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NPI 1518226372 · Conway, SC · Ophthalmology Physician
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Nicholas Marchase is a ophthalmology physician provider located in Conway, South Carolina. This profile covers 26 Medicare and 11 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 | Nicholas Marchase |
| Address | 1404 Main St |
| City | Conway |
| State | SC |
| ZIP | 29526 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | May 14, 2012 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $4.1M |
| Medicaid | $306.4K |
Clinical/service-line profile is heavily retina‑oriented: the provider’s Medicare top revenue drivers are J2777, J2778 and J0178 — intravitreal injections of faricimab, ranibizumab and aflibercept — and supporting retina diagnostics and procedures (notably 92134 OCT imaging and laser/retina procedure codes). This mix indicates an operation focused on medical retina care and recurrent in‑office injections rather than a general ophthalmology clinic.
Medicare revenue is highly concentrated in anti‑VEGF biologics: the top 3 Medicare codes account for 85.0% of the provider’s Medicare revenue, with J2777 generating $1.9M (47.5% of Medicare revenue) and J2778 $1.2M (30.0%). That concentration makes the practice’s Medicare performance especially sensitive to utilization or reimbursement changes for these specific injection products.
National competitive standing for key Medicare drugs is strong: J2777 ranks #57 of 2039 providers (97th percentile) and is described as notably above typical national volume, while J2778 ranks #22 of 1208 providers (98th percentile) and is also notably above typical national volume. By contrast, J0178 (aflibercept) is a routine-level volume for this provider (rank #2040 of 3204, 36th percentile), which suggests the provider’s national prominence is concentrated in faricimab and ranibizumab use rather than across all anti‑VEGF agents.
High diagnostic and new‑patient volumes support the injection workload: 92134 appears as an extreme outlier nationally (2.5K claims, $75.3K revenue; ranks #660 of 26868 providers, 98th percentile), and 99204 is also flagged as an extreme outlier for new‑patient visits (223 claims, $27K revenue; ranks #3498 of 227068, 98th percentile). These patterns are consistent with frequent OCT monitoring and substantial new‑patient assessment activity that feed ongoing injection regimens.
Medicaid activity is concentrated in the same biologics but on a much smaller scale: total Medicaid revenue is $306.4K and the top 3 Medicaid codes account for 91.7% of that revenue, led by J2778 ($143K, 46.6%) and J2777 ($116.4K, 37.9%). The Medicaid mix mirrors the Medicare business model (injection‑centric care) but represents a far smaller portion of overall revenue.
State-level competitive position in Medicaid is mixed: the provider ranks #1 of 2 in-state for J2777 (100th percentile), indicating a leading in-state position for faricimab under Medicaid, while J2778 ranks #4 of 5 in-state (25th percentile), a typical but not leading position for ranibizumab. This suggests strong in-state adoption of faricimab within the provider’s Medicaid panel but less dominance for other agents.
Procedural breadth includes retina laser and surgical activity beyond injections: 67028 is significant on Medicare (2.3K claims, $225.5K revenue; 5.6% of Medicare revenue, rank #235 of 4255, 94th percentile) and also appears in Medicaid (872 claims, $21.8K, 7.1% of Medicaid revenue). Additionally, 67145 (78 claims, $12.8K; rank #11 of 861, 99th percentile) is an extreme outlier, signaling meaningful retina laser/surgical interventions that complement the injection and imaging volumes.
Provider tenure is established: the NPI was enumerated 2012-05-14 (~14 years ago), giving the provider a long enough presence to build sustained referral relationships. Combined with the high national percentiles on key injection codes and extreme outlier imaging and procedure volumes, this tenure supports the interpretation of an established, injection‑focused retina practice with a Medicare‑dominant revenue base.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
26 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 66,480 | $30 | $1.9M |
| J2778 | Injection, ranibizumab, 0.1 mg | 6,690 | $180 | $1.2M |
| J0178 | Injection, aflibercept, 1 mg | 440 | $690 | $304K |
| 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. | 2,350 | $100 | $225.5K |
| 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. | 2,510 | $30 | $75.3K |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 320 | $150 | $47.7K |
| 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… | 520 | $90 | $46.9K |
| 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… | 610 | $70 | $39.9K |
| 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… | 220 | $120 | $27K |
| 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… | 210 | $100 | $20.9K |
Showing 1–10 of 26
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 26 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
26 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 33 | 50 | 970 | $690 | $1.1M |
| J2777 | 2 | 40 | 15,960 | $30 | $594.7K |
| J2778 | 1 | 30 | 1,440 | $180 | $337.4K |
| 67028 | 6 | 50 | 1,140 | $90 | $110.3K |
| J7312 | 3 | 10 | 320 | $150 | $51K |
| 67042 | 24 | 30 | 20 | $1,150 | $32.3K |
| J9035 | 42 | 40 | 200 | $50 | $26.1K |
| 66821 | 137 | 170 | 70 | $100 | $25.3K |
| 92014 | 113 | 540 | 160 | $80 | $24.3K |
| 67108 | 15 | 20 | 20 | $1,150 | $24.1K |
Showing 1–10 of 26
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.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 300 | $480 | $143K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 240 | $490 | $116.4K |
| 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. | 870 | $30 | $21.8K |
| 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. | 1,080 | $10 | $11.8K |
| J9035 | Injection, bevacizumab, 10 mg | 110 | $40 | $4.3K |
| J0178 | Injection, aflibercept, 1 mg | 10 | $350 | $4.2K |
| 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… | 50 | $40 | $1.9K |
| 92250 | Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,… | 150 | $10 | $1.5K |
| 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… | 20 | $40 | $770 |
| 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… | 30 | $30 | $750 |
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How this provider's Medicaid billing volume and revenue compare to other South Carolina providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. South Carolina median
11 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 4 | 10 | 900 | $500 | $994.1K |
| J0178 | Injection, aflibercept, 1 mg | 10 | 10 | 110 | $990 | $881.7K |
| 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… | 2,077 | 2,480 | 350 | $80 | $246K |
| 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. | 7 | 20 | 500 | $50 | $97.7K |
| 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… | 272 | 360 | 290 | $70 | $72.3K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 1 | 10 | 130 | $530 | $70.3K |
| 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… | 385 | 490 | 90 | $100 | $63.6K |
| 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… | 53 | 70 | 80 | $60 | $52.7K |
| 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. | 12 | 30 | 310 | $20 | $30.9K |
| J9035 | Injection, bevacizumab, 10 mg | 6 | 20 | 70 | $30 | $12.1K |
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Other providers in the same ZIP code as Nicholas Marchase, ranked by combined Medicare and Medicaid revenue.
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