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

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

Richard Kaiser (NPI 1124076930)

Field	Value
Entity Type	Individual
Organization	Richard Kaiser
Address	4060 Butler Pike
City	Plymouth Meeting
State	PA
ZIP	19462
Taxonomy	Ophthalmology Physician
NPI Enumerated	May 4, 2006

Payer Source	Total Paid
Medicare	$6.6M
Medicaid	$0

Key Findings

Three codes — J2778 ($1.9M, 28.7%), J0178 ($1.8M, 27.7%), and Q5128 ($1.7M, 26.0%) — together account for 82.4% of this provider's $6.6M in lifetime Medicare revenue, indicating extreme concentration in intravitreal drug administrations and biosimilar use rather than a broad mix of office and surgical services. This preponderance of anti-VEGF and related intravitreal therapy codes is the single dominant revenue driver for the practice.

The code mix (high volumes of J2778, J0178, Q5128 and substantial claims for 67028 and 92134) describes a high-throughput retina/medical-retina operation focused on intravitreal injections and retinal imaging. Claims volumes for injection codes are large (J2778: 10K claims; Q5128: 8K claims; J0178: 2.7K claims) while procedural surgery codes are low in count (67042: 16 claims), suggesting an outpatient injection clinic model with limited surgical throughput.

Competitive standing is bifurcated: the provider is a national outlier on ranibizumab and its biosimilar — J2778 ranks #10 of 1208 providers nationally (99th percentile; extreme outlier) and Q5128 ranks #3 of 373 providers nationally (99th percentile; extreme outlier) — reflecting dominant national-level volume for those specific products. By contrast, J0178 ($1.8M) ranks #263 of 3204 (92th percentile; typical, unremarkable volume), indicating aflibercept utilization is elevated but not an extreme outlier relative to peers.

Beyond the top three drugs, several diagnostic and office codes also show unusually high activity: 92012 (3.2K claims, $216.7K) ranks #12 of 17177 providers (100th percentile; extreme outlier) and 92134 (5.2K claims, $156.6K) ranks #39 of 26868 providers (100th percentile; extreme outlier), signaling very high volumes of intermediate eye exams and retinal imaging that support ongoing injection treatment and monitoring. This reinforces a service-line focused on frequent follow-up and imaging required for intravitreal therapy management.

The provider effectively operates as a single-payer practice: lifetime Medicare revenue is $6.6M and there is no Medicaid billing on file, so Medicaid does not appear in the payer mix. That absence means strategic and operational risk or opportunity is concentrated entirely within the Medicare environment and private-pay/other channels not represented here.

High revenue concentration into three codes (82.4% from J2778, J0178, Q5128) creates both operational leverage and vulnerability: the practice can scale around intravitreal drug delivery and associated imaging, but it is also heavily dependent on utilization patterns and reimbursement for those specific agents. Any shifts in drug utilization, biosimilar adoption, or payer policy affecting these codes could materially change the provider’s revenue profile.

The provider shows long tenure: NPI enumerated 2006-05-04 (~20 years ago), which together with persistent extreme-outlier rankings for multiple retina-related codes suggests a sustained, established high-volume ophthalmology practice rather than a recent volume spike. Longstanding operation aligns with the heavy investment in both drug administration workflows and retinal imaging capacity.

While injections dominate, the practice does bill a mix of other drug and procedure codes at modest levels — for example, J3490 (57 claims, $111.4K) ranks #1427 of 2838 providers (49th percentile; typical, unremarkable volume) and J2777 (3.5K claims, $102.7K) ranks #1753 of 2039 providers (14th percentile; typical, unremarkable volume). These entries show some diversity in drug use and coding but at volumes and percentile standings that are generally typical or modest compared with the extreme outlier status of the ranibizumab-related codes.

Medicare: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2778	Injection, ranibizumab, 0.1 mg	10,030	$190	$1.9M
J0178	Injection, aflibercept, 1 mg	2,650	$690	$1.8M
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	7,950	$220	$1.7M
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.	4,180	$100	$413.7K
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	3,240	$70	$216.7K
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.	5,220	$30	$156.6K
J3490	Unclassified drugs	60	$1,960	$111.4K
J2777	Injection, faricimab‑svoa, 0.1 mg	3,540	$30	$102.7K
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…	710	$90	$61.9K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	240	$120	$28.8K

Showing 1–10 of 20

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Pennsylvania Distribution

Richard Kaiser — 6 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. state median

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	22	140	830	$690	$865.1K
Q5128	2	20	3,830	$220	$838.7K
J2778	2	70	1,030	$190	$417.1K
J2777	80	100	7,950	$30	$360.2K
J2781	18	20	690	$120	$109.1K
67028	2	180	600	$90	$87.5K
J7999	45	110	100	$120	$33.3K
67042	31	50	20	$1,100	$31.9K
J3490	55	110	60	$70	$27.9K
92014	139	1,570	130	$80	$21K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Nemours Foundation	DE	Multi-Specialty Clinic/Center	$0	$172M
The Nemours Foundation	FL	Children's Hospital	$0	$104.9M
The Nemours Foundation	DE	Children's Hospital	$0	$104M
The Nemours Foundation	FL	Multi-Specialty Clinic/Center	$0	$46.2M
Nemours Children's Health, Downtown Orlando, Specialty Care	FL	Multi-Specialty Clinic/Center	$0	$44.4M
Thomas Jefferson University Hospitals Inc	PA	General Acute Care Hospital	$0	$40.3M
Nemours Children's Health, Jacksonville, Specialty Care	FL	Multi-Specialty Clinic/Center	$0	$23.6M
Abington Memorial Hospital	PA	General Acute Care Hospital	$0	$16.6M
Sedigheh Ebadi	FL	Pediatrics Physician	$0	$10.1M
Children's Health Alliance, LLC	FL	Pediatrics Physician	$0	$9.6M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gemma Services	PA	Psychiatric Residential Treatment Facility	$0	$23.8M
Access Services Inc	PA	Community/Behavioral Health Agency	$0	$8.3M
Omesh Gupta	PA	Ophthalmology Physician	$7.1M	$80
Mitchell Fineman	PA	Ophthalmology Physician	$7M	$0
Michael Klufas	PA	Ophthalmology Physician	$7M	$0
Allen Chiang	PA	Ophthalmology Physician	$6.6M	$0
Carl Regillo	PA	Ophthalmology Physician	$6.5M	$0
Allen Ho	PA	Ophthalmology Physician	$6.4M	$0
Yoshihiro Yonekawa	PA	Ophthalmology Physician	$6.4M	$0
James Vander	PA	Ophthalmology Physician	$6.3M	$0

Richard Kaiser — 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