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NPI 1841306693 · Columbia, IL · Otolaryngology Physician
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Ketan Shah is a otolaryngology physician provider located in Columbia, Illinois. This profile covers 11 Medicare and 4 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)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Ketan Shah |
| Address | 1000 Eleven S |
| City | Columbia |
| State | IL |
| ZIP | 62236 |
| Taxonomy | Otolaryngology Physician |
| NPI Enumerated | August 22, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $56K |
| Medicaid | $11.4K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 95811 | During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more. | 150 | $90 | $13.7K |
| 95800 | A patient undergoes a sleep study with no provider physically present. Parameters recorded include heart rate, blood oxygen concentration, respiratory analysis, and the amount of time sleeping. | 220 | $50 | $11.6K |
| 95004 | The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient. | 2,990 | $1 | $9K |
| 95810 | Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,… | 100 | $80 | $8.5K |
| 95165 | In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens. | 920 | $10 | $8.3K |
| 92557 | The provider assesses a patient’s hearing with a series of tones at varying intensities to identify the softest level at which the patient can hear. He also measures the patient’s ability to… | 80 | $30 | $2K |
| 95806 | A technologist is not in attendance during this sleep study, which involves measuring several parameters while the patient sleeps in a clinic or sleep lab to help diagnose sleep disorders. | 50 | $30 | $1.6K |
| 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… | 20 | $40 | $970 |
| 92550 | The provider uses this global service code, which bundles tympanometry and reflex threshold measurement when the provider performs both tests to evaluate the middle ear and inner ear, respectively,… | 60 | $20 | $830 |
| 92588 | The provider performs this noninvasive, diagnostic test to help detect inner ear abnormalities to identify such conditions as functional hearing loss or differentiate between sensory and neural… | 20 | $20 | $380 |
Showing 1–10 of 11
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
11 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 95800 | 2 | 70 | 30 | $100 | $17.3K |
| 95165 | 31 | 80 | 710 | $10 | $12.2K |
| 95811 | 6 | 180 | 40 | $210 | $10.7K |
| 95810 | 15 | 180 | 30 | $210 | $9.1K |
| 99213 | 14,715 | 17,390 | 70 | $60 | $8.8K |
| 95004 | 6 | 130 | 990 | $1 | $4.1K |
| 95117 | 91 | 90 | 300 | $10 | $3.5K |
| 92557 | 186 | 350 | 90 | $30 | $3.1K |
| 92588 | 9 | 10 | 40 | $30 | $1.9K |
| 95806 | 30 | 80 | 30 | $40 | $1.7K |
Showing 1–10 of 11
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99203 | The provider sees a new 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 provider… | 170 | $40 | $7.3K |
| 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… | 140 | $20 | $2.3K |
| 95806 | A technologist is not in attendance during this sleep study, which involves measuring several parameters while the patient sleeps in a clinic or sleep lab to help diagnose sleep disorders. | 30 | $50 | $1.3K |
| 95811 | During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more. | 20 | $40 | $650 |
How this provider's Medicaid billing volume and revenue compare to other Illinois providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Illinois median
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 9,027 | 14,190 | 280 | $20 | $38.9K |
| 95811 | During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more. | 41 | 50 | 50 | $110 | $15.7K |
| 99203 | The provider sees a new 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 provider… | 1,057 | 3,270 | 80 | $40 | $11.1K |
| 95806 | A technologist is not in attendance during this sleep study, which involves measuring several parameters while the patient sleeps in a clinic or sleep lab to help diagnose sleep disorders. | 33 | 50 | 50 | $60 | $9.2K |
Other providers in the same ZIP code as Ketan Shah, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Sierra Wittenauer | IL | Physical Therapist | $131.2K | $0 |
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