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NPI 1093033300 · Camp Hill, PA · Ophthalmology Physician
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Maxwell Stem is a ophthalmology physician provider located in Camp Hill, Pennsylvania. This profile covers 16 Medicare and 2 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Maxwell Stem |
| Address | 220 Grandview Ave Ste 200 |
| City | Camp Hill |
| State | PA |
| ZIP | 17011 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | May 11, 2010 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.9M |
| Medicaid | $31.9K |
This provider’s revenue is overwhelmingly Medicare-driven: total Medicare revenue is $2.9M compared with total Medicaid revenue of $31.9K, so Medicare supplies the vast majority of billed revenue and the practice functions effectively as a Medicare-focused operation. Medicaid activity is present but immaterial by scale in comparison.
Medicare revenue is highly concentrated in intravitreal drug administration: the top three Medicare codes J0178, J2777, and J2778 together account for 87.3% of this provider’s total Medicare revenue, with J0178 alone representing $1.6M (54.8%). That concentration indicates the provider’s Medicare business is dominated by high-value injectable therapies.
The code mix (J0178, J2777, J2778, plus procedure 67028 and imaging 92134) points to a medical-retina service line that performs frequent in-office intravitreal injections for chronic retinal disease and pairs those injections with retinal imaging. Presence of high-volume therapeutic drug codes alongside diagnostic imaging codes suggests ongoing, follow-up–intensive care for retinal conditions rather than a primarily surgical practice.
Competitive standing for the top Medicare drug codes is middle-to-high but not dominant nationally: J0178 ranks #386 of 3204 providers (88th percentile) and is described as typical, unremarkable volume for this code; J2777 ranks #419 of 2039 (79th percentile) and J2778 ranks #317 of 1208 (74th percentile), both also characterized as typical, unremarkable volumes. At the same time, the provider shows notably elevated utilization for certain services: 92134 is in the 97th percentile (notably above typical national volume) and 99213 is an extreme outlier at the 99th percentile (far above typical national volume), indicating unusually high E/M and retinal imaging throughput relative to national peers.
In-state competitive position on Medicaid is modest: 67028 ranks #47 of 99 providers (53th percentile) and 92134 ranks #68 of 183 providers (63th percentile), both described as typical, unremarkable volumes within Pennsylvania. The provider is therefore a routine participant in the state market for injections and retinal imaging rather than a statewide leader.
The practice’s financial profile shows operational sensitivity to changes in drug mix and reimbursement: with the majority of Medicare revenue tied to a small set of injectable drug codes (87.3% concentrated in the top three), shifts in pricing, utilization, or coverage for those agents would have outsized effects on revenue. Medicaid exposure is low but entirely concentrated in injection and imaging codes, so payer-specific policy changes could disproportionately affect those smaller revenue streams.
The provider has an established billing history, with NPI enumerated 2010-05-11 (~16 years ago), indicating long tenure in the Medicare/Medicaid programs that supports stable longitudinal patterns of retinal treatment and follow-up care reflected in the claim mix.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
16 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2,330 | $680 | $1.6M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 23,760 | $30 | $689K |
| J2778 | Injection, ranibizumab, 0.1 mg | 1,380 | $180 | $250K |
| 67028 | The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye. | 1,900 | $80 | $155.8K |
| 99213 | The 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… | 1,020 | $60 | $62.2K |
| 92134 | The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes. | 2,190 | $30 | $61.4K |
| 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… | 180 | $90 | $15.9K |
| 92014 | An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group… | 160 | $80 | $12.8K |
| 67042 | In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina… | 10 | $870 | $11.3K |
| 92004 | The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits. | 110 | $100 | $11.2K |
Showing 1–10 of 16
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
16 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 26 | 140 | 830 | $690 | $865.1K |
| J2778 | 28 | 70 | 1,030 | $190 | $417.1K |
| J2777 | 16 | 100 | 7,950 | $30 | $360.2K |
| 67028 | 31 | 180 | 600 | $90 | $87.5K |
| J7999 | 57 | 110 | 100 | $120 | $33.3K |
| 67042 | 41 | 50 | 20 | $1,100 | $31.9K |
| 92014 | 689 | 1,570 | 130 | $80 | $21K |
| 99214 | 7,518 | 23,230 | 100 | $80 | $14.5K |
| 92235 | 24 | 70 | 40 | $100 | $10K |
| 92134 | 39 | 1,320 | 60 | $30 | $8.4K |
Showing 1–10 of 16
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 67028 | The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye. | 350 | $60 | $22.3K |
| 92134 | The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes. | 480 | $20 | $9.5K |
How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Pennsylvania median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 67028 | The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye. | 47 | 100 | 330 | $70 | $85.4K |
| 92134 | The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes. | 68 | 180 | 290 | $20 | $24.8K |
Other providers in the same ZIP code as Maxwell Stem, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Medstaffers, LLC | PA | Home Health Agency | $0 | $15.1M |
| Penn State Health Holy Spirit Medical Center | PA | General Acute Care Hospital | $0 | $10.2M |
| Penn State Health Life Lion, LLC | PA | Ambulance | $2.4M | $6.9M |
| Shadai Healthcare Services LLC | PA | Home Health Agency | $0 | $9.2M |
| Lawrence Ho | PA | Ophthalmology Physician | $3M | $4.1K |
| Steven Truong | PA | Ophthalmology Physician | $2.7M | $11.5K |
| Paul Baker | PA | Ophthalmology Physician | $2.4M | $3.3K |
| Michael Banach | PA | Ophthalmology Physician | $2.1M | $5.1K |
| Tahsin Khundkar | PA | Ophthalmology Physician | $1.5M | $0 |
| Marissa Wedel | PA | Ophthalmology Physician | $1.4M | $26.3K |
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