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

Why is the Medicaid comparison limited to New Jersey 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. New Jersey (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.

Daniel Roth (NPI 1538132352)

Field	Value
Entity Type	Individual
Organization	Daniel Roth
Address	10 Plum St
City	New Brunswick
State	NJ
ZIP	08901
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	February 10, 2006

Payer Source	Total Paid
Medicare	$3M
Medicaid	$0

Key Findings

This provider is effectively single-payer Medicare: lifetime Medicare revenue is $3M while Medicaid billing is listed as none, so the practice’s revenue exposure is concentrated in Medicare beneficiaries rather than Medicaid. That payer mix suggests commercial and Medicare strategy will drive access and reimbursement risk more than state Medicaid dynamics.

Revenue is highly concentrated in intravitreal drug therapy: the top three Medicare codes (J0178, J2778, J2777) account for 55.1% of this provider's total Medicare revenue, indicating the practice’s financial model is driven primarily by retinal injections. Those codes correspond to aflibercept, ranibizumab, and faricimab injections, consistent with a retina-specialist service line focused on chronic intravitreal therapy.

The provider’s code mix and volumes reflect a high-throughput retinal injection practice supported by in-office diagnostics and procedures: notable activity includes 15.5K claims for J2777, 2.4K claims for J2778, 1.1K claims for J0178, 1.8K claims for 67028 (intravitreal injection), and 2.3K claims for 92134 (retinal imaging). Together these data indicate a clinic workflow optimized for frequent injections plus retinal imaging and extended ophthalmoscopy.

Competitive standing for the major drug codes is mixed: J2778 (ranibizumab) ranks #163 of 1208 nationally (87th percentile; typical, unremarkable volume for this code) indicating above‑median activity for ranibizumab, while J0178 (aflibercept) ranks #1172 of 3204 (63th percentile; typical, unremarkable volume for this code) and J2777 (faricimab) ranks #690 of 2039 (66th percentile; typical, unremarkable volume for this code). In short, the provider is a modest-to-strong national participant for some anti-VEGF agents but not a top-tier national outlier across all injectables.

Several services are clear statistical outliers versus national peers, signaling unusually high clinical throughput in specific areas: 92014 (comprehensive established eye exam) is an extreme outlier at the 98th percentile, 92134 (OCT retinal imaging) is notably above typical national volume at the 97th percentile, and 92202 (extended ophthalmoscopy) is also notably above typical at the 97th percentile. Those high percentiles suggest a patient panel requiring frequent, high-complexity retinal evaluation and imaging in addition to injections.

Drug-billing patterns show reliance on some high‑value or miscellaneous drug codes: J3490 (unclassified drugs) generated $385K in revenue with an average paid/claim of $1842 and ranks #317 of 2838 (89th percentile; typical, unremarkable volume for this code), while J3590 (unclassified biologics) produced $165.3K with an average paid/claim of $2147 and ranks #339 of 631 (46th percentile; typical, unremarkable volume for this code). This mix indicates material revenue from non‑standard drug billing lines in addition to standard injectable biologics and biosimilars such as Q5128 (ranibizumab biosimilar) which also appears on the top-25 list.

Operational scale and throughput appear substantial and sustained: the NPI was enumerated 2006-02-10 (~20 years ago), and the claims counts across high-volume codes (for example 15.5K claims for J2777, 2.3K claims for 92134, and 1.6K claims for 92014) point to an established practice with long-term Medicare engagement and repeated encounter patterns typical of chronic retinal disease management.

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
J0178	Injection, aflibercept, 1 mg	1,110	$690	$770.6K
J2778	Injection, ranibizumab, 0.1 mg	2,430	$190	$453.5K
J2777	Injection, faricimab‑svoa, 0.1 mg	15,480	$30	$448.9K
J3490	Unclassified drugs	210	$1,840	$385K
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…	1,550	$110	$167.5K
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.	1,820	$90	$167.1K
J3590	Unclassified biologics	80	$2,150	$165.3K
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	650	$220	$139.8K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	1,010	$120	$120.6K
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.	2,250	$30	$76.6K

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. New Jersey Distribution

Daniel Roth — 4 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

Full comparison — all codes billed, vs. state median

24 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	34	90	880	$690	$693.6K
J2777	11	60	8,820	$30	$319K
J2778	6	40	1,140	$180	$240.8K
J3590	8	20	50	$2,180	$156.6K
Q5128	7	20	650	$210	$139K
67028	13	100	810	$100	$91.1K
J2781	5	20	570	$120	$88.8K
92014	41	1,130	160	$100	$34.9K
J3490	21	120	70	$230	$30.2K
65800	2	10	30	$460	$29.8K

Showing 1–10 of 24

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Associated Retinal Consultants LLC	DE	Ophthalmology Physician	$0	$25.2M
Rohit Lakhanpal	MD	Retina Specialist (Ophthalmology) Physician	$6.1M	$0
Vinod Voleti	NJ	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Sumit Shah	NJ	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Newman Sund	MD	Ophthalmology Physician	$4M	$0
Eric Suan	MD	Ophthalmology Physician	$3.8M	$0
Matthew Speicher	MD	Ophthalmology Physician	$3.7M	$0
Howard Fine	NJ	Retina Specialist (Ophthalmology) Physician	$3.6M	$0
Timothy Polk	MD	Ophthalmology Physician	$3.5M	$0
Jonathan Prenner	NJ	Retina Specialist (Ophthalmology) Physician	$3.4M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Specialized Hospital	NJ	Children's Rehabilitation Hospital	$0	$200M
Robert Wood Johnson University Hospital, Inc	NJ	General Acute Care Hospital	$0	$198.3M
Saint Peter's University Hospital	NJ	General Acute Care Hospital	$0	$185.5M
Diya Care Inc	NJ	Home Health Agency	$0	$139.8M
Golden Path Adult Day Health Care Inc.	NJ	Adult Day Care Clinic/Center	$0	$17.7M
New Brunswick Board Of Education	NJ	Local Education Agency (LEA)	$0	$12.7M
Care We Love, LLC	NJ	Home Health Agency	$0	$11.2M
Damon House Inc.	NJ	Substance Abuse Rehabilitation Facility	$0	$9.8M
Southern Bank Emergency Physicians LLC	NJ	Emergency Medicine Physician	$0	$9.2M
New Brunswick Counseling Center	NJ	Substance Use Disorder Rehabilitation Clinic/Center	$174.7K	$9M

Daniel Roth — 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