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

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

David Tom (NPI 1437184298)

Field	Value
Entity Type	Individual
Organization	David Tom
Address	2200 Whitney Ave
City	Hamden
State	CT
ZIP	06518
Taxonomy	Ophthalmology Physician
NPI Enumerated	July 11, 2006

Payer Source	Total Paid
Medicare	$2.5M
Medicaid	$0

Key Findings

Practice profile and service line: This provider’s Medicare billing is concentrated in intravitreal drug therapy and retina diagnostics, with J0178 (aflibercept) as the clear operational focus. The dominance of J0178 plus high-volume retinal imaging codes (92134, 92250) and fluorescein angiography (92235) indicates an outpatient retina specialty practice that routinely performs injections and serial imaging for chronic retinal disease.

Revenue concentration risk: The precomputed metric shows the top 3 Medicare codes by revenue account for 78.1% of this provider's total Medicare revenue, and a single code, J0178, represents $1.6M revenue (66.6% of this provider's total Medicare revenue). That level of concentration means changes to reimbursement, utilization, or drug mix for intravitreal agents could materially affect overall Medicare revenue.

Payer mix: This provider is effectively single‑payer on file—Total Medicare revenue: $2.5M and Total Medicaid revenue: none (no Medicaid billing on file). The absence of Medicaid billing suggests limited exposure to state Medicaid populations and near‑total dependence on Medicare revenue streams.

Competitive standing on injections: J0178 ranks #367 of 3204 providers nationally (89th percentile) and is described as typical, unremarkable volume for this code despite producing the majority of this provider’s Medicare revenue. In contrast, alternative intravitreal agents such as J2777 (faricimab) and J2778 (ranibizumab) show much lower revenue shares and lower national standing, indicating aflibercept is the preferred drug in this practice’s mix.

High follow-up and evaluation volume: Office and eye exam codes 92014 (1.2K claims, $118.9K revenue; ranks #1033 of 35415, 97th percentile, notably above typical) and 99214 (965 claims, $99.4K revenue; 97th percentile, notably above typical) are both notably above typical national volume. These elevated E/M and comprehensive exam volumes support a workflow with frequent follow‑ups and chronic disease management consistent with retina care.

Imaging intensity outlier: 92134 (2.8K claims, $93.2K revenue) ranks #479 of 26868 providers nationally (98th percentile) and is labeled an extreme outlier, and 92250 (790 claims, $23.7K revenue) is also an extreme outlier at the 98th percentile. These rankings indicate the provider performs retinal imaging at volumes far above typical peers, reinforcing the practice’s imaging‑driven care model and likely investment in OCT and photography capacity.

Mixed national competitiveness: For some codes the provider is a major outlier (e.g., 92134 and 92250 extreme outliers), while for high‑revenue drug administration (J0178) the provider’s volume is characterized as typical. This combination suggests the practice competes strongly on diagnostics and follow‑up imaging nationally, while its injection volumes are in line with many peers but still produce outsized revenue due to drug unit cost.

Tenure and operational stability: The provider’s NPI was enumerated on 2006-07-11 (~20 years ago), indicating long-standing Medicare enrollment. That tenure, combined with concentrated Medicare revenue and no Medicaid billing on file, suggests an established, Medicare‑focused retina practice with a durable patient cohort for age‑related and chronic retinal conditions.

Medicare: Complete Services Breakdown

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,370	$690	$1.6M
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.	1,630	$100	$163K
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…	1,230	$100	$118.9K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	970	$100	$99.4K
J2777	Injection, faricimab‑svoa, 0.1 mg	3,300	$30	$95.7K
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.	2,820	$30	$93.2K
92235	The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken…	470	$120	$54.3K
J7312	Injection, dexamethasone, intravitreal implant, 0.1 mg	320	$160	$50.6K
J2778	Injection, ranibizumab, 0.1 mg	250	$180	$44.8K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	200	$130	$25.1K

Showing 1–10 of 17

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Connecticut Distribution

David Tom — 7 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Connecticut

Full comparison — all codes billed, vs. state median

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	5	40	830	$690	$713.1K
J2777	27	30	8,190	$30	$340.4K
J2778	13	20	410	$180	$117.8K
67028	4	50	540	$100	$66.4K
J7312	1	10	250	$160	$35.9K
92014	6	580	100	$90	$18.6K
92012	289	300	120	$70	$15.2K
92235	2	30	40	$110	$14.8K
99214	53	6,480	90	$90	$14.2K
J9035	4	30	130	$50	$10.4K

Showing 1–10 of 17

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Refocus Eye Health Of Central Connecticut, P.C.	CT	Ophthalmology Physician	$0	$8.2M
John Huang	CT	Ophthalmology Physician	$2M	$0
Jerry Tsong	CT	Ophthalmology Physician	$1.9M	$0
Erol Verter	CT	Ophthalmology Physician	$1.7M	$0
Gregory Haffner	CT	Ophthalmology Physician	$1.4M	$0
Neil Kalbag	CT	Ophthalmology Physician	$1.1M	$0
Patrick Coady	NJ	Ophthalmology Physician	$728.9K	$0
Rebecca Shields	NY	Ophthalmology Physician	$319.3K	$331.6K
Neal Adams	MD	Ophthalmology Physician	$497.9K	$5.3K
Susel Oropesa	CT	Ophthalmology Physician	$405.3K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Patient Care Hha, LLC	CT	Home Health Agency	$0	$14.6M
Home Health Professionals Network	CT	Home Health Agency	$0	$9.8M
New England Retina Associates, P.C	CT	Retina Specialist (Ophthalmology) Physician	$0	$4.4M
The Center For Pediatric And Family Growth	CT	Behavior Analyst	$0	$3.4M
Heartcare Associates Of Connecticut, LLC	CT	Cardiovascular Disease Physician	$0	$3M
Children's Medical Group, LLC	CT	Pediatrics Physician	$0	$2.6M
Hamden Sleep Disorders Center LLC	CT	Sleep Medicine (Internal Medicine) Physician	$177K	$2.3M
Drs Chen And Seignemartin LLC	CT	Pediatric Dentistry	$0	$2.1M
Hamden Medical Group, LLC	CT	Family Medicine Physician	$0	$1.5M
Supportive Solutions Behavioral Health And Wellness LLC	CT	Clinical Social Worker	$0	$1.3M

David Tom — Billing Profile & Reimbursement Data

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David Tom — 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