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

Why is the Medicaid comparison limited to New Jersey 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. New Jersey (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.

Benjamin Spirn (NPI 1417941592)

Field	Value
Entity Type	Individual
Organization	Benjamin Spirn
Address	1656 Oak Tree Rd
City	Edison
State	NJ
ZIP	08820
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	September 6, 2005

Payer Source	Total Paid
Medicare	$2.8M
Medicaid	$0

Key Findings

Practice profile and payer mix: BENJAMIN SPIRN is a retina specialist (ophthalmology) with an NPI enumerated on 2005-09-06 (~21 years ago) and $2.8M in lifetime Medicare revenue. There is no Medicaid billing on file for this provider, indicating an effectively single-payer (Medicare-focused) outpatient retinal practice at the claims level.

High revenue concentration in intravitreal drug codes: three injection drug codes (J2777, J0178, J2778) together account for 71.6% of this provider's total Medicare revenue, signaling a business model heavily weighted toward reimbursed pharmaceutical therapy. Individually, J2777 generates $800.4K (28.9% of Medicare revenue), J0178 $714.7K (25.8%), and J2778 $469.2K (16.9%), so injectable therapeutics are the primary revenue drivers.

Clinical operations implied by code mix: the dominance of J2777, J0178, and J2778 combined with procedure codes such as 67028 (1.7K claims, $173.6K revenue) indicates frequent intravitreal injection procedures and ongoing anti-VEGF or retina-targeted biologic management. High-volume retinal imaging and follow-up visit codes (92134, 92202, 92014) further suggest routine monitoring and recurring treatment cycles typical of retina subspecialty care.

Competitive standing for top drugs: J2777 ranks #334 of 2039 providers nationally (84th percentile; typical, unremarkable volume for this code), J0178 ranks #1244 of 3204 (61th percentile; typical, unremarkable volume for this code), and J2778 ranks #141 of 1208 (88th percentile; typical, unremarkable volume for this code). These percentiles indicate the provider is a solid, above-average national participant for ranibizumab and faricimab administrations, and a typical-volume participant for aflibercept in the broader provider population.

Volumes and statistical outliers in outpatient evaluation and diagnostics: 92014 has 2.4K claims and $242.9K revenue and ranks #144 of 35415 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code), while 92134 (2.8K claims, $96.7K) ranks #509 of 26868 (98th percentile; extreme outlier). 92202 (2.5K claims, $32.3K) ranks #20 of 2327 (99th percentile; extreme outlier). These standings point to unusually high volumes of comprehensive established-patient visits and retinal imaging relative to national peers, consistent with a high-throughput retina follow-up practice.

Revenue mix beyond top drugs: non-drug procedural and diagnostic codes contribute meaningfully but at smaller shares — 67028 contributes $173.6K (6.3%), 92014 contributes $242.9K (8.8%), and 92134 contributes $96.7K (3.5%) of Medicare revenue. This mix reflects reliance on both drug reimbursement and volume-driven E/M and procedural billing for overall revenue sustainability rather than dependence on office visits alone.

Use of unclassified and emerging therapies: J3490 (unclassified drugs) appears with $72.3K (2.6% of Medicare revenue) and ranks #1883 of 2838 (33th percentile; typical, unremarkable volume for this code), while J2781 (pegcetacoplan) contributes $64.8K (2.3%) and ranks #252 of 490 (47th percentile; typical, unremarkable volume for this code). These entries indicate occasional billing for high-cost or newer retinal therapies and miscellaneous drug items that supplement the core anti-VEGF revenue stream.

Market implications of no Medicaid activity: the absence of Medicaid billing suggests the provider either does not participate in Medicaid or does not see a measurable Medicaid patient base in the claims data; combined with $2.8M Medicare revenue, this shapes a payer strategy that is Medicare-centric and may affect referral patterns, contracting leverage, and access for Medicaid populations.

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
J2777	Injection, faricimab‑svoa, 0.1 mg	27,600	$30	$800.4K
J0178	Injection, aflibercept, 1 mg	1,050	$680	$714.7K
J2778	Injection, ranibizumab, 0.1 mg	2,580	$180	$469.2K
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…	2,380	$100	$242.9K
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.	1,720	$100	$173.6K
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.	2,760	$40	$96.7K
J3490	Unclassified drugs	40	$1,760	$72.3K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	540	$120	$64.8K
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…	2,490	$10	$32.3K
J7312	Injection, dexamethasone, intravitreal implant, 0.1 mg	190	$160	$30.1K

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. New Jersey Distribution

Benjamin Spirn — 5 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

Full comparison — all codes billed, vs. state median

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	35	90	880	$690	$693.6K
J2777	3	60	8,820	$30	$319K
J2778	5	40	1,140	$180	$240.8K
67028	15	100	810	$100	$91.1K
J2781	10	20	570	$120	$88.8K
J7312	8	10	190	$160	$42.3K
92014	14	1,130	160	$100	$34.9K
J3490	79	120	70	$230	$30.2K
92012	342	800	140	$70	$18.5K
J9035	12	60	80	$50	$14.2K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vincent Deninis	SC	Optometrist	$75.3K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hmh Hospitals Corporation	NJ	General Acute Care Hospital	$0	$72.1M
Community Hospital Group Inc	NJ	General Acute Care Hospital	$0	$71.5M
Sewa Adult Day Care LLC	NJ	Adult Care Home Facility	$0	$26.3M
Nirvana Adult Day Care LLC	NJ	Adult Day Care Clinic/Center	$0	$23.4M
Golden Era Medical Adult Day Care LLC	NJ	Adult Day Care Clinic/Center	$0	$19.3M
Edison Adult Day Care Center, LLC	NJ	Adult Day Care Clinic/Center	$0	$16.9M
Care Forever Adult Day Care Center LLC	NJ	Adult Day Care Clinic/Center	$0	$13.6M
Rnj Services, Inc	NJ	Clinical Medical Laboratory	$5.8M	$7.5M
Avantic Medical Lab	NJ	Clinical Medical Laboratory	$604.6K	$5.7M
Q Answer Lab Inc	NJ	Clinical Medical Laboratory	$1.6M	$2.7M

Benjamin Spirn — 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