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

Why is the Medicaid comparison limited to South 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. South 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.

Robert Prinzi (NPI 1508131954)

Field	Value
Entity Type	Individual
Organization	Robert Prinzi
Address	90 Cedar Light Ln
City	Little River
State	SC
ZIP	29566
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	March 19, 2012

Payer Source	Total Paid
Medicare	$5.7M
Medicaid	$0

Key Findings

This provider's billed population is effectively single‑payer: total Medicare revenue is $5.7M while there is no Medicaid billing on file, signaling that Medicaid beneficiaries do not appear in this provider's claims footprint. The NPI was enumerated on 2012-03-19 (~14 years ago), indicating an established practice tenure that has accumulated a multi‑year Medicare billing history.

Revenue is highly concentrated in a narrow set of intravitreal drug administrations: the precomputed top‑3 share shows the top 3 Medicare codes by revenue account for 87.0% of total Medicare revenue, driven by J0178 at 43.9%, J2777 at 36.1%, and J2778 at 7.1%. This concentration indicates that anti‑VEGF and related biologic injections are the primary revenue drivers for this provider.

The code mix and volumes point to a high‑throughput retina injection practice: J0178 has 3.6K claims ($691 avg paid/claim, $2.5M revenue) and J2777 has 70.6K claims ($29 avg paid/claim, $2M revenue), complemented by 67028 (3.9K claims, $88 avg paid/claim, $340.6K revenue) and 92134 imaging (4.3K claims, $28 avg paid/claim, $120.9K revenue). These patterns reflect an operational focus on intravitreal injections supported by frequent posterior‑segment imaging and same‑day or separate vitreous injection procedures.

Competitive standing on key national benchmarks is strong: J0178 ranks #100 of 3204 providers (97th percentile) and J2777 ranks #50 of 2039 providers (98th percentile), both described as notably above typical national volume. Additionally, 67028 ranks #35 of 4255 providers (99th percentile) and 92134 ranks #97 of 26868 providers (100th percentile), marking this provider as a national outlier on injection procedure volume and retinal imaging.

Office evaluation and management services contribute only a small share of revenue compared with procedures and drug administrations: 99213 accounts for $55.1K (1.0% of Medicare revenue) and 99214 accounts for $18.8K (0.3% of Medicare revenue). This split underscores a procedure‑centric revenue model where in‑office injections and associated imaging dominate billing rather than E/M encounters.

Several codes are flagged as statistical outliers in national comparisons: 67028 and 92134 are labeled extreme outliers (far above typical national volume), while J0178 and J2777 are described as notably above typical national volume; by contrast, J2778 is characterized as typical, unremarkable volume. Those labels support the interpretation that this provider operates at unusually high scale for intravitreal injections and posterior‑segment imaging relative to national peers.

Because drug administrations dominate receipts (top 3 = 87.0% of Medicare revenue) and include high‑value units like J0178 ($691 avg paid/claim) alongside very high unit counts like J2777 (70.6K claims at $29 avg paid/claim), the provider's revenue profile is sensitive to shifts in drug utilization patterns, unit dosing practices, or reimbursement rates for these biologics. Sustained revenue performance therefore appears closely tied to continued volume of these specific intravitreal therapies.

The absence of Medicaid billing combined with top‑percentile national ranks suggests a market position that is nationally competitive for retina procedures but not broadly engaged with the Medicaid population locally; this may influence payer negotiation leverage and patient-mix considerations for networks or contracting discussions.

Medicare: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	3,600	$690	$2.5M
J2777	Injection, faricimab‑svoa, 0.1 mg	70,560	$30	$2M
J2778	Injection, ranibizumab, 0.1 mg	2,200	$180	$400.6K
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.	3,870	$90	$340.6K
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.	4,320	$30	$120.9K
J9035	Injection, bevacizumab, 10 mg	1,180	$50	$62.5K
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…	880	$60	$55.1K
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…	650	$80	$51.7K
J7312	Injection, dexamethasone, intravitreal implant, 0.1 mg	270	$160	$43.4K
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…	220	$90	$18.8K

Showing 1–10 of 22

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Carolina Distribution

Robert Prinzi — 4 of 22 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. state median

22 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	4	50	970	$690	$1.1M
J2777	1	40	15,960	$30	$594.7K
J2778	10	30	1,440	$180	$337.4K
67028	2	50	1,140	$90	$110.3K
J7312	5	10	320	$150	$51K
J9035	7	40	200	$50	$26.1K
92014	91	540	160	$80	$24.3K
99214	3,220	7,860	160	$80	$23.2K
92012	233	240	110	$60	$14.2K
92235	17	30	50	$100	$11K

Showing 1–10 of 22

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nicholas Marchase	SC	Ophthalmology Physician	$4.1M	$306.4K
Charles Doering	SC	Ophthalmology Physician	$1.7M	$0
Jeffrey Bezier	PA	Ophthalmology Physician	$1.6M	$31.2K
Catherine Doegg	SC	Ophthalmology Physician	$1.4M	$0
Jorge Jimenez	LA	Retina Specialist (Ophthalmology) Physician	$751.9K	$1.5K
Carl Sloan	SC	Ophthalmology Physician	$614.4K	$0
Alex Mcgaughy	SC	Ophthalmology Physician	$543.4K	$0
Richard Dechamplain	SC	Ophthalmology Physician	$498.3K	$0
Brede Skillings	SC	Ophthalmology Physician	$422.7K	$0
Jennifer Merritt	SC	Ophthalmology Physician	$410.4K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Little River Medical Center Inc	SC	Federally Qualified Health Center (FQHC)	$0	$8M
Little River Medical Center Inc	SC	Dentist	$0	$4M
Mcleod Physician Associates	SC	Obstetrics & Gynecology Physician	$0	$2.6M
Sr Plus Behavior Consultants, Inc.	SC	Behavior Analyst	$0	$2.5M
Elite Pain Management, LLC	SC	Pain Medicine Physician	$0	$1.6M
Timothy Gajewski	SC	Urology Physician	$554.7K	$0
Christopher Walsh	SC	Orthopaedic Surgery Physician	$470.1K	$0
Thirston Phillips	SC	Physical Medicine & Rehabilitation Physician	$454.1K	$0
Lisa Mount	SC	Internal Medicine Physician	$444K	$0
Melanie Hopkins	SC	Anatomic Pathology & Clinical Pathology Physician	$440.5K	$0

Robert Prinzi — 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