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

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

Sean Platt (NPI 1518252915)

Field	Value
Entity Type	Individual
Organization	Sean Platt
Address	24075 Commerce Park
City	Beachwood
State	OH
ZIP	44122
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	June 14, 2011

Payer Source	Total Paid
Medicare	$2.2M
Medicaid	$0

Key Findings

Medicare revenue is concentrated in a small set of intravitreal drug codes: the top 3 Medicare codes (J0178, J2777, J3490) account for 77.4% of this provider's total Medicare revenue, and the practice reports $2.2M in total Medicare revenue. J0178 alone represents $1.1M (49.5% of Medicare revenue), indicating the business is heavily dependent on a single high-value drug code for revenue generation.

Clinical profile and service line align with retina-focused, injection-driven care: high-volume injectable and procedure activity is reflected in 1.6K claims for J0178 (J0178 – Injection, aflibercept) and 1.2K claims for 67028 (intravitreal injection as a separate procedure), alongside specialty drugs J2777 and J2781 on the roster. This mix suggests day-to-day operations center on intravitreal pharmacotherapy plus procedure-based administration rather than primarily general ophthalmology office visits.

Revenue mix within injectables shows a combination of high-cost per-claim and high-frequency, lower-priced drugs: J0178 posts $688 avg paid/claim and $1.1M revenue, while J2777 shows 15.2K claims at $29 avg paid/claim yielding $442K revenue. The presence of both types of reimbursement dynamics (high-dollar biologics and high-volume, lower-paid agents) implies procurement, inventory, and scheduling processes tailored to multiple intravitreal therapies.

Diagnostic and follow-up services are relatively prominent, consistent with active retina management: 92012 has 1.2K claims generating $69.5K and ranks in the 98th percentile (labeled an "extreme outlier, far above typical national volume"), and 92134 has 1.8K claims generating $51.2K and ranks in the 96th percentile ("notably above typical national volume"). These patterns are consistent with frequent monitoring visits and retinal imaging accompanying therapeutic injections.

Competitive standing on the primary drug codes is solid but not dominant nationally: J0178 ranks #762 of 3204 providers (76th percentile, described as "typical, unremarkable volume"), J2777 ranks #705 of 2039 (65th percentile), and J3490 ranks #735 of 2838 (74th percentile). Those percentiles indicate a steady, above-average presence for these drug administrations without positioning the provider as a national leader.

Certain specialty procedures and implants are staffed at above-typical levels: J7312 (dexamethasone intravitreal implant) reports 441 claims and $70.1K revenue with a rank of #73 of 492 providers (85th percentile), suggesting meaningful use of sustained-release steroid implants relative to peers. Similarly, procedures such as 67042 (vitrectomy/ILM peeling) and 67108 (retinal detachment repair) appear but at much lower absolute volumes, consistent with a practice that handles both injections and selected surgical retina cases.

Payer concentration risk is high because the provider bills Medicare exclusively among the two payers shown: $2.2M in Medicare revenue with "none below" for Medicaid indicates no Medicaid billing on file. This effectively single-payer footprint for public programs could influence contracting leverage and sensitivity to Medicare reimbursement changes.

NPI tenure indicates an established practice presence: the NPI was enumerated on 2011-06-14 (~15 years ago), consistent with the cumulative Medicare revenue and the sustained, procedure-heavy service mix observed. The longevity combined with concentrated injectable revenue suggests an established retina specialist practice with developed operational workflows for intravitreal care.

Medicare: Complete Services Breakdown

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

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,590	$690	$1.1M
J2777	Injection, faricimab‑svoa, 0.1 mg	15,240	$30	$442K
J3490	Unclassified drugs	110	$1,650	$173.6K
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.	1,220	$90	$103.6K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	840	$120	$100.8K
J7312	Injection, dexamethasone, intravitreal implant, 0.1 mg	440	$160	$70.1K
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…	1,160	$60	$69.5K
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.	1,830	$30	$51.2K
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	$850	$29.7K
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…	350	$80	$26.7K

Showing 1–10 of 23

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 23 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Ohio Distribution

Sean Platt — 2 of 23 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. state median

23 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	27	100	840	$680	$729K
J2777	22	70	9,480	$30	$353.3K
J2781	12	20	1,040	$120	$152.4K
J3490	27	50	100	$560	$73.1K
67028	38	150	470	$90	$64K
J7312	3	20	240	$160	$41.7K
J3590	79	100	200	$100	$30K
67042	13	50	20	$960	$29.7K
67108	20	30	20	$1,020	$26.5K
92014	194	1,390	100	$70	$12.9K

Showing 1–10 of 23

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Retina Associates Of Cleveland, Inc.	OH	Retina Specialist (Ophthalmology) Physician	$0	$11.2M
Scott Pendergast	OH	Retina Specialist (Ophthalmology) Physician	$6M	$0
David Miller	OH	Retina Specialist (Ophthalmology) Physician	$4.8M	$0
Llewelyn Rao	OH	Retina Specialist (Ophthalmology) Physician	$3.7M	$0
Joseph Coney	OH	Retina Specialist (Ophthalmology) Physician	$3.2M	$140
Arnold Nothnagel	OH	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Shawn Lewis	OH	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
Thomas Hull	OH	Retina Specialist (Ophthalmology) Physician	$2.6M	$0
Hang Pham	OH	Ophthalmology Physician	$2.6M	$0
Michael Novak	OH	Retina Specialist (Ophthalmology) Physician	$2.5M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Primary Care Practices Inc	OH	Internal Medicine Physician	$0	$78.7M
Pearl's Hope, LLC	OH	Home Health Agency	$0	$47.8M
Health Care Bridge, Inc	OH	Home Health Agency	$0	$32.3M
Cleveland Clinic Health System - East Region	OH	General Acute Care Hospital	$0	$31.5M
Altimate Care LLC	OH	Home Health Agency	$0	$24M
Signature Health, Inc	OH	Federally Qualified Health Center (FQHC)	$0	$23M
University Hospitals Ahuja Medical Center, Inc	OH	General Acute Care Hospital	$0	$21.1M
Shaker Clinic, LLC	OH	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$15.5M
Psychological & Behavioral Consultants, LLC	OH	Psychiatry Physician	$0	$14.9M
Northeast Home Health Services	OH	Home Health Agency	$0	$11.9M

Sean Platt — 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