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

Why is the Medicaid comparison limited to South Carolina 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. South Carolina (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.

Stephen Phillips (NPI 1265499693)

Field	Value
Entity Type	Individual
Organization	Stephen Phillips
Address	8609 Montague Ln
City	Myrtle Beach
State	SC
ZIP	29588
Taxonomy	Ophthalmology Physician
NPI Enumerated	April 28, 2006

Payer Source	Total Paid
Medicare	$5M
Medicaid	$0

Key Findings

This provider is highly specialized in intravitreal medication administration and retinal diagnostics: the top revenue codes are J0178, J2778, and J2777 (together accounting for 88.8% of Medicare revenue) which correspond to high-volume anti-VEGF and related intravitreal injections for retinal disease and are supported by substantial OCT imaging volume under 92134. The mix indicates a practice focused on medical retinal care (repeat injections and retinal imaging) rather than general ophthalmic surgery or routine comprehensive exams.

Revenue is heavily concentrated in a very small set of services: the precomputed top three Medicare codes (J0178, J2778, J2777) together account for 88.8% of this provider’s total Medicare revenue, signaling dependence on recurrent injection therapies as the principal revenue stream. This concentration suggests financial exposure to changes in reimbursement, utilization management, or shifts to competing therapies.

On Medicare this provider is a leading national volume performer for specific retinal drug codes: J0178 generates $2.4M (48.7% of Medicare revenue) and ranks #107 of 3204 providers (97th percentile), while J2778 generates $1.2M (23.7% of Medicare revenue) and ranks #25 of 1208 providers (98th percentile). These percentile ranks and revenue shares indicate the provider operates at a substantially higher-than-typical scale for aflibercept and ranibizumab administration compared with national peers.

Several codes are statistical outliers versus national peers for non-drug services as well: 92134 (retinal OCT) has 3.3K claims and $97.8K revenue (2.0% of Medicare revenue) and ranks #308 of 26868 providers (99th percentile), and 99204 (new patient E/M) ranks in the 99th percentile nationally. Those extreme outlier labels indicate unusually large imaging and new-patient evaluation volumes relative to most ophthalmologists billing Medicare.

This provider effectively operates as a Medicare-only biller in the available data: lifetime Medicare revenue is $5M while there is no Medicaid billing on file, so payer mix is single-payer dominated and the practice’s patient population or contracting structure appears not to include Medicaid-reimbursed services. Analysts should treat competitive and access conclusions as Medicare-centric given the absence of Medicaid activity.

Competitive positioning is code-specific: for J0178 and J2778 the provider is a major national participant (97th–98th percentiles), for J2777 the provider is a strong but more typical participant (84th percentile), and for many other ophthalmology codes the provider’s ranks range from typical to extreme outlier. This pattern suggests market leadership in anti-VEGF administration while maintaining higher-than-typical imaging and new-patient volumes.

Tenure in the Medicare program is long-standing: the provider’s NPI was enumerated on 2006-04-28 (~20 years ago), indicating sustained presence in Medicare billing that could support established referral patterns and longitudinal retinal care relationships. The combination of long tenure and high-volume injection activity is consistent with an established retinal practice focused on chronic treatment regimens.

Although the practice bills some lower-revenue or infrequent surgical and diagnostic codes (for example 67028 with $271.5K revenue, 5.4% of Medicare revenue, ranks #94 of 4255 providers at the 98th percentile), the revenue profile is still overwhelmingly dominated by injectable therapeutics. This mix implies operational focus on in-office injection workflows and imaging rather than high volumes of surgical retina procedures.

Given the concentration in biologic drug administration, payer or market shifts that affect drug choice, biosimilar uptake, or reimbursement (for example movement between J0178, J2778, Q5128 and biosimilar codes) could materially change revenue composition. The presence of Q5128 and biosimilar activity (604 claims, $131.1K) shows some adoption of alternatives but at a much smaller scale relative to the primary branded injectable codes.

Medicare: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	3,540	$690	$2.4M
J2778	Injection, ranibizumab, 0.1 mg	6,550	$180	$1.2M
J2777	Injection, faricimab‑svoa, 0.1 mg	28,080	$30	$814.3K
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.	3,050	$90	$271.5K
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	600	$220	$131.1K
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.	3,260	$30	$97.8K
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…	300	$110	$34.1K
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…	160	$90	$13.5K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	250	$30	$6.8K
67145	The provider prevents the detachment of the retina in the presence of small tears or thinning of the edges (lattice degeneration) by applying an intense light (such as a laser) to create scar tissue…	20	$180	$3.1K

Showing 1–10 of 12

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Carolina Distribution

Stephen Phillips — 4 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. state median

12 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	5	50	970	$690	$1.1M
J2777	9	40	15,960	$30	$594.7K
J2778	2	30	1,440	$180	$337.4K
Q5128	11	10	1,150	$220	$273.3K
67028	3	50	1,140	$90	$110.3K
J9035	39	40	200	$50	$26.1K
92014	277	540	160	$80	$24.3K
92134	7	400	90	$30	$9.6K
99204	35	4,520	40	$110	$6.4K
67145	10	20	20	$170	$3.9K

Showing 1–10 of 12

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eric Jablon	SC	Ophthalmology Physician	$8.9M	$0
John Kerrison	SC	Ophthalmology Physician	$5M	$0
Charleston Neurosciences Institute	SC	Ophthalmology Physician	$0	$4.2M
Daniel Alfaro	SC	Ophthalmology Physician	$3.6M	$0
Michael Johnson	SC	Ophthalmology Physician	$3M	$0
Mona Camacci	SC	Ophthalmology Physician	$1.1M	$0
Scott Anfinson	SC	Ophthalmology Physician	$775.5K	$0
John Chancellor	TX	Ophthalmology Physician	$647.3K	$0
Robert Brame	SC	Ophthalmology Physician	$560.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Young Talkers, LLC	SC	Speech-Language Pathologist	$0	$6.7M
Grand Strand Pediatric Dentistry	SC	Pediatric Dentistry	$0	$4M
Little River Medical Center, Inc.	SC	Federally Qualified Health Center (FQHC)	$0	$3.8M
John Hicks	SC	Cardiovascular Disease Physician	$870.3K	$0
Erol Lale	SC	Cardiovascular Disease Physician	$592.4K	$0
Christopher Skvarka	SC	Dermatology Physician	$556.1K	$0
Nathan Jones	SC	Dermatology Physician	$408.2K	$0
Stephen Boatwright	SC	Pain Medicine (Anesthesiology) Physician	$309.3K	$0
Brian Adler	SC	Internal Medicine Physician	$296.8K	$0
Richard Owens	SC	Physical Therapist	$287.1K	$0

Stephen Phillips — 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