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

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

Sonia Mehta (NPI 1902004401)

Field	Value
Entity Type	Individual
Organization	Sonia Mehta
Address	4060 Butler Pike
City	Plymouth Meeting
State	PA
ZIP	19462
Taxonomy	Ophthalmology Physician
NPI Enumerated	July 5, 2007

Payer Source	Total Paid
Medicare	$4.9M
Medicaid	$0

Key Findings

This provider’s Medicare billing profile is concentrated in intravitreal anti-VEGF and related retinal therapeutics: the highest-revenue CPT/HCPCS entries are J0178 (aflibercept), J2777 (faricimab), and Q5128 (ranibizumab biosimilar), which are procedure/drug codes tied to medical retina injection therapy rather than primary care or broad multispecialty services. The code mix—high volumes of injection codes combined with retinal imaging and established-patient eye exams—is consistent with a retina-focused ophthalmology practice that operates a high-throughput injection clinic.

Revenue concentration is pronounced: the precomputed top-3 Medicare codes account for 72.5% of this provider’s total Medicare revenue, with J0178 reported as $2M (40.6%), J2777 as $1M (20.8%), and Q5128 as $542.4K (11.1%) of the provider’s Medicare revenue. That concentration indicates financial dependence on a small set of retina drug administrations.

On payer mix the provider is effectively single-payer: total Medicare revenue is $4.9M while there is no Medicaid billing on file (none below). This absence of Medicaid activity means contracting, utilization review, and population-access considerations should treat Medicare as the dominant and near-exclusive public-payer exposure for this clinician.

Competitive standing for key injection codes shows above-typical national volume for some products but not uniformly across all agents: J0178 ranks #204 of 3204 providers nationally (94th percentile; notably above typical national volume), indicating unusually high aflibercept activity; J2777 ranks #220 of 2039 (89th percentile; typical, unremarkable volume) and Q5128 ranks #49 of 373 (87th percentile; typical, unremarkable volume), indicating a strong but not exceptional national footprint for faricimab and the ranibizumab biosimilar relative to available national peers. These rank/percentile labels suggest a major presence for aflibercept use and solid participation for other retinal drugs.

Service-intensity measures and utilization patterns are extreme relative to peers in diagnostic and injection-related codes: 92012 is reported at 2.5K claims and $175.5K revenue and ranks #38 of 17177 providers nationally (100th percentile; extreme outlier), 92134 is 4.2K claims and $131.2K revenue and ranks #107 of 26868 providers nationally (100th percentile; extreme outlier), and 67028 is 2.7K claims and $268.8K revenue and ranks #134 of 4255 providers nationally (97th percentile; notably above typical national volume). Together these outlier labels and volumes point to very high throughput of established-patient visits, retinal imaging, and standalone intravitreal injection procedures consistent with a high-volume injection clinic workflow.

Ancillary revenue streams are present but comparatively small: J3490 (unclassified drugs) contributed $81.4K (47 claims, $1731 avg paid/claim), and J2781 (pegcetacoplan) contributed $43.2K (360 claims), while surgical retina codes such as 67042 and 67108 appear with low claim counts and modest revenue ($17.6K and $15.7K respectively). This mix reinforces that the practice’s financial model is driven by medical retina injections and diagnostics rather than by surgical vitreoretinal procedures.

The provider’s NPI tenure is long-standing, enumerated 2007-07-05 (~19 years), which combined with the extreme outlier volumes on 92012 and 92134 suggests an established practice with sustained, high procedural throughput for retina services. For payers and competitors, that tenure plus concentration in high-volume injection and imaging codes signals both operational stability and a focused service line that will be important to consider in network negotiations and capacity assessments.

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	2,860	$690	$2M
J2777	Injection, faricimab‑svoa, 0.1 mg	34,920	$30	$1M
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	2,510	$220	$542.4K
J2778	Injection, ranibizumab, 0.1 mg	2,450	$190	$463.1K
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.	2,690	$100	$268.8K
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	2,540	$70	$175.5K
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.	4,230	$30	$131.2K
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…	940	$90	$83.9K
J3490	Unclassified drugs	50	$1,730	$81.4K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	360	$120	$43.2K

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. Pennsylvania Distribution

Sonia Mehta — 4 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. state median

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	17	140	830	$690	$865.1K
Q5128	16	20	3,830	$220	$838.7K
J2778	22	70	1,030	$190	$417.1K
J2777	8	100	7,950	$30	$360.2K
J2781	17	20	690	$120	$109.1K
67028	18	180	600	$90	$87.5K
J7999	41	110	100	$120	$33.3K
67042	27	50	20	$1,100	$31.9K
J3490	67	110	60	$70	$27.9K
92014	80	1,570	130	$80	$21K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Omesh Gupta	PA	Ophthalmology Physician	$7.1M	$80
Mitchell Fineman	PA	Ophthalmology Physician	$7M	$0
Michael Klufas	PA	Ophthalmology Physician	$7M	$0
Richard Kaiser	PA	Ophthalmology Physician	$6.6M	$0
Allen Chiang	PA	Ophthalmology Physician	$6.6M	$0
Carl Regillo	PA	Ophthalmology Physician	$6.5M	$0
Allen Ho	PA	Ophthalmology Physician	$6.4M	$0
Yoshihiro Yonekawa	PA	Ophthalmology Physician	$6.4M	$0
James Vander	PA	Ophthalmology Physician	$6.3M	$0
Marc Spirn	PA	Ophthalmology Physician	$6.3M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gemma Services	PA	Psychiatric Residential Treatment Facility	$0	$23.8M
Access Services Inc	PA	Community/Behavioral Health Agency	$0	$8.3M
Arunan Sivalingam	PA	Ophthalmology Physician	$6M	$0
Sunir Garg	PA	Ophthalmology Physician	$6M	$0
Carl Park	PA	Ophthalmology Physician	$5.5M	$0
Ajay Kuriyan	PA	Ophthalmology Physician	$5.3M	$6.6K
Plymouth Community Ambulance Assn	PA	Land Ambulance	$903.5K	$4.3M
Jason Hsu	PA	Ophthalmology Physician	$4.4M	$0
Michael Cohen	PA	Ophthalmology Physician	$3.9M	$1K
Religen	PA	Clinical Medical Laboratory	$349.2K	$1.7M

Sonia Mehta — 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