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

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

Michael Ward (NPI 1609919406)

Field	Value
Entity Type	Individual
Organization	Michael Ward
Address	915 Old Fern Hill Rd Bldg B Ste 200
City	West Chester
State	PA
ZIP	19380
Taxonomy	Ophthalmology Physician
NPI Enumerated	February 14, 2007

Payer Source	Total Paid
Medicare	$2.7M
Medicaid	$0

Key Findings

MICHAEL WARD is an ophthalmology physician in WEST CHESTER, PA with an NPI enumerated 2007-02-14 (~19 years ago), indicating roughly two decades of billable Medicare activity. The provider’s lifetime Medicare revenue is $2.7M and there is no Medicaid billing on file, so the practice operates effectively as a Medicare-focused entity in this dataset.

Revenue for this provider is highly concentrated in a small set of drug and procedure codes: the precomputed top 3 Medicare codes by revenue account for 83.7% of this provider's total Medicare revenue. Those top three codes are J0178 (1.9K claims, $693 avg paid/claim, $1.3M revenue (49.0%)), J2777 (27.9K claims, $29 avg paid/claim, $809.4K revenue (29.7%)), and 67028 (1.5K claims, $95 avg paid/claim, $138.3K revenue (5.1%)).

The dominant codes indicate a retina/intravitreal injection service line: J0178 (aflibercept) and J2777 (faricimab) together drive the majority of revenue, consistent with ongoing anti-VEGF treatment patterns that require repeated injections. 67028 (intravitreal injection as an isolated procedure) further confirms that intravitreal therapy is a core operational activity rather than occasional ancillary care.

Diagnostic and imaging services are unusually prominent relative to peers: 92134 (2.5K claims, $31 avg paid/claim, $76.7K revenue (2.8%)) ranks #678 of 26868 providers nationally (97th percentile; extreme outlier, far above typical national volume for this code) and 92250 (786 claims, $29 avg paid/claim, $22.8K revenue (0.8%)) ranks #472 of 25087 providers nationally (98th percentile; extreme outlier, far above typical national volume for this code). These extreme outlier rankings suggest the practice performs a high volume of retinal imaging and fundus photography to support its injection-based retina workload.

Competitive standing for the top injectables is middling rather than dominant: J0178 ranks #570 of 3204 providers nationally (82th percentile; typical, unremarkable volume for this code) and J2777 ranks #329 of 2039 providers nationally (84th percentile; typical, unremarkable volume for this code). In other words, while injections account for most revenue locally, the provider’s national rank on those drug codes is around typical peer levels rather than indicating market dominance.

Office evaluation and management volumes are above typical national levels for several codes, supporting a busy outpatient clinic: 92014 (861 claims, $87 avg paid/claim, $74.9K revenue (2.7%)) ranks #2251 of 35415 providers nationally (94th percentile; notably above typical national volume for this code), 99213 (577 claims, $68 avg paid/claim, $39.2K revenue (1.4%)) ranks #20879 of 457151 providers nationally (95th percentile; notably above typical national volume for this code), and 99214 (416 claims, $98 avg paid/claim, $40.8K revenue (1.5%)) ranks #65332 of 479517 providers nationally (86th percentile; typical, unremarkable volume for this code).

The practice also bills for some vitreoretinal surgery codes but these are a small portion of revenue: 67040 (22 claims, $860 avg paid/claim, $18.9K revenue (0.7%)) and 67041/67042 (each 11 claims, ~$10K revenue each, 0.4% each) are present at modest counts and rank at typical peer percentiles. This pattern indicates occasional surgical capability alongside the dominant injection-and-imaging outpatient model.

Given the absence of Medicaid billing (none below), the provider’s payer mix is effectively single‑payer Medicare in this dataset, which concentrates revenue and clinical activity risk on the Medicare population. Analysts should interpret business and access implications accordingly, as any shifts in Medicare reimbursement or utilization of anti‑VEGF agents would disproportionately affect this provider’s revenue base.

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	1,930	$690	$1.3M
J2777	Injection, faricimab‑svoa, 0.1 mg	27,910	$30	$809.4K
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.	1,460	$100	$138.3K
J2778	Injection, ranibizumab, 0.1 mg	680	$180	$123.6K
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.	2,470	$30	$76.7K
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…	860	$90	$74.9K
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…	420	$100	$40.8K
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…	580	$70	$39.2K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	790	$30	$22.8K
67040	The provider removes vitreous humor from the eye to access the posterior segment of the eye and introduce surgical instruments through incisions in the pars plana. This procedure also includes the…	20	$860	$18.9K

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. Pennsylvania Distribution

Michael Ward — 3 of 18 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. state median

18 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	34	140	830	$690	$865.1K
J2778	45	70	1,030	$190	$417.1K
J2777	12	100	7,950	$30	$360.2K
67028	43	180	600	$90	$87.5K
J7999	63	110	100	$120	$33.3K
67042	49	50	20	$1,100	$31.9K
67041	9	10	20	$1,160	$27.8K
92014	97	1,570	130	$80	$21K
67040	1	10	20	$860	$18.9K
99214	2,524	23,230	100	$80	$14.5K

Showing 1–10 of 18

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Leonid Lerner	CA	Ophthalmology Physician	$3.4M	$0
Bruce Saran	PA	Ophthalmology Physician	$2.9M	$0
Michael Colucciello	NJ	Ophthalmology Physician	$2.7M	$0
Jason Ruggiero	VA	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
Anton Kolomeyer	NJ	Ophthalmology Physician	$1.8M	$910
Hilary Brader	PA	Ophthalmology Physician	$784K	$0
Matthew Perez	NJ	Ophthalmology Physician	$658.9K	$0
Vincent Sardi	PA	Retina Specialist (Ophthalmology) Physician	$657K	$0
Sander Cohen	NJ	Ophthalmology Physician	$598.5K	$0
Gregory Oldham	PA	Ophthalmology Physician	$560.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Theraplay, LLC	PA	Occupational Therapist	$0	$38.5M
The Devereux Foundation	PA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$29.7M
County Of Chester	PA	Case Management Agency	$0	$19.5M
Chester County Hospital	PA	General Acute Care Hospital	$410	$10.2M
Muve - West Chester Ambulatory Surgical Center, LLC	PA	Ambulatory Surgical Clinic/Center	$2.4M	$0
Michael Rosen	PA	Internal Medicine Physician	$1.5M	$0
West Chester Endoscopy LLC	PA	Endoscopy Clinic/Center	$1.3M	$0
Good Fellowship Club Of Chester County, Inc.	PA	Land Ambulance	$591.2K	$585K
Raghuram Mallya	PA	Cardiovascular Disease Physician	$1.1M	$0
Turks Head Surgery Center LLC	PA	Ambulatory Surgical Clinic/Center	$955.7K	$0

Michael Ward — Billing Profile & Reimbursement Data

Sign up for Michael Ward — Billing Profile & Reimbursement Data policy alerts

Michael Ward — Billing Profile & Reimbursement Data

Sign up for Michael Ward — Billing Profile & Reimbursement Data policy alerts

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