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

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

Ajay Nehra (NPI 1841278165)

Ajay Nehra is a urology physician provider located in Boston, Massachusetts. This profile covers 17 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.

Provider details (source: NPPES NPI Registry)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Ajay Nehra
Address	55 Fruit St Bldg 1102
City	Boston
State	MA
ZIP	02114
Taxonomy	Urology Physician
NPI Enumerated	January 6, 2006

Payer Source	Total Paid
Medicare	$103.6K
Medicaid	$0

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J3490	Unclassified drugs	370	$70	$25.7K
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…	200	$100	$20K
54405	The provider inserts inflatable synthetic material for a multicomponent, inflatable penile prosthesis into the penis of the patient. The provider also places a pump, the cylinders, and a reservoir…	10	$720	$9.4K
51728	In this procedure, the provider performs a complex cystometrogram along with voiding pressure studies to diagnose certain urinary disorders like an overactive bladder, stress incontinence, or urinary…	20	$340	$7.8K
93980	The provider performs a complete study of the penile blood vessels for abnormalities in blood flow using duplex Doppler ultrasound imaging.	80	$90	$7.1K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	40	$150	$6.5K
99204	The provider sees a new 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 provider…	40	$130	$4.9K
11980	The provider inserts hormone pellets subdermally, normally under the patient's arm skin. These pellets then release levels of synthetic hormones (testosterone and/or estradiol) to treat menopausal…	70	$70	$4.9K
52000	In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a…	30	$150	$4.6K
51797	Voiding pressure (sometimes referred to as leak point pressure) measures contractions of the detrusor muscle and can detect a pressure obstruction if the patient is able to void, or express, urine.	20	$180	$4.1K

Showing 1–10 of 17

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J3490	2	20	60	$380	$49.5K
52000	204	240	90	$170	$17.6K
99214	4,777	15,410	110	$80	$15.6K
99215	2,937	6,360	40	$120	$8.9K
99213	11,025	13,700	70	$60	$8.8K
51728	20	50	20	$230	$8K
54405	3	10	20	$470	$7.5K
99204	2,496	5,870	30	$120	$5.6K
11980	2	10	60	$80	$5.6K
51797	31	70	20	$130	$5.1K

Ajay Nehra — Billing Profile & Reimbursement Data

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Ajay Nehra — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References