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NPI 1508946625 · Bellevue, WA · Ophthalmology Physician
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David Saperstein is a ophthalmology physician provider located in Bellevue, Washington. This profile covers 22 Medicare and 2 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | David Saperstein |
| Address | 1750 112th Ave Ne |
| City | Bellevue |
| State | WA |
| ZIP | 98004 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | October 16, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.3M |
| Medicaid | $100 |
Practice appears strongly retina- and injection-focused: the top three Medicare revenue drivers are J0178, J3490, and J2777, which together account for 70.1% of Medicare revenue. J0178 alone is 2.1K claims and $1.4M revenue (44.0% of Medicare revenue) and J2777 and J3490 contribute $398.2K (12.2%) and $452.6K (13.9%) respectively, indicating the business is built around intravitreal drug administration and related in-office drug billing rather than broad surgical throughput.
High Medicare revenue concentration around a small set of drug/injection codes creates operational dependence on intravitreal therapies: the precomputed top-3 share is 70.1% of Medicare revenue, so changes in reimbursement or utilization of these specific drug codes could materially affect total Medicare receipts. The code mix (branded biologic J0178 plus an unclassified drug J3490 and a newer agent J2777) also suggests sensitivity to product choice and switching between biologics and biosimilars.
This provider is effectively Medicare-centric: lifetime Medicare revenue is $3.3M versus Medicaid revenue of $99, so Medicaid represents a negligible share of billed revenue and the practice functions operationally as single‑payer (Medicare)-dominated. The Medicaid file shows 44 claims for 67028 generating $88 (100.0% of Medicaid revenue), underscoring that Medicaid activity is minimal and low-paid relative to Medicare.
Competitive standing on primary Medicare drug codes is mixed but generally above typical national volume: J0178 ranks #503 of 3204 providers nationally (84th percentile) and J3490 ranks #297 of 2838 (90th percentile), indicating stronger-than-average participation for those drug categories, while J2777 is more middle-of-pack at #743 of 2039 (63rd percentile). In plain terms, the provider is not a national dominant player across all injectables but shows relatively elevated volume for key anti-VEGF/ocular drug billing.
Clinical support services are an outlier relative to national peers: 92134 shows 2.7K claims and $84.2K revenue and ranks #542 of 26868 providers nationally (98th percentile; extreme outlier), which indicates unusually high retinal imaging volume for the specialty and suggests the practice performs substantial diagnostic imaging in‑house. That imaging volume likely complements the high injection throughput and supports ongoing monitoring of retinal disease.
Office evaluation-and-management activity is notable for an ophthalmology practice: 99213 reports 708 claims and $46K revenue and ranks #13925 of 457151 providers nationally (97th percentile; notably above typical national volume). This elevated E/M percentile implies steady established‑patient visit volume that would be consistent with follow-up care after injections and chronic retinal disease management.
Medicaid billing patterns are atypical in scale and payment: the Medicaid top code 67028 accounts for 100.0% of Medicaid revenue but produced only $88 on 44 claims ($2 avg paid/claim) and 92134 appears with 81 claims but $0 revenue reported. Together these items indicate Medicaid encounters are recorded but financially immaterial to the practice, and state-level rank for 67028 (#48 of 57, 16th percentile) positions the provider as a relatively modest Medicaid participant.
Provider tenure and specialty profile support continuity in this service mix: NPI was enumerated 2006-10-16 (~20 years ago) and taxonomy is Ophthalmology Physician, consistent with an established, retina-focused ophthalmology practice that has built a Medicare-centered injection and imaging business over a multi‑year period.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
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 | 2,080 | $690 | $1.4M |
| J3490 | Unclassified drugs | 220 | $2,050 | $452.6K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 14,220 | $30 | $398.2K |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 1,150 | $210 | $244.1K |
| 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. | 1,720 | $100 | $171.8K |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 1,110 | $120 | $133.2K |
| 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. | 2,720 | $30 | $84.2K |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 430 | $150 | $65.8K |
| 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… | 610 | $100 | $58K |
| 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… | 710 | $70 | $46K |
Showing 1–10 of 22
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
Full comparison — all codes billed, vs. state median
22 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J2777 | 23 | 50 | 12,780 | $30 | $599.7K |
| J0178 | 14 | 90 | 470 | $680 | $597.2K |
| Q5128 | 2 | 10 | 520 | $220 | $136.6K |
| J2781 | 3 | 10 | 650 | $120 | $88.6K |
| 67028 | 16 | 110 | 550 | $90 | $72.9K |
| J3490 | 7 | 70 | 70 | $50 | $51.2K |
| Q5124 | 2 | 10 | 220 | $170 | $48.7K |
| J7312 | 4 | 20 | 270 | $160 | $46K |
| 67042 | 10 | 40 | 30 | $1,190 | $39.2K |
| J3590 | 2 | 10 | 20 | $980 | $24.4K |
Showing 1–10 of 22
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 40 | $1 | $90 |
| 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. | 80 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Washington providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Washington median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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. | 48 | 60 | 710 | $40 | $81.7K |
| 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. | 63 | 100 | 240 | $10 | $22.2K |
Other providers in the same ZIP code as David Saperstein, ranked by combined Medicare and Medicaid revenue.
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