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

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

Tina Shah (NPI 1972766368)

Field	Value
Entity Type	Individual
Organization	Tina Shah
Address	4440 Broadway Blvd
City	Kansas City
State	MO
ZIP	64111
Taxonomy	Rheumatology Physician
NPI Enumerated	July 7, 2008

Payer Source	Total Paid
Medicare	$1.6M
Medicaid	$0

Key Findings

This provider is effectively single-payer in scope: lifetime Medicare revenue is $1.6M while there is no Medicaid billing on file. The absence of Medicaid activity suggests the practice’s revenue and access risk are concentrated in Medicare-covered patients rather than a mixed Medicaid/Medicare panel.

Revenue is highly concentrated in biologic drug administration: the top three Medicare revenue-driving codes — J0129 ($374.9K, 23.0%), J0717 ($310.4K, 19.1%), and J1745 ($234.5K, 14.4%) — together account for 56.5% of the provider's total Medicare revenue. This concentration indicates that a majority of Medicare dollars come from a small set of high-cost injectable biologic therapies.

The code mix and specific top codes point to an infusion-centered rheumatology practice model: J0129, J0717, and J1745 are all high-cost biologic injections (abatacept, certolizumab pegol, infliximab) and the presence of administration/infusion CPTs such as 96413 (481 claims, $48.1K revenue, 3.0%) and 96365 (108 claims, $5.1K revenue, 0.3%) supports an in‑office infusion and drug-administration workflow with on-site monitoring. Lab codes used for rheumatologic monitoring (85025, 80076, 86140) further reinforce ongoing medical management and biologic monitoring as core service lines.

Competitive standing on the top biologic codes is mixed: J0129 ranks #422 of 1221 providers (65th percentile) and is described as a typical, unremarkable volume; J0717 ranks #218 of 848 (74th percentile) and is also typical; J1745 ranks #113 of 1352 (92th percentile) and is relatively high nationally, though still characterized in the data as typical, unremarkable volume. Overall this places the provider as a modest-to-strong national participant on certain biologics rather than a dominant national outlier across the board.

Beyond biologics, several CPTs are flagged as statistically elevated for this provider: 99214 (694 claims, $61.1K revenue, 3.8%) is described as notably above typical national volume (94th percentile), and 96372 (600 claims, $6.6K revenue, 0.4%) is described as notably above typical national volume (98th percentile). These elevated E/M and injection-administration volumes suggest steady follow-up clinic throughput and frequent short procedures or injections in addition to high-cost drug administration.

There are additional therapeutic and supportive infusion codes present at nontrivial volumes — for example, 96413 (481 claims, $48.1K revenue, 3.0%) and 96415 (248 claims, $5.5K revenue, 0.3%) — which indicates recurring infusion sessions requiring billing for infusion therapy beyond individual drug HCPCS codes. The presence of chemotherapy/infusion administration CPTs alongside rheumatology biologics implies billing for time-based infusion services common to an infusion suite workflow rather than discrete one-off injections alone.

Operationally, the provider shows an established presence in the market with an NPI enumerated 2008-07-07 (~18 years ago), consistent with a sustained practice that has accumulated $1.6M in Medicare revenue over its tenure. This longevity, combined with the concentration in biologics and elevated follow-up visit volumes, indicates a stable, medically intensive outpatient practice focused on chronic autoimmune disease management.

The lack of Medicaid billing (none below — this provider has no Medicaid billing on file) limits comparisons to in‑state Medicaid peers and indicates concentrated payer exposure to Medicare; payor diversification is minimal. For payer strategy or network negotiations, this concentration should be considered a material business characteristic since Medicaid reimbursement and patient mix do not appear to be contributing to the provider’s recorded workload or revenue on file.

Medicare: Complete Services Breakdown

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

39 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0129	Injection, 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)	11,030	$30	$374.9K
J0717	Injection, 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)	77,600	$1	$310.4K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	9,020	$30	$234.5K
J1569	Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg	5,030	$40	$181.1K
J3262	Injection, tocilizumab, 1 mg	32,240	$1	$129K
J9312	Injection, rituximab, 10 mg	1,820	$60	$114.7K
J1602	Injection, golimumab, 1 mg, for intravenous use	8,250	$10	$82.5K
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…	690	$90	$61.1K
96413	Chemotherapy 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…	480	$100	$48.1K
J0897	Injection, denosumab, 1 mg	1,800	$20	$34.2K

Showing 1–10 of 39

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 39 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Missouri Distribution

Tina Shah — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. state median

39 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	10	20	10,880	$30	$443.6K
J9312	8	10	3,350	$60	$315.8K
J1602	16	20	13,150	$10	$266.8K
J0717	5	10	61,500	$1	$259.7K
J3262	9	10	40,980	$1	$236.8K
J1569	5	10	4,350	$40	$171.2K
J1745	6	40	3,060	$30	$118.1K
J0897	130	210	2,400	$20	$82.4K
96413	19	160	140	$100	$19.1K
99214	330	8,960	100	$80	$13.9K

Showing 1–10 of 39

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
David Dyer	KS	Ophthalmology Physician	$7.5M	$0
Bassam Mattar	KS	Hematology & Oncology Physician	$7.2M	$0
Pavan Reddy	KS	Hematology & Oncology Physician	$6.7M	$0
Jeremy Deutsch	KS	Hematology & Oncology Physician	$5.7M	$0
Thomas Finley	OK	Ophthalmology Physician	$4.8M	$0
Daniel Feiler	KS	Ophthalmology Physician	$4.8M	$0
Travis Koeneke	KS	Hematology & Oncology Physician	$4.4M	$0
Christopher Dakhil	KS	Hematology & Oncology Physician	$4.4M	$0
Stephen Wiles	MO	Ophthalmology Physician	$4.4M	$0
Shaker Dakhil	KS	Hematology & Oncology Physician	$4.4M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Whole Person, Inc.	MO	In Home Supportive Care Agency	$0	$203.1M
Community Choice, Inc.	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$19.6M
St Lukes Hospital Of Kansas City	MO	General Acute Care Hospital	$0	$18.7M
United Seating And Mobility LLC	MO	Durable Medical Equipment & Medical Supplies	$0	$8.8M
Midwest Home Health Care, Inc.	MO	Homemaker	$0	$4.3M
Kalista Engelman	MO	Rheumatology Physician	$1.7M	$0
Julian Magadan	MO	Rheumatology Physician	$1.7M	$0
Kent Huston	MO	Rheumatology Physician	$1.5M	$0
Michael Cassell	MO	Retina Specialist (Ophthalmology) Physician	$1.5M	$0
Hillary Bownik	MO	Gastroenterology Physician	$959.9K	$0

Tina Shah — Billing Profile & Reimbursement Data

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Tina Shah — 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