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.

Scott Pendergast (NPI 1386638682)

Field	Value
Entity Type	Individual
Organization	Scott Pendergast
Address	24075 Commerce Park
City	Beachwood
State	OH
ZIP	44122
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	September 1, 2005

Payer Source	Total Paid
Medicare	$6M
Medicaid	$0

Key Findings

This provider is effectively a Medicare-only practice: lifetime Medicare revenue is $6M while Medicaid billing is listed as none, indicating no Medicaid revenue on file. The NPI was enumerated 2005-09-01 (~21 years ago), consistent with long-standing Medicare participation and an established clinical footprint in BEACHWOOD, OH.

Revenue is highly concentrated in a handful of drug and procedure codes: the precomputed top 3 Medicare codes account for 77.7% of this provider's total Medicare revenue, with a single code, J0178, representing $3.5M or 59.1% of Medicare revenue. That level of concentration implies business sensitivity to utilization or reimbursement changes for those few high-revenue items.

The code mix identifies a retina-focused, injection-centered practice: top revenue drivers include J0178 (aflibercept), J2777 (faricimab), and J2781 (pegcetacoplan), and the standalone intravitreal injection code 67028 appears among top billings. Together these items — high-volume drug administration plus 67028 — indicate day-to-day operations are dominated by physician-administered intravitreal therapies rather than primarily surgical cases.

J0178 is a clear national outlier: it generates $3.5M and the provider ranks #25 of 3204 nationally (99th percentile; extreme outlier), signaling unusually high aflibercept administration compared to peers. This scale for a single drug code puts the provider among the very highest national billers for that therapy.

Other drug- and unclassified-drug activity is also notable: J2781 contributes $388.8K (6.5%) and ranks #12 of 490 (98th percentile; notably above typical national volume for this code), while J3490 contributes $549.8K (9.2%) and ranks #201 of 2838 (93rd percentile; described in the data as typical, unremarkable volume). These ranks show the provider is above peers on several specialty-retina drug codes, not only J0178.

Clinical throughput for follow-up visits and retinal imaging is high relative to peers: 92012 has 1.6K claims and $95.1K (1.6%) with rank #157 of 17177 (99th percentile; extreme outlier), and 92134 has 3.2K claims and $89.9K (1.5%) with rank #327 of 26868 (99th percentile; extreme outlier). These volumes suggest a large established Medicare patient panel and frequent imaging-based surveillance to support the injection-centric practice.

Surgical retina procedures are present but represent a small share of revenue and volume: codes such as 67042 ($12.8K, 0.2%), 67108 ($12.8K, 0.2%), and 67036 ($7.4K, 0.1%) appear at low counts and modest ranks. This pattern reinforces that the provider’s operations emphasize outpatient injections and diagnostics over higher-volume surgical intervention.

From a payer- and business-risk perspective, the combination of single-payer concentration (Medicare-only), heavy reliance on a few high-revenue drug codes (top 3 = 77.7%), and extreme national outlier status on J0178 means the provider’s revenue base could be sensitive to changes in Medicare drug reimbursement, utilization management, or shifting product mix among intravitreal therapies. Analysts should prioritize monitoring policy, pricing, and utilization trends for those leading drug codes.

Medicare: Complete Services Breakdown

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

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	5,090	$690	$3.5M
J2777	Injection, faricimab‑svoa, 0.1 mg	19,140	$30	$555.1K
J3490	Unclassified drugs	310	$1,770	$549.8K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	3,240	$120	$388.8K
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.	3,070	$90	$279.4K
J2778	Injection, ranibizumab, 0.1 mg	980	$190	$183.3K
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…	1,560	$60	$95.1K
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.	3,210	$30	$89.9K
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…	920	$80	$74.7K
J3590	Unclassified biologics	160	$310	$50.2K

Showing 1–10 of 23

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 23 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Ohio Distribution

Scott Pendergast — 8 of 23 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

23 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	1	100	840	$680	$729K
J2777	14	70	9,480	$30	$353.3K
J2781	2	20	1,040	$120	$152.4K
J2778	1	20	370	$180	$73.1K
J3490	6	50	100	$560	$73.1K
67028	1	150	470	$90	$64K
Q5128	1	10	230	$220	$49.5K
J3590	57	100	200	$100	$30K
67042	38	50	20	$960	$29.7K
67108	17	30	20	$1,020	$26.5K

Showing 1–10 of 23

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Associated Retinal Consultants, PC	MI	Ophthalmology Physician	$0	$21.1M
Retina Associates Of Cleveland, Inc.	OH	Retina Specialist (Ophthalmology) Physician	$0	$11.2M
Sandeep Randhawa	MI	Retina Specialist (Ophthalmology) Physician	$7M	$0
David Miller	OH	Retina Specialist (Ophthalmology) Physician	$4.8M	$0
Ramon Lee	IL	Retina Specialist (Ophthalmology) Physician	$4M	$8.5K
Jeremy Wolfe	MI	Retina Specialist (Ophthalmology) Physician	$3.7M	$0
Llewelyn Rao	OH	Retina Specialist (Ophthalmology) Physician	$3.7M	$0
Christianne Wa	CA	Retina Specialist (Ophthalmology) Physician	$3.5M	$0
Douglas Covert	MI	Retina Specialist (Ophthalmology) Physician	$3.2M	$0
Joseph Coney	OH	Retina Specialist (Ophthalmology) Physician	$3.2M	$140

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Primary Care Practices Inc	OH	Internal Medicine Physician	$0	$78.7M
Pearl's Hope, LLC	OH	Home Health Agency	$0	$47.8M
Health Care Bridge, Inc	OH	Home Health Agency	$0	$32.3M
Cleveland Clinic Health System - East Region	OH	General Acute Care Hospital	$0	$31.5M
Altimate Care LLC	OH	Home Health Agency	$0	$24M
Signature Health, Inc	OH	Federally Qualified Health Center (FQHC)	$0	$23M
University Hospitals Ahuja Medical Center, Inc	OH	General Acute Care Hospital	$0	$21.1M
Shaker Clinic, LLC	OH	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$15.5M
Psychological & Behavioral Consultants, LLC	OH	Psychiatry Physician	$0	$14.9M
Northeast Home Health Services	OH	Home Health Agency	$0	$11.9M

Scott Pendergast — 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