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

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

Peter Karth (NPI 1508181355)

Field	Value
Entity Type	Individual
Organization	Peter Karth
Address	3585 Broadway Ave
City	North Bend
State	OR
ZIP	97459
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	April 5, 2010

Payer Source	Total Paid
Medicare	$4.6M
Medicaid	$0

Key Findings

Practice profile and service lines: PETER KARTH is a retina specialist (ophthalmology) whose Medicare billing mix is heavily dominated by intravitreal drug therapy and retina diagnostic imaging and surgery codes. Top billed services include high-volume intravitreal injections and related administration codes such as J2777, J0178, 67028, and 92134, indicating the practice operates as a retina-focused outpatient infusion/injection and procedural practice rather than primary care or broad multispecialty clinic activity.

Revenue concentration: This provider’s Medicare activity is highly concentrated in a few items — the precomputed top 3 Medicare codes by revenue account for 84.4% of total Medicare revenue, with J2777 ($1.7M, 37.9%) and J0178 ($1.6M, 35.3%) representing the bulk of dollars received. That concentration implies revenue is closely tied to utilization and reimbursement of a small set of intravitreal pharmaceuticals.

Payer mix and single-payer footprint: The provider has reported Total Medicare revenue of $4.6M and no Medicaid billing on file, making the practice effectively single-payer in the public program mix. Analysts should treat this entity as Medicare-dependent for public-program benchmarking and competitive comparisons within Oregon.

Competitive standing on high-volume drug codes: The provider ranks at the 97th percentile nationally for J2777 (rank #67 of 2039) and at the 88th percentile for J0178 (rank #377 of 3204), indicating the clinician is a nationally significant high-volume prescriber/administrator of these intravitreal biologics. The J2777 position in particular places the provider well above typical national volume for that code.

Outlier diagnostic and visit volumes: The provider is an extreme outlier in retinal imaging volume for 92134 (2.9K claims, ranks #465 of 26868, 98th percentile), showing exceptionally high use of computerized retinal imaging and interpretation relative to peers. Office visit E/M codes 99214 and 99213 also appear notably above typical national volume (96th and 97th percentiles respectively), consistent with a high-touch retina practice managing frequent follow-up visits.

Surgical activity and procedural mix: The practice performs a modest number of retinal surgeries and related procedures (e.g., 67028 with 2.1K claims, 67042 and 67036 with lower claim counts), which together with the high injection volumes suggests a combined medical and surgical retina practice that provides both ongoing intravitreal treatment and occasional vitrectomy/retinal repair services.

Use of other intravitreal agents and drug coding patterns: In addition to faricimab (J2777) and aflibercept (J0178), the provider reports meaningful use of J3490 (unclassified drugs, $512.1K, 11.2%) and J2781 (pegcetacoplan), indicating administration of drugs not always captured by standard single HCPCS descriptors or use of newer/less-common intravitreal agents. J3490’s 92nd-percentile rank suggests these unclassified drug charges are higher than most peers and warrant attention when reconciling drug utilization.

Tenure and provider stability: The NPI was enumerated on 2010-04-05 (approximately 16 years ago), indicating a long-established presence in the Medicare program. This tenure supports interpretation of volume patterns as reflecting an established retina practice rather than short-term or newly opened activity.

Implications for payers and network planning: Given the concentration of Medicare revenue in high-cost intravitreal drugs and the provider’s above-typical national volumes for those codes, payers should consider this clinician a key local source of retina drug utilization and imaging. Contracting, utilization management, and network adequacy analyses should account for the provider’s outsized role in administering faricimab (J2777) and aflibercept (J0178) to Medicare beneficiaries.

Medicare: Complete Services Breakdown

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

24 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2777	Injection, faricimab‑svoa, 0.1 mg	59,760	$30	$1.7M
J0178	Injection, aflibercept, 1 mg	2,350	$690	$1.6M
J3490	Unclassified drugs	290	$1,770	$512.1K
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.	2,110	$100	$210.9K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	900	$120	$108K
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.	2,860	$30	$82.9K
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…	790	$90	$73.8K
J7312	Injection, dexamethasone, intravitreal implant, 0.1 mg	360	$160	$55.7K
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…	750	$60	$42.6K
67042	In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina…	40	$830	$31.7K

Showing 1–10 of 24

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 24 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Oregon Distribution

Peter Karth — 6 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. state median

24 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	3	60	840	$680	$623.7K
J2777	4	30	10,050	$30	$527.6K
J2781	5	10	690	$120	$102.6K
67028	4	70	580	$90	$72.3K
Q5128	2	10	290	$220	$63.1K
J7312	3	10	300	$150	$47.7K
J3490	1	50	40	$640	$42.9K
67036	3	10	30	$1,000	$29K
67042	2	10	20	$1,100	$27.5K
67108	9	10	20	$1,030	$25.7K

Showing 1–10 of 24

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services, Inc.	UT	Children's Hospital	$0	$129.5M
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$68.7M
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$65.8M
Ihc Health Services Inc	UT	General Acute Care Hospital	$0	$54.1M
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$44.3M
Ihc Health Services Inc	UT	Home Infusion Therapy Pharmacy	$0	$38.1M
Ihc Health Services Inc	UT	Durable Medical Equipment & Medical Supplies	$0	$26.9M
Ihc Health Services Inc	UT	General Acute Care Hospital	$0	$25.3M
Ihc Health Services, Inc.	UT	Clinical Medical Laboratory	$2.7M	$17.9M
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$20.4M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
R Scott Roberts Dds PC	OR	Oral and Maxillofacial Surgery (Dentist)	$0	$1.7M
Bay Eye Clinic P.C.	OR	Ophthalmology Physician	$0	$1.2M
Pony Creek Annex, LLC	OR	Ambulatory Surgical Clinic/Center	$757.6K	$91.1K
Jane Gilbert	OR	Ophthalmology Physician	$483.6K	$2.1K
Hyun Soo Jang	OR	Ophthalmology Physician	$299K	$0
Hammad Qadir	OR	Nephrology Physician	$277.5K	$8K
Jon Kintner	OR	Ophthalmology Physician	$219.5K	$1.9K
William Bennett	OR	Podiatrist	$172.1K	$40.3K
Brandon Harr	OR	Optometrist	$108K	$0
Yvonne Fenrich	OR	Advanced Practice Midwife	$24.7K	$0

Peter Karth — 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