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

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

Associated Retinal Consultants LLC (NPI 1164578894)

Field	Value
Entity Type	Organization
Organization	Associated Retinal Consultants LLC
Address	1 Centurian Dr Ste 114
City	Newark
State	DE
ZIP	19713
Taxonomy	Ophthalmology Physician
NPI Enumerated	January 26, 2007

Payer Source	Total Paid
Medicaid	$25.2M
Medicare	$0

Key Findings

This provider is effectively single-payer in the available data: there is no Medicare billing on file while Medicaid revenue totals $25.2M, so all reported fee-for-service activity in our dataset comes through Medicaid rather than Medicare. That absence of Medicare activity is notable given the scale of Medicaid billing and should be considered when comparing payer mix against typical multi-payer ophthalmology practices.

Revenue is highly concentrated in a small set of outpatient ophthalmology services: the top three Medicaid codes (J0178, 92014, 67028) account for 71.4% of the provider’s total Medicaid revenue. The single largest contributor is J0178 (Injection, aflibercept) with $10.5M (41.8% of Medicaid revenue), followed by 92014 with $4.7M (18.9%) and 67028 with $2.7M (10.8%).

The code mix indicates a retina-focused, high-throughput ambulatory practice: large volumes of intravitreal injection codes (J0178 and 67028) combined with very high utilization of retinal imaging (92134) and established-patient comprehensive visits (92014) point to a clinic model centered on chronic retinal disease management. For example, J0178 shows 12.6K claims at $832 avg paid/claim, 92134 shows 94.5K claims at $23 avg paid/claim, and 92014 shows 79.1K claims at $60 avg paid/claim, consistent with frequent follow-up and imaging around anti-VEGF therapy.

Claim volumes are exceptionally large compared with in-state peers, suggesting either a large patient panel or very frequent follow-up protocols: 92134 has 94.5K claims and is labeled an "extreme outlier, far above typical state volume" (ranks #1 of 15, 100th percentile), while 92014 has 79.1K claims and is also an "extreme outlier, far above typical state volume" (ranks #1 of 43, 100th percentile). Likewise, 67028 has 53.1K claims and is "notably above typical state volume" (ranks #1 of 7, 100th percentile).

Competitive standing within Delaware is dominant for several core service lines: the practice ranks #1 in the state for J0178, 92014, 67028, and 92134 (all 100th percentile where peer comparisons exist). These rankings, along with the "extreme outlier" and "notably above typical" labels, characterize the provider as a major statewide hub for retinal injections, retinal imaging, and high-volume ophthalmology visits rather than a modest or niche operator.

The provider bills a mix of high-cost biologic agents and lower-cost alternatives, indicating active use of multiple anti-VEGF therapies: J0178 (aflibercept) generates $10.5M at $832 avg paid/claim, J2778 (ranibizumab) accounts for $400.4K at $700 avg paid/claim, J9035 (bevacizumab) contributes $258K at $56 avg paid/claim, and J0177 and J2777 appear in smaller volumes. This spread suggests treatment offerings that include both branded and lower-cost biologic options.

Beyond injections and imaging, the practice generates meaningful revenue from E/M visits and new-patient evaluations, indicating comprehensive outpatient management rather than only procedure-based throughput. For example, 99204 produced $992.4K on 8.8K claims (ranks #3 of 182, 99th percentile) and established-patient visits 99214 and 99213 together add several hundred thousand dollars, which aligns with a robust consultative and follow-up workload.

The provider has long-standing enrollment: the NPI was enumerated 2007-01-26 (~19 years ago), indicating sustained presence in the market. Coupled with the high-volume Medicaid footprint, this tenure supports the interpretation of an established clinical operation focused on ongoing management of retinal disease within the state Medicaid population.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

50 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	12,620	$830	$10.5M
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…	79,090	$60	$4.7M
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.	53,090	$50	$2.7M
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.	94,500	$20	$2.2M
99204	The provider sees a new 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 provider…	8,780	$110	$992.4K
J0177	Injection, aflibercept hd, 1 mg	1,080	$540	$584.8K
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.	3,440	$130	$432.9K
J2778	Injection, ranibizumab, 0.1 mg	570	$700	$400.4K
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…	5,080	$70	$360.5K
92226	N/A	21,370	$20	$320.6K

Showing 1–10 of 50

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Delaware providers billing the same CPT/HCPCS codes.

Claims Volume vs. Delaware Distribution

Associated Retinal Consultants LLC — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

50 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	Injection, aflibercept, 1 mg	1	10	1,010	$830	$3.8M
J0177	Injection, aflibercept hd, 1 mg	1	10	1,080	$540	$584.9K
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	10	1,460	$50	$429.3K
J2778	Injection, ranibizumab, 0.1 mg	1	10	400	$630	$250.8K
92202	The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece…	1	10	33,530	$10	$245.9K
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…	124	500	1,130	$50	$235.1K
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…	89	540	1,100	$40	$185.3K
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…	1	40	330	$50	$172.4K
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.	1	20	1,530	$20	$170.6K
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…	4	10	380	$300	$112K

Showing 1–10 of 50

Related Providers

Other providers that share a Tax Identification Number (TIN) with Associated Retinal Consultants LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rohit Lakhanpal	MD	Retina Specialist (Ophthalmology) Physician	$6.1M	$0
Vinod Voleti	NJ	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Sumit Shah	NJ	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Newman Sund	MD	Ophthalmology Physician	$4M	$0
Eric Suan	MD	Ophthalmology Physician	$3.8M	$0
Matthew Speicher	MD	Ophthalmology Physician	$3.7M	$0
Howard Fine	NJ	Retina Specialist (Ophthalmology) Physician	$3.6M	$0
Timothy Polk	MD	Ophthalmology Physician	$3.5M	$0
Jonathan Prenner	NJ	Retina Specialist (Ophthalmology) Physician	$3.4M	$0
David Kim	NJ	Retina Specialist (Ophthalmology) Physician	$3.4M	$0

Nearby Providers

Other providers in the same ZIP code as Associated Retinal Consultants LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Medical Services, LLC	DE	Case Management Agency	$0	$18.7M
Christiana Care Health Services Inc	DE	Hospitalist Physician	$0	$13.6M
Caritas Home Health Services, Inc	DE	Home Health Agency	$0	$11.2M
Delaware Center For Maternal Fetal Medicine Of Christiana Care	DE	Maternal & Fetal Medicine Physician	$0	$9.8M
Christiana Care Health Services Inc	DE	Neonatal-Perinatal Medicine Physician	$0	$8.9M
Medical Oncology Hematology Consultants PA	DE	Hematology & Oncology Physician	$0	$7.7M
Christiana Care Quality Partners	DE	Urgent Care Clinic/Center	$0	$7M
Jamal Misleh	DE	Hematology & Oncology Physician	$6.8M	$0
Mid-atlantic Behavioral Health, LLC	DE	Intellectual & Developmental Disabilities Psychologist	$0	$6.5M
First State Orthopaedics, PA	DE	Orthopaedic Surgery Physician	$0	$6M

Associated Retinal Consultants LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References