Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidOsama Sabbagh
    Ask Trek AI about this page

    Osama Sabbagh — Billing Profile & Reimbursement Data

    NPI 1548647928 · Lexington, KY · Retina Specialist (Ophthalmology) Physician

    Customize your policy alerts

    Sign up for Osama Sabbagh — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Osama Sabbagh is a retina specialist (ophthalmology) physician provider located in Lexington, Kentucky. This profile covers 17 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

    Table of contents

    Progress1 / 9

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationOsama Sabbagh
    Address120 N Eagle Creek Dr Ste 500
    CityLexington
    StateKY
    ZIP40509
    TaxonomyRetina Specialist (Ophthalmology) Physician
    NPI EnumeratedMay 5, 2015

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$1.3M
    Medicaid$0

    Key Findings

    OSAMA SABBAGH is an ophthalmology retina specialist with an NPI enumerated on 2015-05-05 (~11 years ago), indicating over a decade of participation in Medicare billing and an established clinical presence in Lexington, KY. Tenure supports experience in retinal care and continuity with Medicare as the primary payer recorded in public claims data.

    The provider’s lifetime Medicare revenue totals $1.3M while there is no Medicaid billing on file, making this a effectively single-payer (Medicare-only) billing profile in publicly available data. Analysts should treat Medicaid as absent for competitive or payer-mix modeling because no state Medicaid activity is recorded.

    Revenue concentration is high: the top three Medicare codes by revenue account for 76.7% of total Medicare revenue, indicating the practice’s income is heavily driven by a small number of services. This level of concentration suggests a focused service line rather than a broad multispecialty outpatient practice.

    The largest single revenue driver is J0178 (aflibercept injection), which generated $663.6K and represents 49.8% of the provider’s Medicare revenue; this positions intravitreal anti-VEGF therapy as the core business line. Combined with J2777 (faricimab) at $241.9K (18.1%) and 92014 (established comprehensive eye exam) at $118K (8.8%), the mix points to a retina-focused practice where high-cost injectable therapies and follow-up ocular exams dominate throughput.

    Competitive standing by code is mixed. For high-revenue injections, J0178 ranks #1319 of 3204 (59th percentile) and J2777 ranks #1142 of 2039 (44th percentile), indicating typical, unremarkable national volume for these anti-VEGF/related intravitreal therapies rather than market dominance. In contrast, ophthalmology evaluation and certain retinal imaging codes show above-typical volume: 92014 ranks #914 of 35415 (97th percentile) and 92134 ranks #1341 of 26868 (95th percentile), suggesting the provider sees a high volume of comprehensive established visits and retinal imaging relative to peers nationally.

    Procedure-level signals reinforce a retina-specialist operating model: substantial claims and revenue for intravitreal injections (J0178, J2777, J2778) alongside procedure codes for vitreous injection (67028), retinal imaging (92134), and extended ophthalmoscopy (92202/92201). This combination indicates routine office-based retina treatments coupled with diagnostic imaging and follow-up management, consistent with a practice focused on medical retinal disease management rather than primary cataract surgery or general ophthalmology.

    Several codes show statistically notable placement versus peers: 92014 and 92134 are described as “notably above typical” national volume, indicating the provider has higher-than-typical throughput for comprehensive established exams and retinal OCT imaging. Other high-revenue codes (e.g., J0178 and J2777) are characterized as typical/ unremarkable volume nationally, signaling that high revenue is driven more by service intensity and drug costs than by unusually large market share.

    Operational implications for payers: given the Medicare-only footprint and concentration in high-cost intravitreal drugs (J0178 primary), utilization management or drug cost strategies would be the most direct levers for cost control. The absence of Medicaid billing reduces the need for state-level contracting or risk transfer strategies for this provider based on the current claims record.

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    17 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J0178Injection, aflibercept, 1 mg970$690$663.6K
    J2777Injection, faricimab‑svoa, 0.1 mg8,340$30$241.9K
    92014An 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…1,280$90$118K
    J2778Injection, ranibizumab, 0.1 mg570$190$107.3K
    67028The 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.710$90$65.1K
    92134The 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.1,680$30$52.2K
    99204The 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…130$120$16.4K
    99214The 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…150$90$13.1K
    67108The provider repairs a detached retina using heat produced by a laser beam or by freezing the tissues. He may attach a scleral buckle to simplify the passage of fluid through and behind the retina or…10$940$13.1K
    92202The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece…960$10$11.5K

    Showing 1–10 of 17

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    17 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J01781940870$690$858.5K
    J2777193011,040$30$399.1K
    J27781020700$180$148.3K
    670282450650$90$72.9K
    6710891020$1,010$23.2K
    992142,8267,230110$70$14.1K
    92014742090$80$14K
    921342141050$30$6.3K
    9223542030$90$5.3K
    992041393,20030$100$4.8K

    Showing 1–10 of 17

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Kentucky Medical Services Foundation, IncKYInternal Medicine Physician$0$110.4M
    Columbus Radiology CorpOHDiagnostic Radiology Physician$0$49.9M
    The Retina Group Of Washington, PLLCMDOphthalmology Physician$0$19.5M
    Kentucky Medical Services FoundationKYNurse Practitioner$0$12.5M
    Virginia Oncology AssociatesVAHematology & Oncology Physician$0$6.2M
    Rohit LakhanpalMDRetina Specialist (Ophthalmology) Physician$6.1M$0
    Gordon ByrnesVARetina Specialist (Ophthalmology) Physician$4.9M$0
    Kyle ThompsonIDRetina Specialist (Ophthalmology) Physician$4.5M$0
    Daniel BerinsteinMDRetina Specialist (Ophthalmology) Physician$4.3M$0
    Alexander MelamudVARetina Specialist (Ophthalmology) Physician$4.2M$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Saint Joseph Health System, IncKYGeneral Acute Care Hospital$0$67.4M
    Scott-wilson, Inc.KYHome Infusion Therapy Pharmacy$0$24.5M
    Labtox, LLCKYClinical Medical Laboratory$43.5K$21.8M
    Phi Health, LLCKYAir Ambulance$2M$13.2M
    Retina And Vitreous Associates Of Kentucky PLLCKYRetina Specialist (Ophthalmology) Physician$0$13.3M
    Key Assets Kentucky, Inc.KYCommunity/Behavioral Health Agency$0$10.8M
    Grace Place Adult Day Center LLCKYAdult Day Care Clinic/Center$0$9.7M
    Uhs Of Ridge LLCKYPsychiatric Hospital$0$9.1M
    United Seating And Mobility LLCKYDurable Medical Equipment & Medical Supplies$0$8.6M
    Ridge Outpatient Counseling, LLCKYPsychiatric Hospital Unit$0$5.2M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Kentucky Distribution
    Osama Sabbagh — 5 of 17 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Kentucky