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.

Sunir Garg (NPI 1427056134)

Field	Value
Entity Type	Individual
Organization	Sunir Garg
Address	4060 Butler Pike
City	Plymouth Meeting
State	PA
ZIP	19462
Taxonomy	Ophthalmology Physician
NPI Enumerated	July 7, 2005

Payer Source	Total Paid
Medicare	$6M
Medicaid	$0

Key Findings

This provider is a high-volume intravitreal injection specialist: the top revenue drivers are anti-VEGF and related intravitreal drugs (J0178, J2778, Q5128) and the separate intravitreal injection procedure (67028), with J0178 generating $1.9M revenue (31.2% of this provider's total Medicare revenue), J2778 $1.3M (21.9%), and Q5128 $1M (17.6%). The predominance of these drug and injection procedure codes is consistent with a retina-focused practice delivering frequent in-office retinal injections for macular disease rather than general ophthalmology surgical volume. The reported code mix (high shares for injectable agents plus frequent retinal imaging codes) supports an operational model centered on recurring injection visits and imaging follow-up.

Revenue is highly concentrated: the precomputed top-3 codes account for 70.7% of this provider's total Medicare revenue, indicating reliance on a narrow set of high-value retinal therapies for the bulk of billing. That concentration implies that changes in drug use patterns, reimbursement, or biosimilar adoption could materially affect this provider's Medicare revenue profile. Monitor utilization shifts among J0178, J2778, and Q5128 for early signals of revenue volatility.

This provider is effectively single-payer in scale for public programs: Total Medicare revenue: $6M while there is no Medicaid billing on file. The absence of Medicaid activity means payer-mix assessments and network leverage should be framed almost entirely around Medicare business and commercial arrangements rather than state Medicaid relationships.

Competitive standing is strong on nationally benchmarked retinal therapeutics: J2778 ranks #19 of 1208 providers nationally (99th percentile; notably above typical national volume for this code) and Q5128 ranks #13 of 373 providers nationally (97th percentile; notably above typical national volume for this code). J0178 also ranks well at #246 of 3204 providers nationally (92th percentile; notably above typical national volume for this code), indicating above-average adoption and delivery of these injectable therapies compared with peers.

The practice shows extreme outlier volumes for certain diagnostic and evaluation codes that support frequent follow-up care: 92134 ranks #51 of 26868 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code) and 92012 ranks #63 of 17177 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code). These patterns are consistent with a care pathway of repeated imaging and intermediate-level established visits tied to chronic retinal disease management.

There are additional notable high-volume procedural signals consistent with injection clinics: 67028 (intravitreal injection procedure) has 3.3K claims, $333.6K revenue (5.6% of this provider's total Medicare revenue) and ranks #70 of 4255 providers nationally (98th percentile; notably above typical national volume for this code). The concentration of both drug J-codes and the injection CPT suggests a workflow optimized for frequent in-office injections and associated facility use.

Some non-injection codes are also unusually elevated and should be considered in utilization reviews: 99204 (new patient E&M) appears as an extreme outlier at rank #2069 of 227068 providers nationally (99th percentile; extreme outlier, far above typical national volume for this code), which could reflect referral patterns or intake workflow not typical for a purely procedural practice. While not surgical-volume dominant, the provider also bills a range of retina surgery CPTs at modest volumes (e.g., 67042, 67113) that show typical national participation rather than dominance.

The provider has long-standing Medicare enrollment, with NPI enumerated on 2005-07-07 (~21 years ago), indicating an established practice footprint. Given the high Medicare-only revenue base and concentrated reliance on a few high-revenue retinal drug codes, payer negotiations and risk-mitigation strategies should prioritize protections around reimbursement for intravitreal therapies and related imaging follow-up services.

Medicare: Complete Services Breakdown

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

28 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,700	$690	$1.9M
J2778	Injection, ranibizumab, 0.1 mg	6,890	$190	$1.3M
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	4,810	$220	$1M
J2777	Injection, faricimab‑svoa, 0.1 mg	23,160	$30	$671.6K
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.	3,300	$100	$333.6K
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.	4,940	$30	$148.3K
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…	2,100	$70	$146.9K
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…	1,310	$70	$94.3K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	690	$120	$82.8K
J3490	Unclassified drugs	40	$1,820	$63.7K

Showing 1–10 of 28

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 28 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Pennsylvania Distribution

Sunir Garg — 4 of 25 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

28 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	21	140	830	$690	$865.1K
Q5128	8	20	3,830	$220	$838.7K
J2778	5	70	1,030	$190	$417.1K
J2777	17	100	7,950	$30	$360.2K
J2781	10	20	690	$120	$109.1K
67028	12	180	600	$90	$87.5K
J7312	6	10	280	$160	$50.7K
J7999	62	110	100	$120	$33.3K
67042	5	50	20	$1,100	$31.9K
J3490	85	110	60	$70	$27.9K

Showing 1–10 of 28

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Alok Bansal	CA	Ophthalmology Physician	$3M	$4.7M
David Reed	MA	Retina Specialist (Ophthalmology) Physician	$7.7M	$0
Omesh Gupta	PA	Ophthalmology Physician	$7.1M	$80
Mitchell Fineman	PA	Ophthalmology Physician	$7M	$0
Michael Klufas	PA	Ophthalmology Physician	$7M	$0
Richard Kaiser	PA	Ophthalmology Physician	$6.6M	$0
Allen Chiang	PA	Ophthalmology Physician	$6.6M	$0
Carl Regillo	PA	Ophthalmology Physician	$6.5M	$0
Allen Ho	PA	Ophthalmology Physician	$6.4M	$0
Yoshihiro Yonekawa	PA	Ophthalmology Physician	$6.4M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gemma Services	PA	Psychiatric Residential Treatment Facility	$0	$23.8M
Access Services Inc	PA	Community/Behavioral Health Agency	$0	$8.3M
James Vander	PA	Ophthalmology Physician	$6.3M	$0
Marc Spirn	PA	Ophthalmology Physician	$6.3M	$0
Arunan Sivalingam	PA	Ophthalmology Physician	$6M	$0
Carl Park	PA	Ophthalmology Physician	$5.5M	$0
Ajay Kuriyan	PA	Ophthalmology Physician	$5.3M	$6.6K
Plymouth Community Ambulance Assn	PA	Land Ambulance	$903.5K	$4.3M
Sonia Mehta	PA	Ophthalmology Physician	$4.9M	$0
Jason Hsu	PA	Ophthalmology Physician	$4.4M	$0

Sunir Garg — 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