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

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

Brendan Girschek (NPI 1194915710)

Field	Value
Entity Type	Individual
Organization	Brendan Girschek
Address	350 N Switzer Canyon Dr
City	Flagstaff
State	AZ
ZIP	86001
Taxonomy	Ophthalmology Physician
NPI Enumerated	July 30, 2007

Payer Source	Total Paid
Medicare	$3.2M
Medicaid	$0

Key Findings

This provider is effectively single-payer in scope: Total Medicare revenue is $3.2M and there is no Medicaid billing on file, so Medicare drives the entirety of the reported public-payor revenue. That concentration means payer exposure, patient mix, and performance benchmarks should be evaluated primarily against Medicare benchmarks rather than a mixed Medicare/Medicaid profile.

Revenue is heavily concentrated in a small set of drugs and biologics: J2777 ($1M, 31.2% of total Medicare revenue), J0178 ($657.4K, 20.2%), and Q5128 ($253.4K, 7.8%) together account for the majority of Medicare receipts — the top 3 Medicare codes by revenue account for 59.2% of this provider's total Medicare revenue. J2777 alone represents nearly a third of Medicare revenue, indicating financial sensitivity to utilization and reimbursement trends for that product.

The CPT/HCPCS mix is consistent with a retina-focused ophthalmology practice that delivers high-volume intravitreal therapeutics and office-based imaging: the highest-revenue items are intravitreal injection drugs (J2777, J0178, Q5128, J2781) and high-volume retinal imaging codes (92134, 92250). This pattern suggests the provider’s workflow emphasizes recurrent office-based injection visits supported by frequent diagnostic imaging rather than primary-care ophthalmology or broad multispecialty outpatient care.

Injection volumes are large but generally within typical national ranges for those drug codes: J2777 ranks #219 of 2039 (89th percentile; typical, unremarkable volume), J0178 ranks #1331 of 3204 (58th percentile; typical, unremarkable volume), and Q5128 ranks #122 of 373 (67th percentile; typical, unremarkable volume). In other words, the provider is a notable but not dominant national player for anti-VEGF and related intravitreal drug administration.

By contrast, several procedural and diagnostic codes place this provider well above typical national volume, signaling a high-throughput imaging and surgical retina practice footprint. Notable examples include 67028 (rank #189 of 4255, 96th percentile; notably above typical national volume), 92134 (rank #411 of 26868, 98th percentile; extreme outlier, far above typical national volume), 92250 (rank #341 of 25087, 99th percentile; extreme outlier, far above typical national volume), and 67145 (rank #12 of 861, 99th percentile; extreme outlier, far above typical national volume).

Use of unclassified and compounded drug billing is material to revenue mix: J3490 accounts for $245.8K (7.6% of Medicare revenue) and J7999 accounts for $81.5K (2.5%). J3490 ranks #506 of 2838 (82th percentile; typical, unremarkable volume) while J7999 ranks #42 of 1333 (97th percentile; notably above typical national volume), indicating a meaningful role for non-standard or compounded drug billing in the practice’s revenue profile.

Surgical retina capability appears present and contributes meaningful high-dollar items to the ledger: 67042 ($66K, 2.0% of Medicare revenue; rank #48 of 1087, 96th percentile; notably above typical national volume), 67036 ($24.4K, 0.8% of Medicare revenue; rank #140 of 832, 82th percentile; typical, unremarkable volume), and 67108 ($21.8K, 0.7% of Medicare revenue; rank #150 of 706, 77th percentile; typical, unremarkable volume). The presence of these higher-paid procedural codes indicates capability for operating-room level retinal interventions in addition to office-based therapy.

The provider has a long Medicare presence: NPI enumerated 2007-07-30 (~19 years ago), which supports an established referral pipeline and practice stability. Combined with the Medicare-only billing footprint, this tenure likely reflects a practice oriented toward the Medicare population and established referral relationships that sustain both high imaging volumes and recurrent injection-based treatment streams.

Medicare: Complete Services Breakdown

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

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2777	Injection, faricimab‑svoa, 0.1 mg	34,980	$30	$1M
J0178	Injection, aflibercept, 1 mg	950	$690	$657.4K
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	1,170	$220	$253.4K
J3490	Unclassified drugs	140	$1,740	$245.8K
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.	2,480	$100	$240.1K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	1,430	$120	$171.1K
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…	1,590	$90	$141.8K
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.	2,990	$30	$89.6K
J7999	Compounded drug, not otherwise classified	1,120	$70	$81.5K
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…	80	$870	$66K

Showing 1–10 of 26

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 26 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Arizona Distribution

Brendan Girschek — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arizona

Full comparison — all codes billed, vs. state median

26 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	23	50	780	$690	$734.8K
J2777	8	50	9,000	$30	$525.8K
Q5128	6	20	520	$220	$207.5K
67028	7	60	1,240	$90	$119K
J2781	1	10	650	$120	$92.4K
J7312	10	20	270	$160	$48.9K
J7999	11	50	490	$70	$46.8K
67042	3	40	30	$1,160	$46.5K
67036	9	30	30	$1,030	$37.9K
67210	5	10	50	$390	$33.9K

Showing 1–10 of 26

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southwestern Eye Center Ltd	AZ	Ophthalmology Physician	$0	$15.9M
Barnet Dulaney Perkins Eye Center, PC	AZ	Ophthalmology Physician	$0	$10.9M
Nathan Steinle	CA	Retina Specialist (Ophthalmology) Physician	$9.5M	$0
Prema Abraham	SD	Retina Specialist (Ophthalmology) Physician	$7.1M	$0
Sujit Itty	AZ	Ophthalmology Physician	$6.2M	$11.3K
Kyle Thompson	ID	Retina Specialist (Ophthalmology) Physician	$4.5M	$0
Neal Palejwala	AZ	Ophthalmology Physician	$4.4M	$2.9K
Sachin Mehta	AZ	Retina Specialist (Ophthalmology) Physician	$4.4M	$11.8K
Douglas Holmes	WY	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Ronald Hobbs	AZ	Ophthalmology Physician	$4.1M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Flagstaff Medical Center	AZ	General Acute Care Hospital	$0	$63.3M
Flagstaff Medical Center	AZ	Land Ambulance	$0	$46.2M
Flagstaff Medical Center	AZ	Air Ambulance	$0	$37.6M
New Life Wellness Flagstaff	AZ	Community/Behavioral Health Agency	$0	$14.6M
Northern Arizona Healthcare Corporation	AZ	Family Medicine Physician	$0	$11.4M
Flagstaff Emergency Physicians	AZ	Emergency Medicine Physician	$0	$10.4M
Flagstaff Dentistry 4 Kids, PLLC	AZ	General Practice Dentistry	$0	$10.4M
North Country Healthcare, Inc.	AZ	Pediatrics Physician	$0	$7.5M
Emeritol Lo Flagstaff LLC	AZ	Assisted Living Facility	$0	$6.5M
Alexander Hu	AZ	Internal Medicine Physician	$3.8M	$0

Brendan Girschek — 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