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

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

Nigel Stippa (NPI 1104200468)

Field	Value
Entity Type	Individual
Organization	Nigel Stippa
Address	740 Williams St Ste 3
City	Pittsfield
State	MA
ZIP	01201
Taxonomy	Ophthalmology Physician
NPI Enumerated	July 16, 2015

Payer Source	Total Paid
Medicare	$1.5M
Medicaid	$0

Key Findings

This provider’s billing footprint is almost entirely Medicare-driven: Total Medicare revenue is $1.5M while Total Medicaid revenue is none (no Medicaid billing on file), so the practice is effectively single‑payer from a public program perspective. Analysts should treat Medicare payment policy and drug reimbursement changes as primary levers affecting this provider’s revenue.

Revenue is highly concentrated in a small set of codes: the precomputed top 3 Medicare codes account for 78.4% of the provider’s total Medicare revenue. The single largest contributor is J0178 ($956.3K, 64.2% of Medicare revenue), followed by 67028 ($128.2K, 8.6%) and 99213 ($84.7K, 5.7%), indicating a narrow set of revenue drivers.

The service mix points to an injection- and imaging‑focused ophthalmology practice: J0178 (aflibercept injection) dominates revenue and J9035 (bevacizumab) also appears in the top codes, while 92134 (retinal imaging, 2.1K claims, $65.8K) and 67028 (intravitreal injection, 1.4K claims) show high procedural throughput. Together these codes are consistent with a retina/medical retina workflow that centers on frequent intravitreal drug administration and follow-up imaging.

Competitive standing is mixed across services. For J0178 the provider ranks #909 of 3204 nationally (72th percentile; labeled “typical, unremarkable volume”), so they are a modest national participant for aflibercept administration, whereas 99213 ranks #3110 of 457151 (99th percentile; “extreme outlier”), indicating exceptionally high E/M visit volume relative to peers. Likewise, 92134 ranks #927 of 26868 (97th percentile; “notably above typical”), showing strong relative volume in retinal imaging. These contrasts indicate high visit and imaging throughput but not top-tier aflibercept volume nationally.

Tenure in Medicare is established: the NPI was enumerated 2015-07-16 (~11 years ago), suggesting the provider has built this Medicare billing pattern over multiple years. Given the concentrated drug-and-procedure mix, this tenure likely reflects a stable retina-focused ambulatory practice rather than a transient billing pattern.

Although the practice performs some surgical ophthalmology, procedural surgery is a smaller revenue stream: 66984 (cataract with lens insertion) accounts for $74.1K (5.0% of Medicare revenue) and 66821 (YAG capsulotomy) is minor at $13.9K (0.9%). This indicates that while cataract surgery is offered, the dominant business line is medical retina injections and associated follow-up care rather than surgical cataract volume.

The heavy dependence on medication administration codes (J0178 primary, plus J9035 present) means payer policy changes affecting drug reimbursement or utilization management could materially alter the provider’s Medicare revenue profile. Payers and network planners should note that changes to coverage or pricing for aflibercept or related injection protocols will disproportionately affect this practice’s income.

Coding and utilization signals worthy of operational review: 99213 is labeled an “extreme outlier” and 92014 and 92134 are labeled “notably above typical,” which together suggest a pattern of very high-frequency E/M and imaging visits—consistent with frequent injection follow-ups. For utilization management or contracting discussions, these statistical outlier labels flag areas to validate visit complexity, visit bundling, and the clinical justification for high revisit rates.

Medicare: Complete Services Breakdown

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,380	$690	$956.3K
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.	1,380	$90	$128.2K
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…	1,320	$60	$84.7K
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…	920	$90	$79K
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	180	$410	$74.1K
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.	2,120	$30	$65.8K
J9035	Injection, bevacizumab, 10 mg	860	$60	$47.1K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	40	$320	$13.9K
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…	150	$80	$12.5K
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.	120	$100	$11.8K

Showing 1–10 of 17

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Massachusetts Distribution

Nigel Stippa — 2 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. state median

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	24	90	790	$690	$826.5K
66984	160	330	170	$200	$143.2K
67028	27	120	570	$100	$80.7K
92014	100	1,070	160	$90	$30.1K
J9035	7	80	250	$50	$19.7K
66821	112	240	40	$210	$17.4K
99214	6,061	15,410	110	$80	$15.6K
92134	32	670	70	$30	$10.6K
99213	80	13,700	70	$60	$8.8K
92004	120	890	40	$100	$6.3K

Showing 1–10 of 17

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aqeel Khan	IL	Psychiatry Physician	$2.2M	$3.5M
Timothy Fuller	TX	Ophthalmology Physician	$3.5M	$0
David Lally	MA	Ophthalmology Physician	$3.2M	$670
Rebecca Soares	MA	Retina Specialist (Ophthalmology) Physician	$3M	$9.1K
Sreedevi Daggubati	TX	Hematology & Oncology Physician	$2.8M	$0
Sunil Patel	TX	Ophthalmology Physician	$2.6M	$0
Mark Levitan	TX	Ophthalmology Physician	$2.5M	$0
Jason Bradley	TX	Interventional Cardiology Physician	$2.1M	$0
Charles Clark	TX	Ophthalmology Physician	$2.1M	$0
Colbert Perez	TX	Interventional Cardiology Physician	$2M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Commonwealth Of Massachusets	MA	Case Management Agency	$0	$275M
Berkshire Medical Center, Inc	MA	General Acute Care Hospital	$0	$150M
The Brien Center For Mental Health And Substance Abuse Services Inc.	MA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$50.7M
Elder Services Of Berkshire County Inc.	MA	Case Management Agency	$0	$35.9M
Hillcrest Educational Centers Inc	MA	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$21.6M
Berkshire County Arc, Inc.	MA	Foster Care Agency	$0	$19.8M
Berkshire Medical Center, Inc	MA	Substance Abuse Rehabilitation Facility	$0	$15.4M
Ucp Of Western Massachusetts Inc	MA	Early Intervention Provider Agency	$0	$14.9M
Hospicecare In The Berkshires, Inc.	MA	Community Based Hospice Care Agency	$0	$13.8M
Berkshire Faculty Services Inc	MA	Multi-Specialty Clinic/Center	$0	$13.1M

Nigel Stippa — 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