in state programs and concentrated reliance on Medicare reimbursement for cash flow and volume planning.

Revenue is highly concentrated in intravitreal drug administration: the precomputed top 3 Medicare codes by revenue account for 84.4% of this provider's total Medicare revenue, with J0178 representing 50.9%, J2778 representing 17.2%, and J2777 representing 16.3%. This concentration indicates that a small set of injection drugs drives the vast majority of billed Medicare dollars.

The code mix and top revenue drivers identify a procedure‑heavy retina practice centered on frequent intravitreal injections. The three highest‑revenue codes are J0178 (aflibercept), J2778 (ranibizumab), and J2777 (faricimab), and the high claim counts for these agents (J0178: 2.1K claims; J2778: 2.7K claims; J2777: 16.1K claims) are consistent with an outpatient retina service model focused on repeat injections and drug delivery.

Despite high utilization of anti‑VEGF and other intravitreal agents, the provider’s national standing on these codes is more accurately characterized as high‑volume but not dominant. J0178 ranks in the 85th percentile nationally (rank #467 of 3204) and J2778 ranks in the 89th percentile nationally (rank #134 of 1208), with both labeled in the source as “typical, unremarkable volume,” indicating the provider is a prominent user relative to peers but not an extreme national outlier.

Diagnostic imaging volume is a notable outlier within the practice mix: 92134 (retinal imaging) shows 2.7K claims, $71.9K revenue and ranks in the 98th percentile nationally, described as an "extreme outlier, far above typical national volume." This suggests a high throughput of OCT imaging that likely supports frequent injection follow‑ups and monitoring of retinal disease activity.

Office evaluation and management codes contribute only a small share of revenue, reinforcing a procedure‑centric operation. Codes such as 99213 (484 claims, $29.5K, 1.0% of Medicare revenue), 99214 (306 claims, $26.6K, 0.9%), and 92014 (588 claims, $47.6K, 1.7%) together make up a minority of billings, indicating that clinic visits are primarily focused on procedural care rather than high‑revenue E/M services.

Surgical retinal procedures and laser work are present but limited in scale relative to injection and imaging activity. Codes such as 67042 (21 claims, $17.7K, 0.6% of Medicare revenue) and 67108 (11 claims, $9.7K, 0.3%) appear at low volumes and typical national percentiles, which is compatible with a practice model that emphasizes injections and diagnostics over frequent OR‑based retinal surgery.

The provider is longstanding in the Medicare market, with an NPI enumerated on 2009-03-29 (~17 years ago), supporting an established referral and operational base. Combined with the concentrated Medicare revenue and negligible Medicaid billing, this tenure suggests an entrenched Medicare‑focused retina practice that could be sensitive to changes in Medicare drug payment and utilization policy.

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	2,150	$680	$1.5M
J2778	Injection, ranibizumab, 0.1 mg	2,740	$180	$492.3K
J2777	Injection, faricimab‑svoa, 0.1 mg	16,080	$30	$466.3K
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.	1,830	$90	$161.3K
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.	2,660	$30	$71.9K
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…	590	$80	$47.6K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	270	$120	$32.4K
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…	480	$60	$29.5K
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…	310	$90	$26.6K
J9035	Injection, bevacizumab, 10 mg	350	$50	$18.4K

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. Tennessee Distribution

Rohan Shah — 1 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. state median

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	12	80	790	$680	$769.8K
J2777	22	50	15,060	$30	$592.1K
J2778	12	40	1,340	$180	$370.2K
67028	17	80	1,130	$90	$98.5K
J2781	18	20	560	$120	$82.5K
67042	24	40	20	$1,020	$34.5K
67108	28	30	20	$970	$29.2K
92014	94	810	120	$80	$19.2K
J9035	20	70	140	$50	$17.1K
99214	2,638	11,370	120	$80	$16.6K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
James Miller	TN	Retina Specialist (Ophthalmology) Physician	$3.9M	$0
Devon Ghodasra	TN	Retina Specialist (Ophthalmology) Physician	$3.6M	$0
Nicholas Anderson	TN	Retina Specialist (Ophthalmology) Physician	$3M	$0
Scott Barb	TN	Ophthalmology Physician	$2.8M	$0
Robert Shuler	TN	Retina Specialist (Ophthalmology) Physician	$2.6M	$0
Tod Mcmillan	TN	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
Ailee Laham	TN	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
Stephen Perkins	TN	Retina Specialist (Ophthalmology) Physician	$2.3M	$0
Francis Decroos	TN	Retina Specialist (Ophthalmology) Physician	$2.3M	$0
Cristoforo Larzo	TN	Retina Specialist (Ophthalmology) Physician	$2.2M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Galen Medical Group, PC	TN	Internal Medicine Physician	$0	$10.2M
Agilitas Usa Inc	TN	Physical Therapy Clinic/Center	$0	$7.4M
Dental Center, Inc	TN	Dentist	$0	$7.4M
Lighthouse Kids Hixson, LLC	TN	Behavior Analyst	$0	$3.7M
Hixson Pediatric Dentistry PLLC	TN	Pediatric Dentistry	$0	$3.2M
Memorial Health Care System Inc.	TN	General Acute Care Hospital	$0	$2.4M
Chattanooga Pain Management Center LLC	TN	Ambulatory Surgical Clinic/Center	$2.4M	$1.6K
Chelsea Schwind	TN	Dentist	$0	$2.2M
Richard Breazeale	TN	Retina Specialist (Ophthalmology) Physician	$2.1M	$0
Summit Physical Therapy, LLC	TN	Physical Therapy Clinic/Center	$0	$2.1M

Rohan Shah — Billing Profile & Reimbursement Data

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Rohan Shah — 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