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.

Paul Lagonigro (NPI 1295052751)

Field	Value
Entity Type	Individual
Organization	Paul Lagonigro
Address	31455 Winterplace Pkwy
City	Salisbury
State	MD
ZIP	21804
Taxonomy	Ophthalmology Physician
NPI Enumerated	April 23, 2010

Payer Source	Total Paid
Medicare	$3.5M
Medicaid	$0

Key Findings

This NPI represents an ophthalmology physician whose revenue mix is dominated by intravitreal biologic therapy and retinal diagnostics: the top-paid codes are J0178 (injection, aflibercept), J2777 (injection, faricimab-svoa) and J2778 (injection, ranibizumab), and the presence of high-volume 92134 (diagnostic imaging of the retina) and 67028 (injection into the vitreous chamber) supports a practice organized around frequent anti-VEGF/faricimab injections with accompanying retinal imaging and monitoring. These procedure-level codes and imaging services are consistent with a medical retina/injection clinic model rather than a general ophthalmology-only practice.

Revenue is highly concentrated in a few codes: the precomputed top-3 Medicare codes account for 76.3% of this provider's total Medicare revenue, with J0178 alone contributing $1.9M (54.3% of total Medicare revenue). This concentration indicates that changes in reimbursement or utilization for these specific biologic injections would have outsized impact on the provider's Medicare revenue stream.

The provider is effectively single-payer from a public-program perspective: lifetime Medicare revenue is $3.5M while Medicaid billing is listed as none, so this practice has no Medicaid billing on file. That asymmetric payer mix means comparative analyses and contracting discussion should treat Medicare reimbursement and utilization patterns as the primary drivers of revenue and risk for this entity.

Several codes place the provider well above national typical volumes: J0178 ranks #232 of 3204 providers nationally (93th percentile) and is described as notably above typical national volume for this code, while 99214 ranks #345 of 479517 providers nationally (100th percentile) and 92134 ranks #291 of 26868 providers nationally (99th percentile), both labeled as extreme outliers, far above typical national volume. Collectively these high percentiles signal that the provider is a high-volume national participant for both intravitreal injections and E/M/retinal imaging services rather than a low- or mid-volume practice.

Operational cadence implied by claims counts supports a high-throughput injection and follow-up workflow: J2777 shows 16.6K claims ($480.2K revenue) and J0178 shows 2.8K claims ($1.9M revenue), while 92134 has 3.3K claims and 99214 has 2.8K claims. This mix — large counts of injection claims alongside frequent imaging and moderate-to-high-complexity E/M visits — suggests routine, repeated patient visits for injections and monitoring rather than predominantly one-time surgical encounters.

The practice performs a limited volume of procedural/surgical retinal work and ancillary diagnostics in addition to injection therapy: 67040, 67210, 67228 and 67145 appear among top codes but represent much smaller shares of revenue, and 92250 (fundus photography) and 92235 (fluorescein angiography) are present at lower revenue levels. These observations point to a medical-retina focus with occasional laser or surgical interventions rather than a surgeon-heavy retina center.

Smaller but notable revenue contributors include J3590 (unclassified biologics) with 45 claims and $95.4K revenue (2.7% of Medicare revenue) and J9035 (bevacizumab) with 369 claims and $20.7K revenue (0.6%). The presence of J3590 at a relatively high average paid/claim ($2120) and J9035 alongside the branded biologics suggests some diversity in biologic sourcing or coding that will be relevant when comparing drug-mix and per-unit costs across peers.

The provider has an established enrollment history — NPI enumerated 2010-04-23 (~16 years ago) — and a cumulative Medicare billing footprint of $3.5M. This tenure combined with concentrated, high-volume billing in a small set of retina-related codes provides a stable case for peer benchmarking, utilization reviews, and payer discussions focused on medical-retina service lines.

Medicare: Complete Services Breakdown

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,750	$690	$1.9M
J2777	Injection, faricimab‑svoa, 0.1 mg	16,560	$30	$480.2K
J2778	Injection, ranibizumab, 0.1 mg	1,610	$180	$292.8K
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…	2,800	$90	$257.1K
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.	2,100	$90	$195.4K
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.	3,290	$30	$102K
J3590	Unclassified biologics	50	$2,120	$95.4K
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…	970	$60	$62.2K
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…	270	$120	$31.5K
J9035	Injection, bevacizumab, 10 mg	370	$60	$20.7K

Showing 1–10 of 18

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Maryland Distribution

Paul Lagonigro — 4 of 18 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

18 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	16	100	950	$690	$887.3K
J2777	20	70	8,520	$30	$487.3K
J2778	12	50	650	$180	$207.8K
J3590	12	20	50	$2,390	$128.9K
67028	21	120	700	$100	$101.5K
99214	18	10,270	150	$90	$24.1K
67210	12	20	30	$430	$21K
92235	31	90	70	$110	$19.5K
92134	19	490	110	$30	$17.3K
J9035	13	40	240	$50	$16.8K

Showing 1–10 of 18

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Delaware Eye Care Center PA	DE	Ophthalmology Physician	$0	$5.2M
James Rial	MD	Ophthalmology Physician	$4.7M	$510
Joseph Schwartz	MD	Ophthalmology Physician	$4.2M	$0
Timothy Doyle	DE	Ophthalmology Physician	$983K	$38.7K
Edward Hu	IA	Ophthalmology Physician	$706.8K	$2.3K
Michael Summerfield	MD	Ophthalmology Physician	$648.3K	$0
Charles Curry	DE	Ophthalmology Physician	$605.3K	$0
Neal Adams	MD	Ophthalmology Physician	$497.9K	$5.3K
Joshua Fernandes	MD	Retina Specialist (Ophthalmology) Physician	$500.3K	$860
Kristen Semenick	DE	Optometrist	$232.1K	$224.9K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wraparound Maryland, Inc	MD	Case Management Agency	$0	$18.4M
Go-getters, Inc.	MD	Community/Behavioral Health Agency	$0	$14.7M
Board Of Education Of Wicomico County	MD	Local Education Agency (LEA)	$0	$14.6M
Healthport	MD	Community/Behavioral Health Agency	$0	$10.9M
Chesapeake Pediatric & Adolescent Associates, PA	MD	Pediatric Adolescent Medicine Physician	$0	$6.6M
Healthport	MD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.5M
Coastal Hospice Inc	MD	Community Based Hospice Care Agency	$0	$5.3M
Children's Medical Group Of Salisbury, PA	MD	Pediatrics Physician	$0	$5M
Konlian,o'neill & Associates, P.A.	MD	Rehabilitation Practitioner	$0	$5M
John Butler	MD	Ophthalmology Physician	$4.3M	$0

Paul Lagonigro — 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