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NPI 1205952249 · Marion, IL · Retina Specialist (Ophthalmology) Physician
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Omar Ahmad is a retina specialist (ophthalmology) physician provider located in Marion, Illinois. This profile covers 24 Medicare and 11 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 | Omar Ahmad |
| Address | 1200 W Deyoung |
| City | Marion |
| State | IL |
| ZIP | 62959 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | March 21, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.9M |
| Medicaid | $2.1M |
OMAR AHMAD is a retina specialist (Ophthalmology) in MARION, IL with an NPI enumerated 2007-03-21 (~19 years ago). Lifetime billed revenue on file shows $2.9M from Medicare and $2.1M from Medicaid, indicating material activity with both public payers rather than being effectively single‑payer.
Revenue is highly concentrated at both payers: the precomputed top three Medicare codes account for 85.2% of Medicare revenue, and the precomputed top three Medicaid codes account for 85.9% of Medicaid revenue. This concentration means a small set of services disproportionately drives the practice’s financial footprint with payers.
Medicare activity is dominated by intravitreal biologic injections and high-volume follow-up exams: J0178 (aflibercept) accounts for $1.2M (41.9% of Medicare revenue) and J2777 (faricimab) accounts for $1M (35.6% of Medicare revenue), while 92014 (comprehensive established exam) contributes $224.2K (7.8% of Medicare revenue). The mix signals an outpatient retina practice built around recurring injection therapy supported by frequent comprehensive ophthalmologic follow-up.
Medicaid billing similarly centers on injection and retina procedure codes: J0178 is $1M (47.7% of Medicaid revenue) and 67028 (intravitreal injection procedure) is $629.2K (29.8% of Medicaid revenue), with 92014 adding $178.8K (8.5% of Medicaid revenue). For Medicaid patients the practice appears focused on delivering high volumes of intravitreal therapy plus procedural injection services rather than surgery.
The provider’s competitive standing differs by code and payer. Nationally for Medicare, J0178 ranks #660 of 3204 (79th percentile; typical, unremarkable volume) and J2777 ranks #213 of 2039 (90th percentile; typical, unremarkable volume), while 92014 ranks #87 of 35415 (100th percentile; extreme outlier, far above typical national volume) — indicating above‑average injection volumes but an especially outsized volume of established‑patient comprehensive exams relative to national peers.
Statewide for Medicaid the provider is a clear high-volume participant: J0178 ranks #1 of 45 in-state (100th percentile; notably above typical state volume) and 67028 ranks #3 of 120 (98th percentile; notably above typical state volume), with 92134 (retinal imaging) ranking #3 of 250 (99th percentile; extreme outlier, far above typical state volume). These rankings portray a dominant in‑state position for aflibercept injections, injection procedures, and retinal imaging.
Surgical retina codes and other procedures are present but represent a small share of revenue on Medicare, e.g., 67036 ($21.8K, 0.8% of Medicare revenue), 67041 ($19.6K, 0.7% of Medicare revenue) and 67113 ($17.2K, 0.6% of Medicare revenue). This suggests the practice’s operative retina work exists but is not the primary revenue engine compared with repeat intravitreal injections and imaging.
