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NPI 1235315268 · Hagerstown, MD · Ophthalmology Physician
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Allen Hu is a ophthalmology physician provider located in Hagerstown, Maryland. This profile covers 28 Medicare and 6 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 | Allen Hu |
| Address | 1800 Dual Hwy Ste 201 |
| City | Hagerstown |
| State | MD |
| ZIP | 21740 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | January 22, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $8.9M |
| Medicaid | $32.5K |
Practice profile and service mix: Billing is dominated by intravitreal drug therapy and retina diagnostics, consistent with a subspecialty ophthalmology/retina practice. The three highest Medicare revenue drivers are Q5124 ($2.9M), J2777 ($1.6M), and J2781 ($1.2M), and the Medicare CPT list also includes high volumes of retinal imaging (92134) and injection procedure code 67028, indicating a procedural, treatment-heavy workflow rather than a purely clinic-based evaluation practice.
Medicare revenue concentration: The top 3 Medicare codes by revenue account for 62.0% of this provider's total Medicare revenue, signaling that a small set of high-cost intravitreal therapeutics and related procedures drive the majority of Medicare dollars. Relying on these few high-revenue injectable drugs creates concentrated revenue exposure to utilization and reimbursement changes for those items.
Medicaid revenue concentration and scale: On the Medicaid side, billing is effectively concentrated in a pair of retina/ injection services — 67028 ($15.4K) and 92134 ($15K) — which together with 99213 produce the precomputed top-3 share of 96.1% of Medicaid revenue. Total Medicaid revenue ($32.5K) is minuscule compared with Total Medicare revenue ($8.9M), so Medicaid represents a very small portion of this provider's payer mix and operational revenue.
Payer mix and business implications: This provider is effectively Medicare-dominant: Total Medicare revenue is $8.9M versus Total Medicaid revenue of $32.5K, indicating the practice’s patient and revenue base is overwhelmingly Medicare. Strategic or reimbursement shifts in Medicare policy for intravitreal drugs or retinal procedures would therefore have an outsized impact on overall revenue performance.
National competitive standing for key Medicare codes: For several high-revenue items this provider is a major national outlier — Q5124 ranks #2 of 122 (99th percentile; extreme outlier) and J2781 ranks #2 of 490 (100th percentile; extreme outlier), while J2777 is notably above typical national volume (rank #73 of 2039, 96th percentile). These ranks indicate market-leading activity nationally for specific intravitreal biologics rather than routine office-based services.
Procedure-level volume outliers and practice model signals: The provider also posts extreme national volumes for certain procedure and imaging codes: 67028 (4.7K claims, $442.9K revenue) ranks #12 of 4255 (100th percentile; extreme outlier) and 92134 (6K claims, $174.1K revenue) ranks #14 of 26868 (100th percentile; extreme outlier). Those high ranks on both drug administration and diagnostic imaging support a high-throughput intravitreal injection and retina-imaging operation model.
Medicaid competitive standing in-state: By contrast, the provider’s Medicaid footprint is modest within Maryland — 67028 ranks #18 of 29 (39th percentile) and 92134 ranks #27 of 81 (68th percentile) in-state, indicating the provider is not a dominant Medicaid retina provider locally despite high Medicare volumes. Medicaid volumes and payments are small enough that the provider’s regional competitive position on Medicaid does not mirror its national Medicare prominence.
Tenure and operational longevity: The provider’s NPI was enumerated on 2008-01-22 (~18 years ago), indicating a long-established practice presence. That tenure, combined with concentrated, high-volume billing for specialized intravitreal therapeutics and retinal diagnostics, suggests an established specialty practice with operational processes oriented toward high-frequency procedural care.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
28 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| Q5124 | Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg | 17,150 | $170 | $2.9M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 57,120 | $30 | $1.6M |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 10,140 | $120 | $1.2M |
| J3490 | Unclassified drugs | 520 | $1,880 | $984.1K |
| J2403 | Chloroprocaine hcl ophthalmic, 3% gel, 1 mg | 860,000 | $1 | $860K |
| 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. | 4,660 | $100 | $442.9K |
| 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… | 3,260 | $70 | $228.3K |
| J3590 | Unclassified biologics | 80 | $2,460 | $196.9K |
| 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. | 6,010 | $30 | $174.1K |
| 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… | 1,480 | $90 | $127.4K |
Showing 1–10 of 28
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 28 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
28 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| Q5124 | 2 | 10 | 17,150 | $170 | $2.6M |
| J0178 | 93 | 100 | 950 | $690 | $887.3K |
| J2403 | 2 | 10 | 860,000 | $1 | $506.2K |
| J2777 | 5 | 70 | 8,520 | $30 | $487.3K |
| J2781 | 2 | 20 | 620 | $120 | $258.6K |
| J2778 | 38 | 50 | 650 | $180 | $207.8K |
| J3590 | 6 | 20 | 50 | $2,390 | $128.9K |
| 67028 | 2 | 120 | 700 | $100 | $101.5K |
| 92242 | 3 | 10 | 210 | $210 | $63.4K |
| J3490 | 6 | 100 | 70 | $450 | $62.1K |
Showing 1–10 of 28
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.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 410 | $40 | $15.4K |
| 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. | 880 | $20 | $15K |
| 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… | 170 | $10 | $1K |
| 92201 | 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… | 70 | $10 | $870 |
| 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… | 10 | $30 | $420 |
| J2778 | Injection, ranibizumab, 0.1 mg | 30 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Maryland providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Maryland median
6 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 4 | 10 | 2,360 | $260 | $536.5K |
| 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… | 3,590 | 3,670 | 680 | $90 | $310K |
| 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… | 2,273 | 3,280 | 610 | $80 | $296.1K |
| 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. | 18 | 30 | 460 | $40 | $103K |
| 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. | 27 | 80 | 220 | $30 | $82K |
| 92201 | 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… | 12 | 20 | 110 | $20 | $31.2K |
Other providers in the same ZIP code as Allen Hu, ranked by combined Medicare and Medicaid revenue.
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