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

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

Brian Toussaint (NPI 1295969616)

Field	Value
Entity Type	Individual
Organization	Brian Toussaint
Address	1700 Wawaset St
City	Wilmington
State	DE
ZIP	19806
Taxonomy	Ophthalmology Physician
NPI Enumerated	May 13, 2009

Payer Source	Total Paid
Medicare	$1.2M
Medicaid	$0

Key Findings

Provider profile and tenure: BRIAN TOUSSAINT is an ophthalmology physician enumerated on 2009-05-13 (~17 years ago), indicating long-standing Medicare participation. The specialty and long enrollment are consistent with a clinician performing both office-based retinal imaging and intravitreal injections over an extended ambulatory practice career.

Revenue mix and payer concentration: Lifetime Medicare revenue is $1.2M while there is no Medicaid billing on file, so this provider is effectively single-payer from a public-program perspective with Medicare representing the entirety of reported public reimbursement. Absence of Medicaid billing suggests the provider’s panel or contracts are not oriented toward Medicaid-covered patients, or that Medicaid billing occurs through other entities.

Revenue concentration by codes: The top 3 Medicare codes by revenue account for 67.6% of this provider’s total Medicare revenue, indicating a high concentration of income in a small set of services. Specifically, J2777 alone represents 47.8% of Medicare revenue and, together with J0178 (12.5%) and J3490 (7.3%), drives the majority of the practice’s Medicare receipts.

Service-line implications: The dominant codes—J2777 (faricimab injections), J0178 (aflibercept injections), and J3490 (unclassified drugs)—point to a treatment model focused on intravitreal biologic therapies for retinal disease. Substantial volumes of procedure codes such as 67028 (injections into the vitreous) and imaging code 92134 indicate an ophthalmology practice organized around recurrent injection visits, retinal imaging, and associated evaluation and management visits.

Competitive standing on high-revenue drug codes: For J2777 the provider ranks #511 of 2039 (75th percentile), which positions the clinician as an above-median but not top-tier national volume performer for faricimab administration. For J0178 the provider ranks in the 21st percentile nationally (#2525 of 3204), indicating relatively low national volume for aflibercept compared with peers, while J2781 ranks in the 61st percentile (#188 of 490), showing moderate participation in pegcetacoplan injections among the smaller pool of providers who bill that code.

E/M and imaging volumes relative to peers: The provider reports notably above-typical national volumes for 99213 (97th percentile) and 92134 (94th percentile), signaling a high throughput of established-patient office visits and retinal imaging. These elevated percentiles suggest efficient clinic throughput or a panel with frequent follow-up needs, consistent with an injection-focused retina practice.

Procedure and surgical mix: The provider bills a range of surgical retinal codes at modest volumes (for example, 67036 at $17.9K revenue and ranked in the 75th percentile), indicating occasional surgical interventions in addition to medical retina services. Smaller counts on complex surgical codes (e.g., 67108, 67121) imply surgery is a less frequent but present element of the practice.

Statistical outliers and notable percentile labels: The provider shows several codes labeled as “notably above typical” (99213, 92134) and one code labeled as an “extreme outlier” for new-patient high-complexity visits (99204, 98th percentile), which may reflect episodic periods of high-intensity new-patient evaluations or localized referral patterns. Most high-revenue drug codes are described as “typical, unremarkable volume” despite their revenue importance, indicating the provider’s drug administration activity is within the common national practice range for those therapies.

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	20,460	$30	$593.3K
J0178	Injection, aflibercept, 1 mg	220	$690	$155.5K
J3490	Unclassified drugs	50	$1,820	$91.1K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	720	$120	$86.4K
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.	970	$90	$82.6K
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	$60	$46.5K
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…	500	$90	$44.3K
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.	1,450	$30	$43.4K
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…	220	$120	$26.7K
J9035	Injection, bevacizumab, 10 mg	360	$60	$19.9K

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. Delaware Distribution

Brian Toussaint — 3 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. state median

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	7	10	510	$680	$495.6K
J2777	3	10	20,040	$30	$474.7K
J2781	1	10	720	$120	$86.7K
67028	4	10	970	$90	$85.6K
J3490	3	10	50	$990	$65.2K
99214	338	1,830	150	$80	$25.5K
67036	1	10	20	$920	$21.2K
J9035	3	10	290	$50	$15K
99213	116	1,810	120	$60	$13.6K
67108	1	10	10	$900	$11.7K

Showing 1–10 of 17

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Christiana Care Health Services, Inc.	DE	General Acute Care Hospital	$0	$99.4M
Christiana Care Health Services Inc	DE	Hospitalist Physician	$0	$13.6M
Mercy Health System Corporation	WI	Multi-Specialty Clinic/Center	$0	$13.2M
Christiana Care Health Services Inc	DE	Obstetrics & Gynecology Physician	$0	$9.9M
Christiana Care Health Services Inc	DE	Neonatal-Perinatal Medicine Physician	$0	$8.9M
Christiana Care Health Services Inc	DE	Family Medicine Physician	$0	$5.6M
Christiana Care Health Services Inc	DE	Neurology Physician	$0	$5.1M
Christiana Care Health Services, Inc	DE	Family Medicine Physician	$0	$5.1M
Christiana Care Health Services Inc	DE	Student Health Clinic/Center	$0	$3.9M
Christiana Care Health Services, Inc	DE	Psychiatry Physician	$0	$2.9M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nancy Pancko	DE	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$10M
Ingleside Homes, Inc	DE	Assisted Living Facility	$0	$2.5M
Paula Ko	DE	Ophthalmology Physician	$1.7M	$0
Liberty Dialysis - Wilmington LLC	DE	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.6M
Eye Physicians & Surgeons, PA	DE	Ophthalmology Physician	$0	$1.6M
Brandywine Medical Associates, Inc.	DE	Family Medicine Physician	$0	$1.3M
Ingleside Homes, Inc	DE	Homemaker	$0	$1.2M
Rmb Group, LLC	DE	In Home Supportive Care Agency	$0	$1.1M
Philip Schwartz	DE	Rheumatology Physician	$937.1K	$0
Anthony Vattilana	DE	General Practice Dentistry	$0	$668.6K

Brian Toussaint — 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