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

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

Chetankumar Patel (NPI 1851393466)

Field	Value
Entity Type	Individual
Organization	Chetankumar Patel
Address	7101 Guilford Dr
City	Frederick
State	MD
ZIP	21704
Taxonomy	Ophthalmology Physician
NPI Enumerated	August 12, 2005

Payer Source	Total Paid
Medicare	$3.9M
Medicaid	$0

Key Findings

This provider's Medicare activity is concentrated in intravitreal and ophthalmic therapeutic services, with J2778 (6.1K claims, $1.1M revenue) and J2777 (27.1K claims, $784.7K revenue) among the top revenue drivers and J2403 (520K claims, $520K revenue) also a major contributor. The code mix (multiple anti-VEGF/biologic injection codes plus a high-volume topical ophthalmic product) indicates an operational focus on retina/injection-based care rather than primarily refractive or surgical ophthalmology services.

Revenue concentration is high: the precomputed top 3 Medicare codes account for 59.3% of this provider's total Medicare revenue, and Total Medicare revenue is $3.9M while there is no Medicaid billing on file. This makes the practice effectively single-payer from a public-program perspective, with Medicare representing the entirety of reported public reimbursement.

Competitive standing for key injection and imaging codes is strong: J2778 ranks #29 of 1208 providers nationally (98th percentile; notably above typical national volume for this code) and J2403 ranks #4 of 76 providers nationally (96th percentile; notably above typical national volume for this code). At the same time J2777 ranks #342 of 2039 providers nationally (83th percentile; typical, unremarkable volume for this code), indicating leadership in certain biologic/injection lines but more typical positioning for others.

Clinical throughput is high for both procedural and evaluation services: 99214 shows 4K claims and $390.1K revenue and ranks #66 of 479517 providers nationally (100th percentile; extreme outlier), while 92134 has 3.7K claims and $112.1K revenue and ranks #174 of 26868 providers nationally (99th percentile; extreme outlier). These figures together suggest a practice with a large established-patient panel receiving frequent complex visits and retinal imaging.

The provider bills a mix of branded and biosimilar biologics: Q5128 (1.5K claims, $318K revenue) and J2778 (ranibizumab) sit alongside J2777 (faricimab) and J2781 (pegcetacoplan, 1.6K claims, $192.6K revenue). This pattern indicates active use of multiple intravitreal agents for retinal disease management rather than reliance on a single drug.

Ancillary diagnostic and procedure volumes are elevated relative to peers: 67028 (2.9K claims, $256.6K revenue) ranks #114 of 4255 (97th percentile; notably above typical national volume), 92014 (1.2K claims, $118.4K revenue) ranks #1020 of 35415 (97th percentile; notably above typical national volume), and 92235 (403 claims, $42.7K revenue) ranks #121 of 2192 (95th percentile; typical, unremarkable volume). The combination of injections, imaging, and office E/M suggests a vertically integrated clinic model performing diagnostics and treatments on-site.

Drug billing includes high per-claim items outside standard HCPCS biologic codes: J3490 shows 97 claims at $1768 avg paid/claim for a total of $171.5K revenue and ranks #811 of 2838 providers nationally (71th percentile; typical, unremarkable volume). While not among the top three revenue sources, these unclassified drug payments make a meaningful contribution to the Medicare topline and merit review when modeling drug cost drivers.

Provider tenure is long-standing: NPI enumerated on 2005-08-12 (~21 years ago), which supports interpretation of the high-volume patterns as established operational behavior rather than a short-term anomaly. Given the absence of Medicaid activity, any competitive analysis or network contracting should treat this entity as a Medicare-centric practice with concentrated revenue exposure to a small set of ophthalmic therapies and services.

Medicare: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2778	Injection, ranibizumab, 0.1 mg	6,140	$190	$1.1M
J2777	Injection, faricimab‑svoa, 0.1 mg	27,060	$30	$784.7K
J2403	Chloroprocaine hcl ophthalmic, 3% gel, 1 mg	520,000	$1	$520K
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…	4,020	$100	$390.1K
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	1,490	$210	$318K
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.	2,850	$90	$256.6K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	1,610	$120	$192.6K
J3490	Unclassified drugs	100	$1,770	$171.5K
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…	1,230	$100	$118.4K
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.	3,740	$30	$112K

Showing 1–10 of 16

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Maryland Distribution

Chetankumar Patel — 5 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. state median

16 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2403	3	10	860,000	$1	$506.2K
J2777	14	70	8,520	$30	$487.3K
J2781	4	20	620	$120	$258.6K
J2778	1	50	650	$180	$207.8K
67028	4	120	700	$100	$101.5K
Q5128	1	20	200	$210	$78K
J3490	36	100	70	$450	$62.1K
92014	65	620	210	$90	$44K
99214	3	10,270	150	$90	$24.1K
92235	10	90	70	$110	$19.5K

Showing 1–10 of 16

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pediatric Dental Center Of Frederick, LLC	MD	Pediatric Dentistry	$0	$22.9M
Frederick Institute	MD	Methadone Clinic	$0	$6.8M
Serenity Treatment Center, Inc.	MD	Addiction (Substance Use Disorder) Counselor	$0	$6.7M
Frederick Endoscopy Center LLC	MD	Endoscopy Clinic/Center	$1.3M	$0
Anish Desai	MD	Pulmonary Disease Physician	$302.4K	$374.2K
Scott Henry	MD	Podiatrist	$415.1K	$0
Michael Tolino	MD	Pulmonary Disease Physician	$373.5K	$0
Phuong Ho	MD	Internal Medicine Physician	$315.3K	$0
Jennifer Giegel	MD	Occupational Therapist	$227.4K	$0
Neil Waravdekar	MD	Pulmonary Disease Physician	$224.4K	$0

Chetankumar Patel — Billing Profile & Reimbursement Data

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Chetankumar Patel — 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

Nearby Providers

Frequently Asked Questions

References