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

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

Thomas Ward (NPI 1609892595)

Field	Value
Entity Type	Individual
Organization	Thomas Ward
Address	11373 Cortez Blvd
City	Brooksville
State	FL
ZIP	34613
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	July 14, 2006

Payer Source	Total Paid
Medicare	$4.7M
Medicaid	$0

Key Findings

This provider reports Total Medicare revenue: $4.7M and has no Medicaid billing on file, making its publicly observed payer mix effectively single-payer (Medicare) in scale. The precomputed top-3 concentration is high: the top 3 Medicare codes by revenue account for 87.3% of this provider's total Medicare revenue, indicating extreme revenue dependence on a narrow set of services.

The code mix centers on intravitreal anti-VEGF therapy and office-based retina care: J0178 (5.3K claims, $688 avg paid/claim, $3.6M revenue; 76.9% of Medicare revenue), 67028 (3.5K claims, $96 avg paid/claim, $333.4K revenue; 7.1% of Medicare revenue) and 99213 (2.4K claims, $64 avg paid/claim, $155.2K revenue; 3.3% of Medicare revenue) dominate billings. This pattern is consistent with a high-throughput retina practice that delivers frequent intravitreal injections supported by routine follow-up office visits.

With 87.3% of Medicare revenue concentrated in the top three codes, the practice has a concentrated revenue profile that will be sensitive to changes in reimbursement or utilization for J0178, 67028, and 99213. Payers and network managers should treat these codes as the primary levers of financial and utilization risk for this provider.

On national competitiveness, the provider is an outlier in anti-VEGF and injection procedure volume: J0178 ranks #23 of 3204 providers nationally (99th percentile; extreme outlier) and 67028 ranks #52 of 4255 providers nationally (99th percentile; extreme outlier). Those ranks characterize the provider as a national-level high-volume injector for aflibercept, substantially above typical national volume for these services.

Adjunct diagnostic and compound-drug activity supports the injection-focused practice: 92134 (4.6K claims, $29 avg paid/claim, $134K revenue; 2.8% of Medicare revenue) ranks #71 of 26868 providers nationally (100th percentile; extreme outlier), and J7999 (1.6K claims, $66 avg paid/claim, $104.6K revenue; 2.2% of Medicare revenue) ranks #18 of 1333 providers nationally (99th percentile; notably above typical national volume). These findings indicate heavy in-office retinal imaging capacity plus meaningful use of compounded products, consistent with a procedure-centric retina clinic.

Visit-level E/M volume is also materially elevated: 99213 (2.4K claims, $64 avg paid/claim, $155.2K revenue) ranks #443 of 457151 providers nationally (100th percentile; extreme outlier) and 99214 (973 claims, $90 avg paid/claim, $87.6K revenue; 1.9% of Medicare revenue) ranks #12211 of 479517 providers nationally (97th percentile; notably above typical national volume). This skew toward established-patient visits aligns with frequent follow-up and monitoring visits that accompany high injection throughput.

The provider’s use of alternative anti-VEGF and drug codes is selective: J2778 (505 claims, $181 avg paid/claim, $91.4K revenue; 1.9% of Medicare revenue) is at a typical national volume (39th percentile), and J3490 (38 claims, $1954 avg paid/claim, $74.3K revenue; 1.6% of Medicare revenue) sits at a typical percentile (30th). This suggests a dominant preference for aflibercept (J0178) with occasional use of other agents or unclassified drug billing rather than balanced uptake across multiple branded therapies.

The provider has long tenure in the NPI registry (NPI enumerated: 2006-07-14, ~20 years), implying an established referral base and operational stability; combined with the high-procedure volumes and imaging footprint, this profile is consistent with a dedicated retina specialist practice that has scaled injection workflows over time.

Medicare: Complete Services Breakdown

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	5,280	$690	$3.6M
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.	3,470	$100	$333.4K
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…	2,430	$60	$155.2K
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.	4,620	$30	$134K
J7999	Compounded drug, not otherwise classified	1,590	$70	$104.6K
J2778	Injection, ranibizumab, 0.1 mg	510	$180	$91.4K
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…	970	$90	$87.6K
J3490	Unclassified drugs	40	$1,950	$74.3K
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…	400	$120	$47.5K
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…	200	$110	$21.2K

Showing 1–10 of 18

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Florida Distribution

Thomas Ward — 6 of 18 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. state median

18 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	2	250	800	$690	$817.6K
J2778	69	110	660	$180	$234.1K
67028	10	300	710	$90	$91.1K
J3490	135	180	70	$280	$87.5K
67108	33	60	20	$1,200	$27.5K
99214	1,957	32,760	140	$90	$25K
J7999	3	190	130	$70	$16.4K
99213	84	30,010	80	$60	$12K
92235	23	190	50	$100	$12K
92134	10	1,610	110	$30	$11.9K

Showing 1–10 of 18

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Elia Mavrofrides	FL	Ophthalmology Physician	$6.2M	$240
Paul Raskauskas	FL	Retina Specialist (Ophthalmology) Physician	$5.2M	$0
Keye Wong	FL	Retina Specialist (Ophthalmology) Physician	$4.9M	$0
Thomas Barnard	FL	Ophthalmology Physician	$4.5M	$6.5K
John Niffenegger	FL	Retina Specialist (Ophthalmology) Physician	$4.4M	$0
Samuel Houston	FL	Ophthalmology Physician	$4.2M	$39.3K
Matthew Cunningham	FL	Ophthalmology Physician	$4M	$1.8K
Elizabeth Richter	FL	Retina Specialist (Ophthalmology) Physician	$3.5M	$0
Jaya Kumar	FL	Ophthalmology Physician	$3.4M	$3K
Abdallah Jeroudi	FL	Ophthalmology Physician	$3.3M	$2.9K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Phoenix Counseling Service Inc	FL	Community/Behavioral Health Agency	$0	$11.9M
Hca Health Services Of Florida, Inc.	FL	General Acute Care Hospital	$0	$10.6M
Hernando-pasco Hospice, Inc.	FL	Community Based Hospice Care Agency	$0	$8.8M
Shaminder Bhullar	FL	Ophthalmology Physician	$1.6M	$1.8K
Anas Moureiden	FL	Specialist	$1.2M	$0
Georges Joseph	FL	Interventional Cardiology Physician	$1.2M	$0
Thomas Mathews	FL	Specialist	$1M	$0
Aaron Denson	FL	Hematology & Oncology Physician	$1M	$0
Vatsala Sastry	FL	Infectious Disease Physician	$834.3K	$60.3K
Omar Hamoui	FL	Urology Physician	$728.8K	$0

Thomas Ward — 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