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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
Sister Sites: OpenMedicaid ยท OpenFeds ยท OpenSpending

ยฉ 2026 OpenMedicare. Independent data journalism. Built by TheDataProject.ai

Methodologyโ€ขDownload Data
  1. Home
  2. Providers
  3. Sanjay Shah
๐Ÿ’‰
MDIndividual

Sanjay Shah, MD

NPI: 1770558413
Spring House, PA
10 years of data
Anesthesiology
$4.4M
Total Payments
23.4K
Beneficiaries
52.6K
Services
6.31x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$4.4M
Specialty median$26.7K

๐Ÿ“‹ Key Findings

1Billed $4.4M over 10 years
26.31x markup ratio (above median)
399th percentile in Anesthesiology by payments
4Payments surged 122% in 2018
520 procedures with >3x markup
โœ“ No flags detected

๐Ÿ”Ž Data Analysis

This provider's $4.4M in total Medicare payments ranks in the 99th percentile of Anesthesiology providers nationally.

Their average markup ratio of 6.31x is significantly above the specialty median of 8.8x.

Medicare payments to this provider grew 1458% from 2014 to 2023.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

๐Ÿ“ˆ

Notable: Payments increased 122% in 2018

Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid โ€” the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$789.44$78.0010.12x$711.44$57.8K858657
2015$666.77$70.119.51x$596.66$64.8K932723
2016$577.71$72.377.98x$505.34$81.9K1.1K782
2017$746.01$79.719.36x$666.30$171.2K2.2K1.4K
2018$709.42$80.728.79x$628.70$379.8K4.7K2.3K
2019$777.45$100.707.72x$676.75$396.4K5.2K2.7K
2020$1.0K$148.347.04x$895.83$569.4K7.2K3.2K
2021$1.4K$160.818.66x$1.2K$932.7K9.6K3.7K
2022$931.40$125.477.42x$805.93$833.1K9.8K3.9K
2023$1.5K$170.528.88x$1.3K$900.0K11.1K4.2K

Top Procedures (20)

99214Established patient office or other outpatient, visit typically 25 minutesโš  4.9x markup
$1.5M
15.6K services$93.64/svc4.86x markup
62323Injection of substance into spinal canal of lower back or sacrum using imaging guidanceโš  7.5x markup
$554.1K
3.4K services$163.29/svc7.47x markup
0275TRemoval of bone from lower spine for decompression of nerve tissue using imaging guidance, accessed through the skinโš  7.0x markup
$367.4K
444 services$827.52/svc6.95x markup
80307Testing for presence of drugโš  4.7x markup
$197.3K
3.2K services$61.25/svc4.73x markup
G0483Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/msโš  4.1x markup
$174.2K
711 services$245.02/svc4.08x markup
G0480Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/msโš  5.1x markup
$166.5K
1.5K services$112.59/svc5.12x markup
62321Injection of substance into spinal canal of upper or middle back using imaging guidanceโš  7.9x markup
$166.2K
1.0K services$165.59/svc7.92x markup
99204New patient office or other outpatient visit, typically 45 minutesโš  4.5x markup
$165.8K
1.3K services$130.55/svc4.47x markup
G0481Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/msโš  5.1x markup
$140.4K
915 services$153.45/svc5.08x markup
64483Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidanceโš  13.1x markup
$119.8K
697 services$171.92/svc13.10x markup
64493Injections of lower or sacral spine facet joint using imaging guidanceโš  12.5x markup
$90.0K
616 services$146.04/svc12.54x markup
99213Established patient office or other outpatient visit, typically 15 minutesโš  4.2x markup
$75.1K
1.3K services$59.48/svc4.23x markup
99490Chronic care management services at least 20 minutes per calendar monthโš  4.0x markup
$70.2K
1.5K services$45.75/svc4.00x markup
64635Destruction of lower or sacral spinal facet joint nerves using imaging guidanceโš  8.4x markup
$60.3K
241 services$250.38/svc8.42x markup
22612Fusion of lower spine bones, posterior or posterolateral approachโš  5.9x markup
$48.6K
35 services$1.4K/svc5.87x markup
62311Injections of substances into lower or sacral spineโš  9.6x markup
$42.9K
472 services$90.96/svc9.64x markup
64494Injections of lower or sacral spine facet joint using imaging guidanceโš  10.9x markup
$39.8K
514 services$77.46/svc10.90x markup
96127Brief emotional or behavioral assessmentโš  6.7x markup
$37.7K
9.3K services$4.07/svc6.71x markup
77002Fluoroscopic guidance for insertion of needleโš  4.5x markup
$36.9K
425 services$86.88/svc4.46x markup
64484Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidanceโš  14.4x markup
$36.2K
519 services$69.66/svc14.43x markup
Show detailed table โ–พ
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
99214Established patient office or other outpatient, visit typically 25 minutes15.6K$1.5M$93.644.86x
62323Injection of substance into spinal canal of lower back or sacrum using imaging guidance3.4K$554.1K$163.297.47x
0275TRemoval of bone from lower spine for decompression of nerve tissue using imaging guidance, accessed through the skin444$367.4K$827.526.95x
80307Testing for presence of drug3.2K$197.3K$61.254.73x
G0483Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms711$174.2K$245.024.08x
G0480Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms1.5K$166.5K$112.595.12x
62321Injection of substance into spinal canal of upper or middle back using imaging guidance1.0K$166.2K$165.597.92x
99204New patient office or other outpatient visit, typically 45 minutes1.3K$165.8K$130.554.47x
G0481Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms915$140.4K$153.455.08x
64483Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance697$119.8K$171.9213.10x
64493Injections of lower or sacral spine facet joint using imaging guidance616$90.0K$146.0412.54x
99213Established patient office or other outpatient visit, typically 15 minutes1.3K$75.1K$59.484.23x
99490Chronic care management services at least 20 minutes per calendar month1.5K$70.2K$45.754.00x
64635Destruction of lower or sacral spinal facet joint nerves using imaging guidance241$60.3K$250.388.42x
22612Fusion of lower spine bones, posterior or posterolateral approach35$48.6K$1.4K5.87x
62311Injections of substances into lower or sacral spine472$42.9K$90.969.64x
64494Injections of lower or sacral spine facet joint using imaging guidance514$39.8K$77.4610.90x
96127Brief emotional or behavioral assessment9.3K$37.7K$4.076.71x
77002Fluoroscopic guidance for insertion of needle425$36.9K$86.884.46x
64484Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance519$36.2K$69.6614.43x

Markup Analysis

Charge-to-Payment Ratio

6.31x

This provider submits charges 6.31 times higher than what Medicare actually pays.

What This Means

A markup ratio of 6.31x means for every $100 Medicare pays, this provider initially charges $631. This is higher than the national average.

Location

Spring House, PA

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

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Data Sources

  • โ€ข Centers for Medicare & Medicaid Services (CMS)
  • โ€ข Medicare Provider Utilization and Payment Data (2014-2023)
  • โ€ข National Plan and Provider Enumeration System (NPPES)

Last Updated: February 2026 (data through 2023, the latest CMS release)

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.

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