Physician

Ajay K Mathur, M.D.

According to 2025 Medicare claims, Ajay Mathur, M.D. (NPI: 1619979002) practices rheumatology in the Pittsburgh, PA market, with the plurality of this provider's patient population coming from Washington, PA. This provider's primary affiliated billing organization is HIGHLANDS HOSPITAL AND HEALTH CENTER (NPI: 1326750852; TIN: 251494705) and primary practice location at 15063-1564.

Mathur's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 137 traditional Medicare patients, billed 272 HCPCS/CPT codes, and received $18,417 in Medicare payments. The top billing code was 99204 (New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more). Part D data shows 4,560 prescription claims across 507 beneficiaries totaling $1,120,251 in drug costs, led by Enbrel (Etanercept). Open Payments data shows 6 records totaling $152. 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 fallen sharply in recent years, from $46,786 to $18,417. Concurrently, Part D prescription costs did not follow a clear longitudinal pattern. For DME billing, this provider has fewer than 5 years of reported data, so a reliable trend cannot be assigned.

Part B Carrier Billing Trend

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

Part B Carrier Billing Trend. X-axis: year 2015-2024. Y-axis: Medicare payment, unit: USD. Field: Tot_Mdcr_Pymt_Amt. Source: Medicare Physician & Other Practitioners by Provider.0$129K$259K2015 Medicare payment: $46,786 (USD; Tot_Mdcr_Pymt_Amt)2016 Medicare payment: $99,751 (USD; Tot_Mdcr_Pymt_Amt)2017 Medicare payment: $123,835 (USD; Tot_Mdcr_Pymt_Amt)2018 Medicare payment: $176,251 (USD; Tot_Mdcr_Pymt_Amt)2019 Medicare payment: $257,883 (USD; Tot_Mdcr_Pymt_Amt)2020 Medicare payment: $223,628 (USD; Tot_Mdcr_Pymt_Amt)2021 Medicare payment: $258,690 (USD; Tot_Mdcr_Pymt_Amt)2022 Medicare payment: $206,634 (USD; Tot_Mdcr_Pymt_Amt)2023 Medicare payment: $30,890 (USD; Tot_Mdcr_Pymt_Amt)2024 Medicare payment: $18,417 (USD; Tot_Mdcr_Pymt_Amt)2015201620172018201920202021202220232024
YearPatientsClm LinesPayment
2015274847$46,786
20162562,125$99,751
20172602,521$123,835
20182693,672$176,251
20192685,558$257,883
20202345,007$223,628
20212206,050$258,690
20221975,574$206,634
2023179631$30,890
2024137272$18,417

Part D Events Trend

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

Part D Events Trend. X-axis: year 2015-2024. Y-axis: Drug cost, unit: USD. Field: Tot_Drug_Cst. Source: Medicare Part D Prescribers by Provider.0$920K$1.8M2015 Drug cost: $1,135,234 (USD; Tot_Drug_Cst)2016 Drug cost: $1,074,983 (USD; Tot_Drug_Cst)2017 Drug cost: $1,456,155 (USD; Tot_Drug_Cst)2018 Drug cost: $1,407,077 (USD; Tot_Drug_Cst)2019 Drug cost: $1,840,781 (USD; Tot_Drug_Cst)2020 Drug cost: $1,760,822 (USD; Tot_Drug_Cst)2021 Drug cost: $1,656,241 (USD; Tot_Drug_Cst)2022 Drug cost: $1,552,384 (USD; Tot_Drug_Cst)2023 Drug cost: $1,625,722 (USD; Tot_Drug_Cst)2024 Drug cost: $1,120,251 (USD; Tot_Drug_Cst)2015201620172018201920202021202220232024
YearPatientsClaimsDrug Cost
20155895,696$1,135,234
20166336,353$1,074,983
20176556,662$1,456,155
20186786,833$1,407,077
20196986,985$1,840,781
20206886,902$1,760,822
20216696,480$1,656,241
20226545,690$1,552,384
20236335,247$1,625,722
20245074,560$1,120,251

DME Billing Trend

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

No connected DME records

No connected DME records

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

Top 5 Part B carrier billing codes in 2024

By total payments.

CodeDescriptionPatientsClm LinesTotal Payment
99204New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more1717$123
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more5276$90
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more99151$59
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg1214$1

Top 5 Part D drugs in 2024

By total drug costs.

DrugGenericClaimsTotal Day SupplyTotal Drug Cost
EnbrelEtanercept321,120$288,771
Humira(Cf)Adalimumab251,092$232,175
Enbrel MiniEtanercept20560$144,260
Enbrel SureclickEtanercept17476$124,447
OtezlaApremilast19570$95,624

Top 5 DME services in 2024

No connected or detailed DME service-level records for 2024.

Open Payments Summary in 2024

CategoryDefinitionRecordsTotal Reported AmountTop Related Entity
General PaymentsReported payment or transfer-of-value amount.6$152Amgen Inc.
Research PaymentsReported research-related payment or transfer-of-value amount.0$0N/R
Ownership / Investment InterestsReported value of ownership or investment interests.0$0N/R

FAQ

What Medicare data is available for Ajay K. Mathur, M.D.?

Tedicare shows public-source Medicare data for Ajay K. Mathur, M.D. (NPI 1619979002), 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 K. Mathur, M.D. have ACO affiliation data?

No ACO affiliation record is shown in the available Tedicare data for this profile.

What billing organization is linked to Ajay K. Mathur, M.D.?

Ajay K. Mathur, M.D. is linked to HIGHLANDS HOSPITAL AND HEALTH CENTER (billing NPI 1326750852) in the available physician profile data.

Does Ajay K. Mathur, M.D. have Open Payments data?

Ajay K. Mathur, M.D. has 6 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.