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    OpenPayerNPI Medicare & MedicaidLiza Varghese
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    Liza Varghese — Billing Profile & Reimbursement Data

    NPI 1952306193 · Crestview Hills, KY · Rheumatology Physician

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    Liza Varghese is a rheumatology physician provider located in Crestview Hills, Kentucky. This profile covers 14 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.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationLiza Varghese
    Address2616 Legends Way
    CityCrestview Hills
    StateKY
    ZIP41017
    TaxonomyRheumatology Physician
    NPI EnumeratedJune 15, 2005

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$1M
    Medicaid$0

    Key Findings

    This profile is Medicare-dominated: lifetime Medicare revenue is $1M and there is no Medicaid billing on file, making the provider effectively single-payer in the available dataset. Analysts should treat Medicaid as not present when modeling payer mix or access patterns for this NPI.

    Revenue is highly concentrated in a few injectable therapies: the precomputed top 3 Medicare codes (J0129, J0717, J0897) account for 79.4% of this provider's total Medicare revenue. Those top codes are J0129 ($356.2K, 34.0%), J0717 ($326.4K, 31.2%), and J0897 ($149K, 14.2%), signaling that biologic and specialty injectable drugs are the primary revenue drivers.

    The service mix indicates an infusion/injection-focused rheumatology practice: leading codes are for infused or clinician-administered biologics and bone-targeted injections (J0129, J0717, J0897, J1745), supplemented by in-office chemotherapy/infusion administration codes (96401, 96413, 96415). This pattern suggests the practice operates an on-site drug administration/infusion capability rather than relying primarily on office visits alone.

    Competitive standing on the top biologics is modest-to-typical nationally: J0129 ranks #449 of 1221 (63th percentile) and is described as "typical, unremarkable volume," J0717 ranks #204 of 848 (76th percentile) and is also "typical, unremarkable volume," and J0897 ranks #1515 of 10057 (85th percentile) with the same label. Collectively these ranks indicate the provider is neither a national outlier nor a market leader for these products, but maintains above-minimal presence for some agents.

    Administration and steroid injection activity shows notable signals: J1040 (methylprednisolone acetate, 80 mg) is $3.7K and ranks #226 of 8535 (97th percentile), explicitly labeled "notably above typical national volume," while infusion/administration codes such as 96401 ($28.2K, rank #235 of 3868, 94th percentile) and 96372 ($3.4K, rank #3104 of 58224, 95th percentile) are reported as "typical, unremarkable volume." This suggests particularly elevated use of certain depot steroid injections alongside routine infusion services.

    Office E/M activity is a meaningful but secondary revenue source: 99214 represents 631 claims for $52.4K (5.0% of Medicare revenue) and ranks #32299 of 479517 (93th percentile) as "typical, unremarkable volume," while 99213 and the new-patient code 99204 appear at much lower revenue shares (99213 $11.2K, 1.1%; 99204 $1.3K, 0.1%). The pattern implies the practice treats established patients frequently in the context of ongoing injection/infusion care, with limited new-patient visit volume on file.

    The provider has a long-enumerated NPI (enumerated 2005-06-15, ~21 years ago), indicating an established billing history; combined with the concentrated biologic/infusion revenue mix, this points to a stable, service-line–specific operation centered on in-office injectable therapies rather than a broad multiservice outpatient clinic.

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    14 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J0129Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)10,480$30$356.1K
    J0717Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)81,600$1$326.4K
    J0897Injection, denosumab, 1 mg8,280$20$149K
    J1745Injection, infliximab, excludes biosimilar, 10 mg3,180$30$82.6K
    99214The 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…630$80$52.4K
    96401The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient.550$50$28.2K
    96413Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…260$90$24.6K
    99213The 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…180$60$11.2K
    20610In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…100$50$5.3K
    J1040Injection, methylprednisolone acetate, 80 mg460$10$3.7K

    Showing 1–10 of 14

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    14 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J012913309,700$30$415.4K
    J071763046,400$1$288.1K
    J17454102,010$30$93.6K
    J08976802,280$20$59.6K
    964131350100$90$16.7K
    96401320200$50$14.3K
    992143637,230110$70$14.1K
    992131,7417,25080$50$7.7K
    2061026664080$40$6.6K
    992042,8653,20030$100$4.8K

    Showing 1–10 of 14

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Joseph TemmingKYRheumatology Physician$1.1M$0
    Kerrin BurteKYRheumatology Physician$1.1M$0
    Christopher ColglazierKYRheumatology Physician$923.6K$0
    Rebecca CallisKYRheumatology Physician$631.5K$0
    Michael WallsKYInterventional Pain Medicine Physician$299.2K$0
    Nichole ScherpenbergKYPhysical Therapist$55.2K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    St Elizabeth Medical Center, IncKYGeneral Acute Care Hospital$41.7K$188.3M
    Transitions, Inc.KYSubstance Abuse Rehabilitation Facility$0$31.3M
    Compass Emergency Physicians PscKYEmergency Medicine Physician$0$28.8M
    Bluegrass Behavioral Health Group, LLCKYBehavior Analyst$0$23.7M
    Redwood School And Rehabilitation CenterKYChild Intellectual and/or Developmental Disabilities Respite Care$0$12M
    Radiology Associates Of Northern Kentucky, PLLCKYDiagnostic Radiology Physician$0$9.4M
    Orthocincy Orthopaedics & Sports Medicine PscKYOrthopaedic Surgery Physician$0$9.4M
    Redwood School And Rehabilitation CenterKYCommunity Health Clinic/Center$0$9.2M
    Interim Healthcare Of Cincinnati, IncKYHome Health Agency$0$7.9M
    New Perceptions IncKYDevelopmentally Disabled Services Day Training Agency$0$6.5M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Kentucky Distribution
    Liza Varghese — 1 of 14 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Kentucky