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

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

Eric Lee (NPI 1356329981)

Field	Value
Entity Type	Individual
Organization	Eric Lee
Address	200 Executive Center Parkway R.g.w.
City	Frederickburg
State	VA
ZIP	22401
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	January 4, 2006

Payer Source	Total Paid
Medicare	$2.6M
Medicaid	$0

Key Findings

This provider is a retina-focused ophthalmology practice whose revenue mix is heavily driven by intravitreal biologic injections and ancillary retina imaging and procedures. The top Medicare codes by revenue—J0178, 92014 and J2777—reflect high-volume anti-VEGF therapy (aflibercept and faricimab), comprehensive established-patient ophthalmic visits, and retina-directed drug administrations, indicating a clinical footprint centered on medical retina care rather than primary care or broad ophthalmic surgery.

Medicare revenue dominance is clear: lifetime Medicare revenue is $2.6M while there is no Medicaid billing on file, so this provider functions effectively as a single-payer (Medicare) revenue stream in available data. Analysts should treat the entity as Medicare-dependent for observed payer-level activity and competitive benchmarking because Medicaid contributes no recorded revenue.

Revenue concentration is high: precomputed results show the top 3 Medicare codes by revenue account for 76.2% of total Medicare revenue. This indicates a concentrated service-line mix where a few procedure/drug codes—primarily high-cost intravitreal pharmacologic therapy and routine comprehensive established visits—drive the majority of billings and payments.

J0178 (aflibercept) is the single largest revenue driver at $1.6M (60.6% of Medicare revenue) and ranks #413 of 3204 providers nationally (87th percentile), which places the provider as a sizeable but not top-tier national participant for that drug. The combination of very large revenue share for J0178 and a typical national rank suggests the practice administers a substantial volume of aflibercept relative to its own revenue base while remaining within common volume ranges for ophthalmology retina specialists nationally.

92014 (comprehensive established eye exam) is the next largest code with $232.6K (9.0% of Medicare revenue) and an extreme outlier national rank (#110 of 35415, 100th percentile). This suggests unusually high utilization of comprehensive established-patient visits compared with peers, implying a practice model with sustained longitudinal follow-up and frequent re-evaluation of established Medicare patients in addition to procedural work.

J2777 (faricimab) contributes $170.5K (6.6% of Medicare revenue) and ranks #1409 of 2039 providers nationally (30th percentile), which is a modest national position for that specific agent. Combined with J2778 (ranibizumab) and biosimilar Q5128 activity, the presence of multiple anti-VEGF/faricimab/ranibizumab codes indicates diversified biologic use rather than exclusive reliance on a single agent.

Several additional codes show notably high percentile rankings that point to concentrated retina service intensity beyond injections: 92134 (retinal OCT) generates $100.9K (3.9% of revenue) and ranks in the 99th percentile nationally, and 92202 (extended ophthalmoscopy with drawing) is an extreme outlier (98th percentile) with $24K. These high ranks for imaging and extended ophthalmoscopy are consistent with a practice workflow that pairs frequent intravitreal injections with detailed diagnostic imaging and documentation.

Procedure mix shows limited surgical retina volume relative to injection and imaging services: codes for retinal repair or more invasive retinal surgeries (e.g., 67108, 67145) are present but account for small shares of revenue ($12.6K and $3.4K respectively), suggesting the provider focuses primarily on medical retina management and diagnostics rather than high-volume retinal surgery.

Tenure is long: the provider’s NPI was enumerated on 2006-01-04 (approximately 20 years ago), indicating an established practice and likely sustained referral relationships and Medicare patient panels that align with the high utilization of established-patient visits and recurring intravitreal therapy documented in the billing data.

Medicare: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,260	$690	$1.6M
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…	2,610	$90	$232.6K
J2777	Injection, faricimab‑svoa, 0.1 mg	5,880	$30	$170.5K
J2778	Injection, ranibizumab, 0.1 mg	740	$190	$137.3K
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.	1,490	$90	$135.3K
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.	3,360	$30	$100.9K
J3590	Unclassified biologics	40	$2,440	$97.5K
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	170	$210	$35.3K
92202	The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece…	2,000	$10	$24K
67108	The provider repairs a detached retina using heat produced by a laser beam or by freezing the tissues. He may attach a scleral buckle to simplify the passage of fluid through and behind the retina or…	10	$1,050	$12.6K

Showing 1–10 of 20

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Virginia Distribution

Eric Lee — 2 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. state median

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	24	80	1,400	$690	$1.1M
J2777	42	60	13,200	$30	$517.1K
J2778	14	40	560	$180	$171.5K
J3590	6	20	40	$2,290	$126K
67028	34	90	1,000	$90	$107.1K
Q5128	6	10	190	$220	$70.7K
92014	10	870	170	$80	$32.8K
67108	15	20	20	$1,180	$23.5K
99214	6,590	12,890	140	$80	$21K
J9035	29	60	170	$50	$19.9K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Retina Group Of Washington, PLLC	MD	Ophthalmology Physician	$0	$19.5M
Virginia Oncology Associates	VA	Hematology & Oncology Physician	$0	$6.2M
Rohit Lakhanpal	MD	Retina Specialist (Ophthalmology) Physician	$6.1M	$0
Gordon Byrnes	VA	Retina Specialist (Ophthalmology) Physician	$4.9M	$0
Daniel Berinstein	MD	Retina Specialist (Ophthalmology) Physician	$4.3M	$0
Alexander Melamud	VA	Retina Specialist (Ophthalmology) Physician	$4.2M	$0
Michael Lai	MD	Retina Specialist (Ophthalmology) Physician	$4.2M	$0
Jordana Fein	VA	Retina Specialist (Ophthalmology) Physician	$4.2M	$0
Eric Weichel	MD	Ophthalmology Physician	$4.1M	$0
Gayatri Reilly	MD	Retina Specialist (Ophthalmology) Physician	$4.1M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rappahannock Area Community Services Board	VA	Community/Behavioral Health Agency	$0	$142.5M
Mary Washington Hospital Inc.	VA	General Acute Care Hospital	$0	$80.1M
Paragon Autism Services, LLC	VA	Behavior Analyst	$0	$21.6M
Fredericksburg Emergency Medical Alliance, Inc.	VA	Emergency Medicine Physician	$0	$15M
Mary Washington Healthcare Physicians	VA	Family Medicine Physician	$0	$13.3M
Pedsplus Urgent Care, LLC	VA	Urgent Care Clinic/Center	$0	$11M
Preferred Pediatrics At Snowden	VA	Pediatrics Physician	$0	$6.4M
Sunny Home Care Inc.	VA	Home Health Agency	$0	$6.3M
Thomas Johnson	VA	Retina Specialist (Ophthalmology) Physician	$3.6M	$0
Central Virginia Surgi-center LP	VA	Ambulatory Surgical Clinic/Center	$3.2M	$318.9K

Eric Lee — 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