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

Why is the Medicaid comparison limited to New York 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. New York (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.

Peter Coombs (NPI 1306137104)

Field	Value
Entity Type	Individual
Organization	Peter Coombs
Address	19 Bradhurst Ave Ste 3750s
City	Hawthorne
State	NY
ZIP	10532
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	April 27, 2011

Payer Source	Total Paid
Medicare	$1.4M
Medicaid	$0

Key Findings

This provider’s billing footprint is effectively single‑payer: Total Medicare revenue is $1.4M and there is no Medicaid billing on file, so the practice’s scale and risk exposure are concentrated in Medicare beneficiaries and Medicare drug reimbursement. Absence of Medicaid billing suggests limited participation in state Medicaid networks or no Medicaid‑eligible volume on record.

Revenue concentration is highly focused on three injectable retinal drugs: the precomputed top three Medicare codes account for 86.9% of this provider’s total Medicare revenue, with J0178 generating $519.6K (38.3%), J2777 generating $384.5K (28.4%), and J2778 generating $274.9K (20.3%). This concentration indicates that a small set of high‑value drug administrations drive the majority of topline Medicare receipts.

The code mix is characteristic of an outpatient retina practice centered on intravitreal pharmacotherapy. J0178 (aflibercept) shows 752 claims with $691 avg paid/claim and $519.6K revenue, J2777 (faricimab) has 13.3K claims with $29 avg paid/claim and $384.5K revenue, and J2778 (ranibizumab) records 1.5K claims with $180 avg paid/claim and $274.9K revenue, which together reflect heavy reliance on repeated injection services and mixed reimbursement profiles across agents. Ancillary diagnostic codes such as 92134 (795 claims, $28 avg paid/claim, $22.3K revenue) appear as supportive services rather than primary revenue drivers.

The practice performs limited surgical retina procedures in addition to injections: 67042 appears with 12 claims, $875 avg paid/claim and $10.5K revenue, and 67036 with 13 claims, $669 avg paid/claim and $8.7K revenue. These low claim counts and modest revenues imply occasional operative work rather than a high‑volume surgical practice.

Competitive standing on key Medicare codes is generally modest to above typical rather than dominant. J0178 ranks #1563 of 3204 providers nationally (51th percentile; typical, unremarkable volume for this code) and J2777 ranks #782 of 2039 providers nationally (61th percentile; typical, unremarkable volume for this code), while J2778 is stronger at rank #286 of 1208 providers nationally (76th percentile; typical, unremarkable volume for this code); overall the provider is a competent regional participant but not a top national outlier for these injections.

There are select relative strengths in diagnostic imaging volume: 92134 ranks #2536 of 26868 providers nationally (91th percentile; typical, unremarkable volume for this code) with 795 claims and $22.3K revenue, indicating a higher‑than‑average deployment of retinal imaging services relative to peers even if the revenue share is small. This suggests consistent use of OCT for management of retinal disease in the patient panel.

The provider’s NPI was enumerated on 2011‑04‑27 (~15 years ago), signaling an established practice tenure that likely supports steady referral patterns for retina injections and imaging. Longevity in the Medicare file paired with the concentrated drug mix suggests operational continuity in administering intravitreal therapies over multiple years.

Operational and reimbursement sensitivities are notable given the clinical dependence on a few drug codes: top revenue drivers are expensive biologic injections and together account for 86.9% of Medicare revenue, so changes in formulary placement, payer coverage, or unit pricing for J0178, J2777, or J2778 could materially affect revenue. The data also show contrasting payment profiles across those drugs (for example, $691 avg paid/claim for J0178 versus $29 avg paid/claim for J2777 despite faricimab’s very high claim count of 13.3K), which creates exposure to both volume and unit‑price shifts in payer policies.

Medicare: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	750	$690	$519.6K
J2777	Injection, faricimab‑svoa, 0.1 mg	13,260	$30	$384.5K
J2778	Injection, ranibizumab, 0.1 mg	1,530	$180	$274.9K
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.	850	$90	$77.4K
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…	300	$80	$22.9K
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.	800	$30	$22.3K
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…	120	$90	$10.6K
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…	10	$880	$10.5K
J7999	Compounded drug, not otherwise classified	140	$70	$9.3K
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.	10	$670	$8.7K

Showing 1–10 of 16

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New York Distribution

Peter Coombs — 0 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New York

Full comparison — all codes billed, vs. state median

16 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	16	230	560	$690	$693K
J2777	12	120	7,740	$30	$364.9K
J2778	4	70	510	$180	$131.6K
67028	18	300	400	$100	$65.9K
92014	87	2,220	160	$100	$29.3K
67036	14	50	20	$940	$23.5K
67042	13	40	20	$1,030	$22.7K
99214	1,481	30,450	90	$100	$19K
92012	157	1,640	100	$70	$17.4K
J7999	10	10	90	$90	$13.5K

Showing 1–10 of 16

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Amir Salem	NY	Vascular & Interventional Radiology Physician	$5M	$605.9K
Mitchell Goff	UT	Retina Specialist (Ophthalmology) Physician	$3.8M	$0
Clinton Ellingson	ID	Retina Specialist (Ophthalmology) Physician	$2.7M	$126.5K
Howard Charles	NY	Ophthalmology Physician	$2.7M	$13.9K
Lisa Leishman	UT	Ophthalmology Physician	$1.6M	$419.9K
Howard Kaplan	NY	Retina Specialist (Ophthalmology) Physician	$1.9M	$11.9K
Nancy Miller-rivero	NY	Retina Specialist (Ophthalmology) Physician	$1.4M	$0
Payam Shakouri	NY	Nephrology Physician	$1.3M	$55.2K
Claron Alldredge	UT	Ophthalmology Physician	$1.3M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Boston Children's Health Physicians, LLP	NY	Pediatrics Physician	$0	$52.9M
New Vision Home Care Services, LLC	NY	Home Health Agency	$0	$18.8M
Anthony Gilet	NY	Diagnostic Radiology Physician	$1.2M	$63.7K
Albert Deluca	NY	Cardiovascular Disease Physician	$788.3K	$3K
Jean Tostanoski	NY	Ophthalmology Physician	$443.6K	$860
Carmine Sorbera	NY	Clinical Cardiac Electrophysiology Physician	$291.7K	$0
Edmund Farris	NY	Ophthalmology Physician	$267.6K	$50
Karen Seiter	NY	Hematology & Oncology Physician	$180.1K	$41.2K
Delong Liu	NY	Hematology & Oncology Physician	$134.9K	$9.3K
Preeti Puntambekar	NY	Neurology Physician	$123.4K	$0

Peter Coombs — 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