Physician

Ajay Verma, MD

According to 2025 Medicare claims, Ajay Verma, MD (NPI: 1285609321) practices pulmonary disease in the Decatur, IL market, with the plurality of this provider's patient population coming from Macon, IL. This provider's primary affiliated billing organization is DECATUR MEMORIAL HOSPITAL (NPI: 1164477725; TIN: 370661199) and primary practice location at 62526-4163. Verma is affiliated with the IRCCO (ACO ID: A2619), participating under the MSSP model.

Verma's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 597 traditional Medicare patients, billed 1,697 HCPCS/CPT codes, and received $89,415 in Medicare payments. The top billing code was 99233 (Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes). Part D data shows 781 prescription claims across 150 beneficiaries totaling $263,774 in drug costs, led by Pirfenidone (Pirfenidone). DME data shows 925 claims. Open Payments data shows 5 records totaling $24. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has declined steadily, from $180,334 to $89,415. Concurrently, Part D prescription costs have moved up and down with repeated peaks and valleys, starting at $307,880 and ending at $263,774. For DME billing, reported payments moved up and down with repeated peaks and valleys, starting at $120,185 and ending at $79,417.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	1,032	2,528	$180,334
2016	1,221	2,942	$205,492
2017	1,223	2,766	$209,462
2018	1,108	2,407	$153,354
2019	1,093	2,175	$138,183
2020	937	2,038	$145,952
2021	917	2,053	$150,807
2022	610	1,455	$103,848
2023	554	1,348	$95,732
2024	597	1,697	$89,415

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	250	1,481	$307,880
2016	220	1,066	$296,965
2017	217	1,023	$356,612
2018	189	979	$280,377
2019	258	1,270	$500,290
2020	275	1,339	$524,095
2021	248	1,198	$416,985
2022	256	1,349	$489,610
2023	200	940	$352,456
2024	150	781	$263,774

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	357	1,591	$131,351
2016	350	1,583	$85,547
2017	418	1,568	$59,812
2018	456	1,645	$68,679
2019	448	1,579	$78,090
2020	431	1,759	$128,416
2021	421	1,894	$160,475
2022	482	1,572	$104,109
2023	361	1,338	$98,327
2024	236	925	$77,555

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
99233	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	126	289	$91
94618	Test for exercise-induced lung stress	123	131	$17
94726	Test to determine lung volumes using sensors	201	204	$9
94729	Test to examine how well the lungs exchange gases	212	215	$7
94010	Test to measure expiratory airflow and volume	145	146	$6

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Pirfenidone	Pirfenidone	13	390	$57,391
Trelegy Ellipta	Fluticasone/Umeclidin/Vilanter	91	2,696	$55,186
Incruse Ellipta	Umeclidinium Bromide	67	2,190	$24,684
Breo Ellipta	Fluticasone/Vilanterol	57	1,710	$21,154
Spiriva Handihaler	Tiotropium Bromide	17	990	$17,064

Top 5 DME services in 2024

By Total Medicare Payment Amount.

HCPCS Code	HCPCS Description	Supplier Rental Indicator	Total Supplier Beneficiaries	Total Supplier Claims	Total Medicare Payment Amount
E0466	Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)	Y	N/R	31	$31,653
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	Y	32	230	$19,970
E0471	Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)	Y	N/R	18	$3,920
A7031	Face mask interface, replacement for full face mask, each	N	20	41	$3,912
A7030	Full face mask used with positive airway pressure device, each	N	20	39	$3,567

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	5	$24	Electromed, Inc.
Research Payments	Reported research-related payment or transfer-of-value amount.	0	$0	N/R
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

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FAQ

What Medicare data is available for Ajay Verma, MD?

Tedicare shows public-source Medicare data for Ajay Verma, MD (NPI 1285609321), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Ajay Verma, MD have ACO affiliation data?

Ajay Verma, MD is shown with ACO affiliation data for IRCCO (MSSP, ACO ID A2619).

What billing organization is linked to Ajay Verma, MD?

Ajay Verma, MD is linked to DECATUR MEMORIAL HOSPITAL (billing NPI 1164477725) in the available physician profile data.

Does Ajay Verma, MD have Open Payments data?

Ajay Verma, MD has 5 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.