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

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

Thomas Shane (NPI 1285826024)

Field	Value
Entity Type	Individual
Organization	Thomas Shane
Address	2401 University Pkwy
City	Sarasota
State	FL
ZIP	34243
Taxonomy	Ophthalmology Physician
NPI Enumerated	August 15, 2007

Payer Source	Total Paid
Medicare	$6.5M
Medicaid	$0

Key Findings

This provider is effectively a Medicare-only practice: lifetime Medicare revenue is $6.5M and there is no Medicaid billing on file. The NPI was enumerated 2007-08-15 (~19 years ago), indicating long-tenured participation in the Medicare program and an established practice footprint focused on fee-for-service Medicare patients.

Revenue is highly concentrated in a small set of drug administration codes: the precomputed top 3 Medicare codes account for 79.6% of total Medicare revenue. Those top three are J2777 ($3.6M, 54.6%), J0178 ($1.2M, 18.1%), and J3490 ($450K, 6.9%), which together drive the majority of the provider’s Medicare book of business and indicate dependence on intravitreal therapeutics for revenue.

The code mix and volumes point to a retina-focused ophthalmology operation that delivers high volumes of intravitreal injections and retinal diagnostics. High-revenue drug codes J2777 (faricimab), J0178 (aflibercept), and J2781 (pegcetacoplan) appear alongside large volumes of retinal imaging (92134: 5.2K claims, $149.8K revenue) and injection procedure coding (67028: 3.1K claims, $286.7K revenue), consistent with a clinic organized around frequent injection visits plus diagnostic imaging and follow-up exams.

The provider is a national outlier on specific retinal/therapeutic codes: J2777 ranks #10 of 2039 providers nationally (100th percentile; extreme outlier), indicating exceptionally high faricimab volume relative to peers. Complementary evidence of unusually high diagnostic and evaluation activity includes 92134 (rank #42 of 26868; 100th percentile; extreme outlier) and 92014 (rank #199 of 35415; 99th percentile; extreme outlier), which together suggest both procedure and visit throughput are well above typical national levels.

Several additional injection and retina codes are notably above typical peer volume, reinforcing the specialty profile rather than one-off behavior. J2781 reports 2.7K claims and $325.8K revenue (5.0%) and ranks #18 of 490 providers nationally (97th percentile; notably above typical), while 67028 (3.1K claims, $286.7K revenue, 4.4%) ranks #95 of 4255 (98th percentile; notably above typical), showing sustained, above-average use of newer and established intravitreal therapies.

Despite the strong outpatient injection and imaging footprint, the provider also reports measurable surgical retina activity at smaller scale. For example, 67036 appears with 92 claims and $55.7K revenue (0.9%) and ranks #16 of 832 providers nationally (98th percentile; extreme outlier), and other retina surgery codes (67108, 67041, 67042) are present at lower volumes, indicating capability to perform operative retinal procedures in addition to office-based injections.

From a payer or network-planning perspective, this profile signals a specialist referral target for retinal drug delivery and imaging in Medicare populations but limited utility for Medicaid-covered access since there is no Medicaid billing on file. Analysts modeling provider capacity or drug utilization should treat this entity as a high-volume Medicare retinal injector with minimal to no Medicaid participation.

Multiple codes cluster in the highest peer percentiles (labels include "extreme outlier" and "notably above typical"), which is relevant for utilization management and benchmarking. The extreme outlier status for J2777 and for imaging/visit codes (92134, 92014) means this provider will substantially influence local supply-demand estimates for intravitreal faricimab and associated imaging services, and deserves targeted benchmarking when setting payer expectations for specialty drug use and visit volume.

Medicare: Complete Services Breakdown

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

29 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2777	Injection, faricimab‑svoa, 0.1 mg	122,760	$30	$3.6M
J0178	Injection, aflibercept, 1 mg	1,700	$690	$1.2M
J3490	Unclassified drugs	630	$720	$450K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	2,720	$120	$325.8K
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	$286.7K
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…	2,170	$90	$186.7K
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.	5,170	$30	$149.8K
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.	90	$610	$55.7K
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.	550	$100	$53.6K
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…	740	$70	$48.6K

Showing 1–10 of 29

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 29 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Florida Distribution

Thomas Shane — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. state median

29 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	67	250	800	$690	$817.6K
J2777	1	170	12,810	$30	$549.2K
J2781	2	50	500	$120	$102K
67028	14	300	710	$90	$91.1K
J3490	12	180	70	$280	$87.5K
67042	58	80	20	$1,180	$36.5K
67036	3	70	20	$1,050	$31.4K
92014	23	2,180	160	$80	$28.5K
67108	15	60	20	$1,200	$27.5K
67039	10	20	20	$1,050	$26.3K

Showing 1–10 of 29

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Anita Shane	FL	Ophthalmology Physician	$1.6M	$0
Jonathan Brugger	FL	Ophthalmology Physician	$373.3K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
United Cerebral Palsy Of South West Florida Inc.	FL	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$10.2M
Lakewood Ranch Surgical Suites, LLC	FL	Ambulatory Surgical Clinic/Center	$1.8M	$0
Kunal Saigal	FL	Therapeutic Radiology Physician	$1.5M	$0
Reliant Scientific LLC	FL	Clinical Medical Laboratory	$1.3M	$48K
International Medical Laboratory Inc	FL	Clinical Medical Laboratory	$1.1M	$280
David Sax	FL	Dermatology Physician	$844.1K	$0
James Floyd	FL	Geriatric Medicine (Internal Medicine) Physician	$618K	$0
Viengsouk Phommachanh	FL	Otolaryngology Physician	$276.4K	$0
Nicholas Sutera	FL	Internal Medicine Physician	$230.8K	$0
Vladimir Einisman	FL	Psychiatry Physician	$128K	$0

Thomas Shane — Billing Profile & Reimbursement Data

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Thomas Shane — 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