From a payer/contracting perspective, the practice’s financial exposure centers on high‑cost biologic injectables and frequent follow-up/imaging: on Medicare the top injectables report $1.2M (J0178) and $1M (J2777), and on Medicaid J0178 alone is $1M and 67028 is $629.2K. Payers assessing network capacity or utilization management should prioritize injectable biologic access and monitoring of follow‑up visit and imaging utilization given their outsized share of revenue.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
24 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1,760 | $680 | $1.2M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 35,220 | $30 | $1M |
| 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… | 2,770 | $80 | $224.2K |
| 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. | 1,630 | $90 | $141.5K |
| 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. | 2,690 | $30 | $75.4K |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 330 | $160 | $52.3K |
| 67036 | The provider removes vitreous fluid from the eye to access the posterior segment of the eye and introduce surgical instruments through incisions in the pars plana. | 40 | $620 | $21.8K |
| 67041 | In this procedure, the provider removes scar tissue from the retinal membrane that obscures vision. He removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical… | 20 | $850 | $19.6K |
| J9035 | Injection, bevacizumab, 10 mg | 330 | $60 | $18.4K |
| 67113 | The provider repairs a complicated detached retina. He removes vitreous humor, the gelatinous material that gives shape to the eye, and peels the retinal membrane. He reattaches the retina with… | 20 | $860 | $17.2K |
Showing 1–10 of 24
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 24 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
24 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 23 | 140 | 700 | $690 | $688.4K |
| J2777 | 9 | 90 | 9,180 | $30 | $451K |
| 67028 | 24 | 190 | 400 | $90 | $64.4K |
| J7312 | 7 | 30 | 240 | $160 | $45.1K |
| J3590 | 4 | 10 | 40 | $320 | $36.1K |
| 67041 | 6 | 10 | 20 | $1,140 | $26.3K |
| 92014 | 7 | 1,420 | 130 | $80 | $24.7K |
| J9035 | 39 | 130 | 140 | $60 | $24.6K |
| 67210 | 12 | 20 | 30 | $410 | $22K |
| 67042 | 26 | 50 | 20 | $870 | $21.8K |
Showing 1–10 of 24
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.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1,370 | $740 | $1M |
| 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. | 4,430 | $140 | $629.2K |
| 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… | 7,450 | $20 | $178.8K |
| J9035 | Injection, bevacizumab, 10 mg | 2,250 | $60 | $126.2K |
| 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. | 8,030 | $10 | $112.4K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 30 | $930 | $27.8K |
| 92226 | N/A | 1,360 | $10 | $19K |
| 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… | 330 | $30 | $10.1K |
| 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… | 80 | $10 | $980 |
| 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… | 140 | $1 | $290 |
Showing 1–10 of 11
How this provider's Medicaid billing volume and revenue compare to other Illinois providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Illinois median
11 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1 | 50 | 200 | $1,100 | $391.2K |
| 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. | 3 | 120 | 540 | $160 | $166.3K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 5 | 10 | 70 | $920 | $142.9K |
| 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… | 37 | 1,230 | 450 | $40 | $54.1K |
| J9035 | Injection, bevacizumab, 10 mg | 5 | 80 | 290 | $60 | $43.4K |
| 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… | 6,735 | 14,190 | 280 | $20 | $38.9K |
| 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. | 3 | 250 | 510 | $20 | $20.1K |
| 92226 | N/A | 12 | 50 | 430 | $20 | $19.5K |
| 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… | 460 | 670 | 230 | $30 | $16K |
| 92133 | The provider performs computerized diagnostic imaging of the optic nerve in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both… | 158 | 170 | 100 | $20 | $4.6K |
Showing 1–10 of 11
Other providers in the same ZIP code as Omar Ahmad, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Pediatric Group LLC | IL | Rural Health Clinic/Center | $0 | $13.7M |
| Shawnee Health Service And Development Corp | IL | Federally Qualified Health Center (FQHC) | $0 | $6.8M |
| Advantage Nursing Services, Inc. | IL | Nursing Care Agency | $0 | $4.9M |
| Heartland Pediatric Clinic | IL | Rural Health Clinic/Center | $0 | $4.2M |
| Centerstone Of Illinois, Inc | IL | Mental Health Clinic/Center (Including Community Mental Health Center) | $0 | $3.7M |
| Heartland Women's Healthcare Ltd | IL | Rural Health Clinic/Center | $0 | $3.6M |
| Williamson County Special Ed | IL | Local Education Agency (LEA) | $0 | $3.4M |
| Michael Schifano | IL | Obstetrics Physician | $6.6K | $1.5M |
| Air Evac Ems Inc | IL | Air Ambulance | $780.4K | $627.2K |
| Robert Hatchett | IL | Urology Physician | $620.1K | $160.7K |
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