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

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

Adam Gerstenblith (NPI 1265654875)

Field	Value
Entity Type	Individual
Organization	Adam Gerstenblith
Address	246 Eastern Blvd N
City	Hagerstown
State	MD
ZIP	21740
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	May 3, 2007

Payer Source	Total Paid
Medicare	$4.2M
Medicaid	$0

Key Findings

ADAM GERSTENBLITH is a retina specialist in HAGERSTOWN, MD with an NPI enumerated 2007-05-03 (~19 years ago). Lifetime Medicare revenue on file is $4.2M and there is no Medicaid billing on file, so the provider’s publicly visible payer mix is effectively single‑payer Medicare at this time.

Revenue is highly concentrated in a very small set of services: the precomputed top 3 codes by revenue account for 83.0% of the provider’s Medicare revenue. Those top three are J2777 ($2.1M, 49.5% of Medicare revenue), J0178 ($1.1M, 27.2%), and 92014 ($262.1K, 6.3%), indicating the practice derives the bulk of revenue from a narrow procedure and drug mix.

The code mix strongly indicates an office‑based, injection‑centric retina practice: J2777 and J0178 together dominate revenue and are intravitreal drug injections (faricimab and aflibercept), while 92014 and 92134 are high‑volume office evaluation and retinal imaging codes that support ongoing medical retina care. The presence of 67028 (2.2K claims, $194.9K) alongside high imaging volume reinforces that routine injections plus diagnostic imaging are the core service lines rather than primarily surgical retina work.

This provider is a high national outlier on several measures for Medicare: J2777 ranks #46 of 2039 providers nationally (98th percentile; notably above typical national volume for this code) and 92014 ranks #73 of 35415 providers nationally (100th percentile; extreme outlier). 92134 also ranks as an extreme outlier at the 99th percentile, while J0178 sits at a more modest competitive position (rank #731 of 3204, 77th percentile), so the practice is a dominant high‑volume injector for faricimab and a heavy coder of comprehensive established exams and retinal imaging.

Operationally, the claims and payment patterns show contrasting reimbursement profiles: J2777 has very high claim count (71.2K claims) but a low average paid/claim ($29), whereas J0178 has far fewer claims (1.6K) and a much higher avg paid/claim ($689). This divergence suggests the provider’s revenue mix depends both on very high volume, low‑unit‑payment billing for one drug and lower volume, higher‑unit‑payment billing for another, which has implications for sensitivity to unit‑price or utilization changes for either product.

Ancillary and surgical procedure volume is present but limited relative to injections and imaging: 92134 (3K claims, $91.4K) and 67028 (2.2K claims, $194.9K) are meaningful contributors, while vitrectomy and other surgical codes (67042, 67036, 67028 variants) appear in much smaller counts and dollar amounts. This pattern is consistent with a practice model focused on chronic retina disease management (injections and imaging) rather than a high‑volume surgical retina center.

The absence of any Medicaid billing on file is a notable business profile signal: there is no recorded Medicaid revenue to offset Medicare concentration, which limits payer diversification and could affect access patterns for non‑Medicare populations. For payer or network analysts, that absence means competitor bench‑marks in Medicaid will not be informative for this provider and any policy or contract changes in Medicare could have outsized impact on the practice.

Multiple codes are flagged as statistical outliers or 'notably above typical' in the supplied benchmarking: J2777 is 'notably above typical national volume', 92014 and 92134 are labeled 'extreme outlier', and 67028 is 'notably above typical national volume.' These repeated outlier labels across injection, evaluation, and imaging codes indicate a sustained, above‑typical intensity of retina treatment and monitoring relative to national peers and should be treated as characteristic features of this provider’s Medicare billing profile.

Medicare: Complete Services Breakdown

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2777	Injection, faricimab‑svoa, 0.1 mg	71,160	$30	$2.1M
J0178	Injection, aflibercept, 1 mg	1,640	$690	$1.1M
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…	2,880	$90	$262.1K
J3490	Unclassified drugs	110	$1,810	$197.3K
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.	2,170	$90	$194.9K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	1,090	$120	$130.2K
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.	3,050	$30	$91.4K
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.	350	$110	$36.9K
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…	20	$930	$15.8K
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…	80	$130	$9.9K

Showing 1–10 of 17

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Maryland Distribution

Adam Gerstenblith — 4 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. state median

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	29	100	950	$690	$887.3K
J2777	1	70	8,520	$30	$487.3K
J2781	6	20	620	$120	$258.6K
67028	17	120	700	$100	$101.5K
J3490	30	100	70	$450	$62.1K
92014	13	620	210	$90	$44K
67042	18	30	20	$1,060	$25.4K
67036	13	20	20	$960	$22K
92235	49	90	70	$110	$19.5K
92134	22	490	110	$30	$17.3K

Showing 1–10 of 17

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Robert Parnes	MD	Retina Specialist (Ophthalmology) Physician	$3.3M	$0
Adam Wenick	MD	Retina Specialist (Ophthalmology) Physician	$1.8M	$0
Raza Shah	MD	Ophthalmology Physician	$681.9K	$0
Shawn Weigel	PA	Ophthalmology Physician	$462.8K	$0
Scott Piette	MI	Glaucoma Specialist (Ophthalmology) Physician	$341.9K	$0
Cory Seylar	PA	Optometrist	$322.1K	$0
Glen Elliott	PA	Optometrist	$178.1K	$0
Mark Kropinak	PA	Ophthalmology Physician	$159.7K	$0
Michelle Hessen	MD	Optometrist	$78.2K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dr. David M. Vieth 2, P.C.	MD	General Practice Dentistry	$0	$77.8M
Potomac Case Management Services, Inc.	MD	Case Management Agency	$0	$28M
Phoenix Health Center LLC	MD	Methadone Clinic	$507.7K	$21.4M
Awakenings Recovery Center, LLC	MD	Substance Abuse Rehabilitation Facility	$0	$19.8M
Qualitycare Internet, LLP	MD	Mental Health Counselor	$0	$19.4M
Walnut Street Community Health Center, Inc.	MD	Federally Qualified Health Center (FQHC)	$0	$19.3M
Board Of Education Of Washington County	MD	Local Education Agency (LEA)	$0	$19.1M
Center For Pain Management, LLC	MD	Interventional Pain Medicine Physician	$0	$18.9M
Metro Treatment Of Maryland LP	MD	Community/Behavioral Health Agency	$361K	$16.6M
The Western Maryland Counseling Center	MD	Community/Behavioral Health Agency	$0	$16.5M

Adam Gerstenblith — 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