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NPI 1851312326 · Merrillville, IN · Ophthalmology Physician
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Sahana Vyas is a ophthalmology physician provider located in Merrillville, Indiana. This profile covers 17 Medicare and 6 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 | Sahana Vyas |
| Address | 8679 Connecticut Street |
| City | Merrillville |
| State | IN |
| ZIP | 46410 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | July 21, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.6M |
| Medicaid | $399.4K |
Provider scale and tenure: SAHANA VYAS reports $1.6M in lifetime Medicare revenue and $399.4K in lifetime Medicaid revenue, with an NPI enumerated 2006-07-21 (~20 years ago), indicating a long-standing ophthalmology practice with materially larger Medicare receipts than Medicaid. This payer-weighted scale suggests Medicare is the primary revenue engine for this clinician.
Service-line focus: The billing mix is concentrated in retina-focused medical ophthalmology, with high-volume intravitreal injection and imaging codes present across both payers (notably J0178, J2778, J2777, J9035, 67028 and 92134). The combination of anti-VEGF biologic injections and retinal imaging supports characterization of the practice as oriented toward medical retina care and frequent follow-up visits for chronic retinal disease.
Medicare revenue concentration: The top three Medicare codes account for 74.5% of this provider's total Medicare revenue, driven primarily by J0178 which contributes $899.9K (55.8% of Medicare revenue), followed by 99214 at $167.3K (10.4%) and J2778 at $135.8K (8.4%). This concentration means shifts in utilization or reimbursement of those specific drugs or the E/M office visits could materially change the provider's Medicare revenue.
Medicaid revenue concentration: The top three Medicaid codes account for 87.7% of this provider's total Medicaid revenue, with 67028 alone representing $257.8K (64.7%), complemented by 99214 at $57K (14.3%) and 92134 at $34.7K (8.7%). Medicaid revenue is heavily dependent on procedural intravitreal injections (67028), so Medicaid-facing reimbursement or coverage changes for injection procedures would disproportionately affect the provider's Medicaid performance.
Medicare competitive standing and outliers: The provider’s 99214 volume is an extreme outlier nationally (rank #1664 of 479,517; 100th percentile), indicating unusually high Medicare E/M visit volume compared with national peers; 92134 is also notably above typical national volume (96th percentile). By contrast, J0178 sits at the 69th percentile (rank #982 of 3,204), reflecting a typical but substantial share of anti-VEGF drug billing rather than a dominant national position.
Medicaid/state competitive position: In-state rankings show the provider as a modest participant rather than a dominant player for Medicaid—67028 ranks #27 of 55 in-state (52th percentile) and 92134 ranks #27 of 84 in-state (69th percentile). These placements indicate typical to above-typical procedural and imaging volumes within Indiana but not a top-tier statewide dominance.
Claims and unit-payment profile nuance: The Medicare file shows different utilization dynamics across drug codes—J0178 appears as fewer claims (1.3K) with a high average paid per claim ($688) producing $899.9K, while J2777 shows a very high claim count (4K) with a low average paid per claim ($29) producing $116.6K (7.2% of Medicare revenue). These patterns suggest the practice bills both high-cost biologic agents and lower-paid injection line items frequently, which produces distinct revenue sensitivities to unit-price versus volume changes.
Analytic implications for payers and partners: Given that top-3 Medicare codes drive 74.5% of Medicare revenue and top-3 Medicaid codes drive 87.7% of Medicaid revenue, analysts should prioritize monitoring utilization and payment trends for J0178, 67028 and 99214 when assessing revenue risk or negotiating contracts. The combination of an extreme E/M outlier on Medicare (99214) and procedure/drug concentration on both payers makes this provider sensitive to policy shifts in office visit reimbursement and anti-VEGF/injection coverage.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
17 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1,310 | $690 | $899.9K |
| 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… | 1,880 | $90 | $167.3K |
| J2778 | Injection, ranibizumab, 0.1 mg | 770 | $180 | $135.8K |
| 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. | 1,550 | $80 | $128.9K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 4,020 | $30 | $116.6K |
| 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. | 1,980 | $30 | $57.5K |
| J3590 | Unclassified biologics | 430 | $70 | $30.3K |
| 92235 | The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken… | 210 | $100 | $20.8K |
| 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… | 160 | $110 | $17.5K |
| J9035 | Injection, bevacizumab, 10 mg | 180 | $60 | $10.1K |
Showing 1–10 of 17
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
17 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 21 | 60 | 830 | $690 | $868.8K |
| J2777 | 25 | 40 | 6,750 | $30 | $395.6K |
| J2778 | 5 | 10 | 560 | $180 | $150K |
| 67028 | 19 | 80 | 550 | $80 | $78.6K |
| J3590 | 15 | 50 | 220 | $60 | $24.5K |
| J9035 | 18 | 30 | 200 | $50 | $19.2K |
| 92235 | 9 | 40 | 90 | $100 | $15.8K |
| 99214 | 17 | 10,540 | 110 | $80 | $15.5K |
| 67228 | 9 | 20 | 30 | $230 | $9.8K |
| 67210 | 10 | 10 | 30 | $370 | $8.5K |
Showing 1–10 of 17
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.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 1,300 | $200 | $257.8K |
| 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… | 1,080 | $50 | $57K |
| 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. | 1,650 | $20 | $34.7K |
| J9035 | Injection, bevacizumab, 10 mg | 550 | $60 | $34K |
| 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… | 480 | $30 | $14.3K |
| 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… | 10 | $70 | $920 |
How this provider's Medicaid billing volume and revenue compare to other Indiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Indiana median
6 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 987 | 2,120 | 870 | $60 | $450.6K |
| 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… | 318 | 690 | 360 | $70 | $110.9K |
| 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. | 27 | 60 | 1,260 | $50 | $108.4K |
| 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… | 752 | 790 | 150 | $90 | $99.4K |
| J9035 | Injection, bevacizumab, 10 mg | 20 | 30 | 700 | $40 | $46.4K |
| 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. | 27 | 80 | 680 | $20 | $34.5K |
Other providers in the same ZIP code as Sahana Vyas, ranked by combined Medicare and Medicaid revenue.
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