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NPI 1275532996 · Kennewick, WA · Ophthalmology Physician
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Charles Sung is a ophthalmology physician provider located in Kennewick, Washington. This profile covers 21 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 | Charles Sung |
| Address | 317 N Delaware St |
| City | Kennewick |
| State | WA |
| ZIP | 99336 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | July 14, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.2M |
| Medicaid | $41K |
Practice is organized around intravitreal injection therapy and retina-focused diagnostics: the Medicare top revenue drivers are J0178 and J2777 along with procedure 67028, and code descriptions show routine administration of anti-VEGF/biologic injections plus isolated intravitreal injection procedures. This mix (and the heavy revenue concentration on injection/drug codes) is consistent with a retina treatment model rather than a general comprehensive ophthalmology clinic.
Medicare revenue is highly concentrated: the precomputed top 3 Medicare codes by revenue account for 90.7% of this provider's total Medicare revenue, driven primarily by J0178, J2777, and 67028. That degree of concentration suggests the provider’s Medicare business is mainly derived from a small set of repeat-treatment drug and injection procedure codes, which concentrates clinical and revenue risk on those service lines.
Medicaid participation is minimal relative to Medicare: lifetime Medicare revenue is $3.2M compared with lifetime Medicaid revenue of $41K, so this provider is effectively Medicare-dominated on scale. The small absolute Medicaid revenue and the fact that the top 3 Medicaid codes account for 92.6% of Medicaid revenue indicate similarly concentrated services in the state Medicaid book but at very low dollar scale.
National competitive standing for Medicare injection volumes is high in percentile but described as typical for specialists: J0178 ranks #292 of 3204 providers nationally (91th percentile; typical, unremarkable volume for this code) and J2777 ranks #257 of 2039 providers nationally (87th percentile; typical, unremarkable volume for this code). In plain terms, the provider is an active user of high-value intravitreal drugs on Medicare and sits above many peers, but the source data characterizes those volumes as within the expected range for clinicians who treat retinal disease, not as extreme outlier activity.
State-level Medicaid standing is limited for high-cost drugs: J0178 on Medicaid generates $22.6K and ranks #25 of 26 providers in-state (4th percentile; typical, unremarkable volume for this code), indicating the provider bills little Medicaid for aflibercept relative to in-state peers. Medicaid ranks for 67028 and 92134 sit in middle-to-low in-state percentiles (34th and 55th), reinforcing a modest Medicaid presence for retina services.
Ancillary diagnostic and intermediate exam volumes are notably above typical national levels, which supports the retina-focused interpretation of operations: 92012 ranks #633 of 17177 providers nationally (96th percentile; notably above typical national volume for this code) and 92134 ranks #1716 of 26868 providers nationally (94th percentile; notably above typical national volume for this code), while 92250 also sits at the 94th percentile. High relative volumes in imaging and intermediate exams imply ongoing monitoring visits and follow-up care consistent with chronic retinal disease management.
Therapeutic mix shows preference for aflibercept and faricimab with limited use of alternatives: J0178 ($1.8M Medicare revenue) and J2777 ($950K Medicare revenue) dominate drug revenue, while J2778 (ranibizumab) is much smaller (358 Medicare claims, ranks #902 of 1208 nationally, 25th percentile). The presence of some intravitreal steroid implant billing (J7312) and compounded drugs (J7999) indicates occasional alternative or adjunct therapies but at modest scale compared with the two dominant biologics.
Long tenure and mid-size regional footprint: NPI was enumerated 2005-07-14 (~21 years ago), and the provider has generated $3.2M in lifetime Medicare revenue, which together suggest an established practice with a sustained Medicare referral and treatment base. The combination of long tenure, concentrated injection revenue, and above-typical diagnostic volumes is consistent with a stable retina-focused practice that is a recognizable, but not dominant, presence nationally for key drug administration codes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
21 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2,570 | $680 | $1.8M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 32,760 | $30 | $950K |
| 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. | 1,950 | $90 | $182.8K |
| J2778 | Injection, ranibizumab, 0.1 mg | 360 | $190 | $67.3K |
| 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… | 880 | $60 | $54.8K |
| 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. | 1,320 | $30 | $37.1K |
| 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… | 330 | $90 | $28.6K |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 150 | $160 | $24.3K |
| 92235 | The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken… | 230 | $110 | $24K |
| J7999 | Compounded drug, not otherwise classified | 300 | $70 | $22K |
Showing 1–10 of 21
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
21 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J2777 | 12 | 50 | 12,780 | $30 | $599.7K |
| J0178 | 4 | 90 | 470 | $680 | $597.2K |
| J2778 | 19 | 30 | 510 | $180 | $117.1K |
| 67028 | 7 | 110 | 550 | $90 | $72.9K |
| J7312 | 15 | 20 | 270 | $160 | $46K |
| 66821 | 203 | 260 | 50 | $230 | $20.4K |
| 92014 | 156 | 790 | 110 | $80 | $16.8K |
| J7999 | 16 | 70 | 150 | $70 | $15.9K |
| 92012 | 10 | 220 | 70 | $70 | $12.9K |
| 65800 | 1 | 10 | 40 | $390 | $10.9K |
Showing 1–10 of 21
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 |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 20 | $1,410 | $22.6K |
| 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. | 310 | $40 | $11K |
| 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. | 370 | $10 | $4.5K |
| 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… | 110 | $30 | $2.9K |
| 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,… | 20 | $10 | $200 |
| 1036F | N/A | 20 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Washington providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Washington median
6 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 25 | 30 | 550 | $930 | $892.3K |
| 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. | 38 | 60 | 710 | $40 | $81.7K |
| 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. | 46 | 100 | 240 | $10 | $22.2K |
| 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… | 39 | 70 | 130 | $30 | $16.1K |
| 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,… | 139 | 180 | 140 | $20 | $10.6K |
| 1036F | N/A | 80 | 100 | 100 | $1 | $1 |
Other providers in the same ZIP code as Charles Sung, ranked by combined Medicare and Medicaid revenue.
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