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

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

Philip Scharper (NPI 1346285426)

Field	Value
Entity Type	Individual
Organization	Philip Scharper
Address	2150 Harrisburg Pike
City	Lancaster
State	PA
ZIP	17601
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	June 20, 2006

Payer Source	Total Paid
Medicare	$1.6M
Medicaid	$0

Key Findings

PHILIP SCHARPER is effectively a Medicare-focused retina practice: total Medicare revenue is $1.6M and Total Medicaid revenue is none (no Medicaid billing on file), so the provider operates as a single-payer (Medicare) biller in the available data. The NPI was enumerated on 2006-06-20 (~20 years ago), indicating long-standing activity that aligns with an established specialty practice rather than a recently launched clinic.

Revenue is highly concentrated in intravitreal biologic injections: J0178 (aflibercept) alone accounts for $887.9K in revenue (53.9% of total Medicare revenue) and, together with J2777 (faricimab) and J2778 (ranibizumab), the top three codes account for 75.4% of the provider's Medicare revenue. This concentration points to a medical-retina service line dominated by anti-VEGF and related intravitreal therapies rather than surgical or broad multispecialty services.

The procedural mix supports a high-throughput injection and diagnostics workflow: 1.3K claims for J0178 with $683 avg paid/claim and 1.4K claims for 67028 ($126.4K revenue) indicate frequent in-office intravitreal injections and separate injection procedure coding. High volumes of imaging and photography — 2.1K claims for 92134 ($58.9K revenue) and 691 claims for 92250 ($18K revenue) — accompany the injection work, consistent with a retina clinic that pairs anti-VEGF therapy with OCT and fundus photography for monitoring.

Competitive standing on high-revenue biologics is modest to typical: J0178 ranks #993 of 3204 providers nationally (69th percentile; typical, unremarkable volume for this code), J2777 ranks #1230 of 2039 (40th percentile; typical, unremarkable volume for this code), and J2778 ranks #525 of 1208 (57th percentile; typical, unremarkable volume for this code). In plain terms, the provider is not a national outlier for anti-VEGF use but maintains respectable, practice-sustaining volumes for these drugs.

Several codes show above-typical national volume for diagnostics and routine visits, suggesting a busy follow-up clinic: 92134 ranks #944 of 26868 providers nationally (96th percentile; notably above typical national volume for this code), 92250 ranks #630 of 25087 (97th percentile; notably above typical national volume for this code), and 92235 ranks #375 of 2192 (83th percentile; typical, unremarkable volume for this code). These imaging and angiography volumes indicate robust use of monitoring services that support ongoing injection therapy.

Office evaluation-and-management coding is an outlier relative to national peers: 99213 has 1K claims and $60.6K revenue and ranks #6284 of 457151 providers nationally (99th percentile; extreme outlier, far above typical national volume for this code), and 99204 ranks #6832 of 227068 providers nationally (97th percentile; notably above typical national volume for this code). This pattern suggests a high frequency of established-patient visits and substantial new-patient visit activity relative to most Medicare-fee-for-service providers, consistent with sustained patient follow-up and throughput.

Ancillary and less-common procedure activity is present but not dominant: surgical vitrectomy codes such as 67042 ($28.7K revenue, ranks #217 of 1087, 79th percentile; typical, unremarkable volume for this code) and 67036 ($12.7K revenue, ranks #358 of 832, 54th percentile; typical, unremarkable volume for this code) appear at modest volumes, indicating the practice focuses mainly on medical retina care with occasional surgical cases. Compounded drug billing (J7999) appears with 651 claims and $48.8K revenue and ranks #103 of 1333 providers nationally (92th percentile; typical, unremarkable volume for this code), which may reflect some use of office-prepared agents or ancillary compounded medications but not a major revenue stream.

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
J0178	Injection, aflibercept, 1 mg	1,300	$680	$887.9K
J2777	Injection, faricimab‑svoa, 0.1 mg	7,440	$30	$215.8K
J2778	Injection, ranibizumab, 0.1 mg	780	$180	$139K
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.	1,440	$90	$126.4K
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…	1,010	$60	$60.6K
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.	2,100	$30	$58.9K
J7999	Compounded drug, not otherwise classified	650	$80	$48.8K
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…	30	$850	$28.7K
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…	180	$110	$20.2K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	690	$30	$18K

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. Pennsylvania Distribution

Philip Scharper — 5 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. state median

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	12	140	830	$690	$865.1K
J2778	2	70	1,030	$190	$417.1K
J2777	11	100	7,950	$30	$360.2K
67028	10	180	600	$90	$87.5K
J7999	1	110	100	$120	$33.3K
67042	5	50	20	$1,100	$31.9K
67036	4	30	20	$830	$19.9K
99214	2,904	23,230	100	$80	$14.5K
92235	5	70	40	$100	$10K
J9035	39	60	80	$50	$8.7K

Showing 1–10 of 17

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Derek Barker	SC	Retina Specialist (Ophthalmology) Physician	$4.7M	$0
Columbia Eye Surg Center Inc	SC	Ophthalmologic Surgery Clinic/Center	$3.5M	$1.2K
Roy Brod	PA	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
Dina Gewaily	PA	Ophthalmology Physician	$1.8M	$2.7K
Salman Porbandarwalla	PA	Retina Specialist (Ophthalmology) Physician	$1.6M	$0
Lili Kaplan	PA	Retina Specialist (Ophthalmology) Physician	$987.9K	$0
Edward Mintz	SC	Ophthalmology Physician	$359.2K	$0
Edward Crosswell	SC	Ophthalmology Physician	$330.2K	$0
Stephen Cross	SC	Ophthalmology Physician	$313.6K	$0
William Johnson	SC	Ophthalmology Physician	$303.2K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bayada Home Health Care, Inc.	PA	Home Health Agency	$0	$34.4M
Andventure, LLC	PA	Home Health Agency	$0	$26.7M
Efcc Acquisition Corp	PA	Home Health Agency	$0	$13.1M
Smilebuilderz LLC	PA	Dentist	$0	$11.5M
Teamcare Behavioral Health, LLC	PA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.3M
Horizon Healthcare Services, LLC	PA	Home Infusion Therapy Pharmacy	$12.2K	$6.5M
Penn State Health Lancaster Medical Center	PA	General Acute Care Hospital	$0	$5.4M
Advanced Surgery Center Of Lancaster, LLC	PA	Ambulatory Surgical Clinic/Center	$4M	$0
Midatlantic Endoscopy LLC	PA	Ambulatory Surgical Clinic/Center	$1.2M	$183.7K
Lancaster Pet Partnership, LLP	PA	Radiology Clinic/Center	$1.4M	$0

Philip Scharper — 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