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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Daniel Bennett (NPI 1376715565)

Field	Value
Entity Type	Individual
Organization	Daniel Bennett
Address	4414 Lake Boone Trl Ste 302
City	Raleigh
State	NC
ZIP	27607
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	March 27, 2008

Payer Source	Total Paid
Medicare	$3M
Medicaid	$0

Key Findings

This provider is revenue-driven by intravitreal anti-VEGF therapy and high-volume retinal outpatient care: J0178 (aflibercept) alone represents $1.5M and 50.5% of Medicare revenue, and two additional injection codes, J2778 and Q5124, together with J0178 are the primary clinical drivers. High counts for injection codes alongside significant volumes for fundus photography (92250) and OCT imaging (92134) indicate an operation centered on frequent injection clinics supported by diagnostic imaging.

Revenue concentration is pronounced: the precomputed top 3 codes account for 71.5% of this provider’s total Medicare revenue, with J0178 at 50.5%, J2778 at 12.9%, and Q5124 at 8.1%. This concentration indicates most Medicare dollars flow from a narrow set of high-cost drug administrations rather than a broad mix of procedures.

The provider’s payer mix is effectively single-payer Medicare: lifetime Medicare revenue is $3M and there is no Medicaid billing on file. Analysts should treat this profile as a Medicare-focused retinal practice with no observable Medicaid service volume to inform network or access considerations.

On competitive standing for the top drugs, the provider is a solid national participant but not dominant: J0178 ranks #446 of 3204 providers nationally (86th percentile; typical, unremarkable volume), J2778 ranks #205 of 1208 (83th percentile; typical, unremarkable volume), and Q5124 ranks #23 of 122 (82th percentile; typical, unremarkable volume). These ranks show above-average placement for high-revenue drugs without reaching an elite volume tier.

There are clear statistical outliers in office visits and imaging throughput: 99213 is ranked #2268 of 457151 providers nationally (100th percentile; extreme outlier, far above typical national volume) and 92250 is ranked #57 of 25087 providers nationally (100th percentile; extreme outlier, far above typical national volume), while 92134 is ranked #1625 of 26868 (94th percentile; notably above typical national volume). This pattern suggests unusually high ambulatory visit and retinal imaging volumes relative to national peers, consistent with a high-frequency injection clinic model.

Reimbursement and product-mix dynamics are unequal across drugs: average paid per claim for J0178 is $690 compared with $179 for J2778 and $172 for Q5124, while J2777 shows a large claim count (5.8K claims) but a low avg paid/claim of $29, producing only $167K in revenue. These contrasts mean claim counts alone are not predictive of revenue contribution; higher-cost agents like J0178 drive revenue disproportionately despite comparable or lower claim volumes.

Other procedure and biologic activity is present but secondary: code 67028 (isolated intravitreal injection procedure) generated $161.6K (5.4% of Medicare revenue) and ranks #555 of 4255 (87th percentile; typical, unremarkable volume), while J3590 (unclassified biologics) contributed $152.6K (5.1% of Medicare revenue) and ranks #412 of 631 (34th percentile; typical, unremarkable volume). Surgical retina codes such as 67041/67042 appear with small claim counts and modest revenue shares, indicating some surgical capacity but with the bulk of revenue coming from injections and imaging.

The provider is an established entrant with sustained Medicare activity: the NPI was enumerated 2008-03-27 (~18 years ago), and the lifetime Medicare revenue of $3M combined with concentrated drug revenue and very high outpatient imaging/E&M volumes suggests an established retinal practice structured around recurring injection visits and diagnostics rather than broad mixed-payer ambulatory care.

Medicare: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,180	$690	$1.5M
J2778	Injection, ranibizumab, 0.1 mg	2,140	$180	$382.7K
Q5124	Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg	1,400	$170	$240.8K
J2777	Injection, faricimab‑svoa, 0.1 mg	5,760	$30	$167K
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.	1,760	$90	$161.6K
J3590	Unclassified biologics	50	$2,940	$152.6K
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	520	$220	$112.5K
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…	1,470	$60	$88.4K
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,…	1,730	$30	$43.2K
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.	1,420	$30	$41.1K

Showing 1–10 of 19

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. North Carolina Distribution

Daniel Bennett — 3 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. state median

19 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	18	100	950	$690	$881K
J2777	53	70	12,990	$30	$503.7K
Q5124	2	10	890	$170	$259K
J2778	6	50	620	$180	$202.2K
J3590	3	10	30	$2,570	$95K
Q5128	2	10	370	$220	$83.6K
67028	19	120	780	$90	$80K
67042	25	30	20	$990	$23.8K
67041	9	10	20	$1,050	$23.2K
99214	11,995	18,060	110	$80	$15.1K

Showing 1–10 of 19

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shil Patel	VA	Ophthalmology Physician	$6.1M	$0
James Pate	NC	Ophthalmology Physician	$5.2M	$0
Nitin Gupta	NC	Ophthalmology Physician	$4.7M	$0
John Thordsen	NC	Retina Specialist (Ophthalmology) Physician	$3.5M	$0
Rebecca Manning	NC	Retina Specialist (Ophthalmology) Physician	$3.4M	$0
William Clark	SC	Ophthalmology Physician	$3.3M	$0
Sachin Mudvari	NC	Retina Specialist (Ophthalmology) Physician	$3.2M	$0
Andrew Mcfarland	VA	Retina Specialist (Ophthalmology) Physician	$3.1M	$0
Brian Lehpamer	NC	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Daniel Kasuga	TX	Retina Specialist (Ophthalmology) Physician	$2.9M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Autism Society Of North Carolina, Inc.	NC	Community/Behavioral Health Agency	$0	$95.7M
Rex Hospital Inc.	NC	General Acute Care Hospital	$0	$25.3M
Bayada Home Health Care, Inc.	NC	Home Health Agency	$0	$24.8M
Nc Dept Of Health And Human Service	NC	Clinical Medical Laboratory	$0	$16.4M
Jeffers Mann & Artman Pediatric & Adolesent Medicine PA	NC	Pediatric Adolescent Medicine Physician	$0	$10.9M
Pediatric Therapy Associates	NC	Physical Therapist	$0	$10.2M
Blue Ridge Day Surgery Center, LP	NC	Ambulatory Surgical Clinic/Center	$1.6M	$2.2M
John Denny	NC	Retina Specialist (Ophthalmology) Physician	$2.3M	$0
Eugene Milder	NC	Retina Specialist (Ophthalmology) Physician	$2.1M	$0
Raynor Casey	NC	Retina Specialist (Ophthalmology) Physician	$1.9M	$0

Daniel Bennett — 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