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

Why is the Medicaid comparison limited to Ohio 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. Ohio (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 Tsai (NPI 1316919640)

Field	Value
Entity Type	Individual
Organization	Thomas Tsai
Address	650 Graham Rd
City	Cuyahoga Falls
State	OH
ZIP	44221
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	February 2, 2006

Payer Source	Total Paid
Medicare	$2.1M
Medicaid	$0

Key Findings

This provider bills almost exclusively to Medicare: total Medicare revenue is $2.1M while there is no Medicaid billing on file, so operational scale and payer exposure are effectively single-payer. The absence of Medicaid activity means Medicaid-driven patient volume or state-level reimbursement dynamics are not contributing to this provider's current revenue mix.

Revenue is heavily concentrated in a small set of drug-injection codes: the top 3 Medicare codes by revenue account for 81.2% of this provider's total Medicare revenue, with J0178 ($937.1K; 44.7%), J2777 ($614.2K; 29.3%), and J3490 ($152K; 7.3%) listed as the leading drivers. This concentration indicates that high-cost intravitreal pharmacologic therapy is the primary revenue engine for the practice.

The code mix and claim volumes point to an intravitreal retina practice model focused on repeated drug injections and retina imaging: J0178 has 1.4K claims and J2777 has 21.2K claims, alongside procedure codes such as 67028 (973 claims) and retinal imaging 92134 (1.6K claims). Those volumes, together with presence of J2781 (930 claims) and other intravitreal drug codes, are consistent with ongoing management of retinal diseases that require frequent pharmacologic injections and imaging follow-up.

On competitive standing for the top anti-VEGF and related drug codes, this provider is a modest national participant rather than a dominant outlier: J0178 ranks #928 of 3204 providers (71th percentile; typical, unremarkable volume), J2777 ranks #491 of 2039 providers (76th percentile; typical, unremarkable volume), and J3490 ranks #933 of 2838 providers (67th percentile; typical, unremarkable volume). Those percentiles indicate activity above the median in some cases but still within typical national ranges rather than extreme leadership.

Diagnostic and follow-up services are relatively strong versus peers: intermediate established exam 92012 has 920 claims and $54.3K revenue and ranks #578 of 17177 providers (97th percentile; notably above typical national volume), and retinal imaging 92134 has 1.6K claims and $42.1K revenue and ranks #1459 of 26868 providers (95th percentile; notably above typical national volume). These high percentiles suggest robust outpatient throughput and imaging utilization relative to most ophthalmology peers.

The provider shows below-typical volumes for certain implant and unclassified biologic codes, indicating selective use of those therapies: J7312 (182 claims) ranks #355 of 492 providers (24th percentile; typical, unremarkable volume) and J3590 (30 claims) ranks #511 of 631 providers (18th percentile; typical, unremarkable volume). This pattern implies the practice concentrates on specific intravitreal drugs rather than a broad mix of implantable or other biologic therapies.

Tenure and operational stability are evident: the NPI was enumerated on 2006-02-02 (~20 years ago), indicating an established practice history that aligns with the sustained Medicare revenue stream. Longevity may support stable referral relationships and repeated-treatment patient panels typical for retina subspecialists.

From a market and reimbursement-sensitivity perspective, reliance on high-cost injected drugs (J0178 and J2777 together represent major shares of revenue) combined with no Medicaid billing means revenue exposure is concentrated both by drug-reimbursement policy and by Medicare program dynamics. Payer concentration and the high share of pharmacologic-treatment revenue make the practice sensitive to any shifts in coverage, utilization management, or drug pricing for those specific codes.

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	1,360	$690	$937.1K
J2777	Injection, faricimab‑svoa, 0.1 mg	21,180	$30	$614.2K
J3490	Unclassified drugs	90	$1,770	$152K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	930	$120	$111.6K
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.	970	$90	$88.5K
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…	920	$60	$54.3K
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.	1,560	$30	$42.1K
J7312	Injection, dexamethasone, intravitreal implant, 0.1 mg	180	$160	$28.9K
J3590	Unclassified biologics	30	$510	$15.3K
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…	160	$80	$13.7K

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. Ohio Distribution

Thomas Tsai — 1 of 18 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. state median

18 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	34	100	840	$680	$729K
J2777	10	70	9,480	$30	$353.3K
J2781	11	20	1,040	$120	$152.4K
J3490	33	50	100	$560	$73.1K
67028	49	150	470	$90	$64K
J7312	15	20	240	$160	$41.7K
J3590	96	100	200	$100	$30K
92014	468	1,390	100	$70	$12.9K
99214	13,197	20,010	100	$70	$11.7K
92012	9	330	50	$60	$8K

Showing 1–10 of 18

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Retina Associates Of Cleveland, Inc.	OH	Retina Specialist (Ophthalmology) Physician	$0	$11.2M
Scott Pendergast	OH	Retina Specialist (Ophthalmology) Physician	$6M	$0
David Miller	OH	Retina Specialist (Ophthalmology) Physician	$4.8M	$0
Llewelyn Rao	OH	Retina Specialist (Ophthalmology) Physician	$3.7M	$0
Joseph Coney	OH	Retina Specialist (Ophthalmology) Physician	$3.2M	$140
Arnold Nothnagel	OH	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Shawn Lewis	OH	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
Thomas Hull	OH	Retina Specialist (Ophthalmology) Physician	$2.6M	$0
Hang Pham	OH	Ophthalmology Physician	$2.6M	$0
Michael Novak	OH	Retina Specialist (Ophthalmology) Physician	$2.5M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Midwest Home Care Ltd	OH	Home Health Agency	$0	$39.8M
Hometown Care LLC	OH	Home Health Agency	$0	$19.9M
The Light Center Recovery LLC	OH	Community/Behavioral Health Agency	$0	$6.9M
City Of Cuyahoga Falls	OH	Ambulance	$277.8K	$842.8K
Davis Eye Center, Inc	OH	Ambulatory Surgical Clinic/Center	$870.3K	$14.1K
Charles Davis	OH	Ophthalmology Physician	$355.7K	$0
Jonelle Mcdonnell	OH	Dermatology Physician	$206.7K	$0
Datinder Deo	OH	Nephrology Physician	$188.6K	$0
Rajat Maheshwari	OH	Nephrology Physician	$188K	$0
Anita Lawrenz	OH	Internal Medicine Physician	$136K	$5K

Thomas Tsai — Billing Profile & Reimbursement Data

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Thomas Tsai — 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