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

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

Jeffrey Heier (NPI 1578546917)

Field	Value
Entity Type	Individual
Organization	Jeffrey Heier
Address	50 Staniford St
City	Boston
State	MA
ZIP	02114
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	November 21, 2005

Payer Source	Total Paid
Medicare	$3.6M
Medicaid	$0

Key Findings

This provider’s public-payer footprint is effectively single‑payer: lifetime Medicare revenue is $3.6M while Medicaid is listed as none (no Medicaid billing on file), indicating no recorded Medicaid activity to date. The top 3 Medicare codes by revenue account for 78.7% of total Medicare revenue, so public revenue is highly concentrated.

Clinical/service-line profile is dominated by intravitreal biologic injections and retina procedures: J0178 (aflibercept) generates $2.1M (58.0% of Medicare revenue), J2777 (faricimab) contributes $518.5K (14.5%), and 67028 (isolated intravitreal injection) adds $221.6K (6.2%). This mix is consistent with a retina specialist whose practice model emphasizes frequent anti‑VEGF injections and related procedural care.

Revenue concentration around anti‑VEGF therapy is substantial — the precomputed top‑3 share of 78.7% highlights operational and reimbursement sensitivity to changes in injectable drug utilization or pricing. Because a majority of Medicare revenue is tied to a small set of injection codes, shifts in payer coverage or drug mix could materially affect revenue.

Competitive standing on key retinal services is strong: J0178 ranks #183 of 3204 providers nationally (94th percentile; notably above typical national volume for this code), and 67028 ranks #332 of 4255 (92th percentile; notably above typical national volume for this code). In addition, imaging and exam volumes are extreme outliers — 92014 and 92134 both rank in the 99th percentile (92014: #413 of 35415, 92134: #140 of 26868), indicating exceptionally high throughput of comprehensive eye exams and retinal imaging relative to peers.

The E/M and clinic visit profile shows substantial established‑patient volume but limited share of revenue: 99213 has 639 claims and $45.4K (1.3% of Medicare revenue) and ranks #17187 of 457151 providers nationally (96th percentile; notably above typical national volume for this code), while 92014 generates $169.9K (4.7%). This suggests the practice bills many office encounters but derives the bulk of dollars from drug and procedure codes rather than E/M alone.

On ancillary services, high retina imaging volumes support in‑house diagnostics: 92134 has 3.9K claims and $133.6K (3.7% of Medicare revenue) and ranks #140 of 26868 providers nationally (99th percentile; extreme outlier). Lower‑revenue modalities such as 76512 (55 claims, $2.2K) are present, indicating a mix of imaging capabilities beyond injections.

Presence of unclassified drug codes points to nonstandard or bundled drug billing alongside labeled biologics: J3590 accounts for $129.3K (3.6% of Medicare revenue) and ranks #388 of 631 providers nationally (38th percentile; typical, unremarkable volume), and J3490 contributes $77.4K (2.2%). These entries suggest occasional use of unclassified billing lines that represent a material portion of ancillary drug revenue.

Provider tenure is long‑standing: NPI enumerated 2005-11-21 (~21 years ago), which aligns with an established referral base and the observed high procedure and imaging volumes. Long enumeration combined with national high‑percentile rankings for core retina codes supports the view of an experienced, high‑throughput retina specialist in the Medicare market.

Medicare: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	3,000	$690	$2.1M
J2777	Injection, faricimab‑svoa, 0.1 mg	17,880	$30	$518.5K
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.	2,130	$100	$221.6K
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…	1,720	$100	$169.9K
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.	3,930	$30	$133.6K
J3590	Unclassified biologics	60	$2,160	$129.3K
J2778	Injection, ranibizumab, 0.1 mg	570	$180	$102.6K
J3490	Unclassified drugs	50	$1,720	$77.4K
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…	640	$70	$45.4K
J9035	Injection, bevacizumab, 10 mg	460	$60	$25.4K

Showing 1–10 of 19

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Massachusetts Distribution

Jeffrey Heier — 4 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. state median

19 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	7	90	790	$690	$826.5K
J2777	14	50	7,080	$30	$343.1K
J2778	14	30	560	$180	$200.7K
Q5124	9	10	800	$160	$186K
J3590	1	10	40	$2,100	$81.7K
67028	7	120	570	$100	$80.7K
J3490	14	20	60	$380	$49.5K
92014	25	1,070	160	$90	$30.1K
J9035	18	80	250	$50	$19.7K
67113	2	10	10	$1,240	$18.6K

Showing 1–10 of 19

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The General Hospital Corporation	MA	General Acute Care Hospital	$0	$438M
Community Physicians Of Indiana Inc	IN	Family Medicine Physician	$0	$185M
Massachusetts General Physicians Organization Inc	MA	Dermatology Physician	$0	$60.2M
Boston Emergency Physician Foundation, Inc.	MA	Emergency Medicine Physician	$0	$24.3M
Colorado Permanente Medical Group, P.C.	CO	Internal Medicine Physician	$0	$23.2M
David Reed	MA	Retina Specialist (Ophthalmology) Physician	$7.7M	$0
Torsten Wiegand	MA	Retina Specialist (Ophthalmology) Physician	$7.6M	$0
Chirag Shah	MA	Retina Specialist (Ophthalmology) Physician	$5M	$0
Roger Goldberg	CA	Retina Specialist (Ophthalmology) Physician	$4.6M	$0
Miriam Englander-paschalis Ilios	MA	Retina Specialist (Ophthalmology) Physician	$4.5M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Massachusetts Eye And Ear Infirmary	MA	General Acute Care Hospital	$0	$68.1M
Bay Cove Human Services, Inc	MA	Community/Behavioral Health Agency	$630.5K	$36.4M
Jewish Family & Children's Service	MA	Case Management Agency	$0	$12.5M
Commonwealth Of Massachusetts	MA	Case Management Agency	$0	$10.4M
Massachusetts Eye And Ear Associates, Inc.	MA	Ophthalmology Physician	$0	$6.6M
Adam Chin	MA	Ophthalmology Physician	$3.4M	$870
Tina Cleary	MA	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
Boston Eye Surgery & Laser Center Trust	MA	Ambulatory Surgical Clinic/Center	$2.1M	$415.8K
Marianeli Rodriguez	MA	Ophthalmology Physician	$2.4M	$0
Scott Brannan	MA	Diagnostic Radiology Physician	$1.8M	$0

Jeffrey Heier — 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