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

Why is the Medicaid comparison limited to Michigan 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. Michigan (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 Apple (NPI 1649565045)

Field	Value
Entity Type	Individual
Organization	Daniel Apple
Address	4717 Saint Antoine St
City	Detroit
State	MI
ZIP	48201
Taxonomy	Ophthalmology Physician
NPI Enumerated	June 14, 2011

Payer Source	Total Paid
Medicare	$1.8M
Medicaid	$0

Key Findings

Daniel Apple is an ophthalmology physician enumerated on 2011-06-14 (~15 years ago), indicating long-standing Medicare enrollment that supports an established ambulatory retinal/injection practice in Detroit, MI. Tenure suggests sustained participation in Medicare eye-care services over many years.

Medicare is effectively this provider’s sole public-payer footprint: total Medicare revenue is $1.8M and there is no Medicaid billing on file, so payer mix is single-payer (Medicare-dominated) in the available public datasets. This absence of Medicaid billing means state-level Medicaid competitive comparisons are not applicable.

Revenue concentration is high: the precomputed top 3 Medicare codes by revenue account for 80.6% of the provider’s total Medicare revenue, indicating that a small set of procedures — primarily intravitreal pharmacologic therapy — drives most Medicare receipts. This concentration implies clinical specialization rather than a broad, general ophthalmology billing mix.

The dominant single code is J0178 (aflibercept) with $990.7K in revenue, representing 53.9% of total Medicare revenue, which underscores a practice focused on anti-VEGF intravitreal injections for retinal disease. J2777 (faricimab) and 67028 (intravitreal injection as an isolated procedure) together with J0178 form the top three revenue drivers supporting an injection-centered service line.

Competitive standing on high-volume ophthalmology services is mixed: for procedure-level evaluation codes and imaging the provider is a high national-volume outlier — 92014 ranks in the 94th percentile (notably above typical national volume) and 92134 ranks in the 97th percentile (extreme outlier), indicating above-typical throughput on eye exams and retinal imaging. These high percentiles suggest strong local demand or referral flow for diagnostic and follow-up services.

For intravitreal drug codes the provider’s national ranks are generally typical to above-typical: J0178 ranks in the 73th percentile (typical, unremarkable volume) while J2777 ranks in the 62th percentile (typical, unremarkable volume), indicating the provider’s injection volumes are within expected ranges nationally rather than being an extreme outlier for those drugs. J2778 (ranibizumab) and other drug and implant codes show lower national percentiles, consistent with clinical preference/market share toward aflibercept and faricimab in this practice.

Evaluation and management billing shows unusually high activity in some categories: 99213 ranks in the 99th percentile (extreme outlier, far above typical national volume) and 99204 ranks in the 98th percentile (notably above typical national volume), which together indicate heavy outpatient visit volumes for both new and established patients relative to national peers. This pattern is consistent with a busy clinic that pairs frequent office visits with high-volume imaging and injection services.

Smaller procedural codes and less-common retina services are present but contribute little to revenue: multiple retina-specific and diagnostic codes (for example J9035 bevacizumab, 92235 fluorescein angiography, and 67145 laser for retinal tears) each account for small percentages of revenue and are concentrated at low national percentiles or typical volumes, reinforcing that the practice’s business model centers on pharmaceutical intravitreal therapy and associated imaging rather than extensive surgical retina work.

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	1,440	$690	$990.7K
J2777	Injection, faricimab‑svoa, 0.1 mg	13,320	$30	$386.3K
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.	1,160	$90	$105.6K
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…	920	$80	$76.1K
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…	1,130	$70	$75.4K
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.	2,340	$30	$67.8K
J2778	Injection, ranibizumab, 0.1 mg	350	$180	$62K
J7312	Injection, dexamethasone, intravitreal implant, 0.1 mg	160	$160	$25K
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…	210	$110	$23.5K
J9035	Injection, bevacizumab, 10 mg	260	$50	$13.9K

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. Michigan Distribution

Daniel Apple — 4 of 18 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. state median

18 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	24	110	680	$690	$630.2K
J2777	18	60	7,200	$30	$321K
J2778	36	50	730	$180	$240.5K
67028	27	160	440	$90	$57.6K
J7312	13	10	230	$150	$36.1K
92014	22	1,080	100	$80	$14.8K
99214	12,435	15,470	80	$80	$11.4K
J9035	8	30	70	$50	$9.5K
92235	71	100	40	$100	$7.8K
92134	13	820	60	$30	$7.1K

Showing 1–10 of 18

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Joshua Robinson	MI	Ophthalmology Physician	$3.7M	$0
John Renfro	SC	Ophthalmology Physician	$3.1M	$0
Gregg Kaiser	SC	Ophthalmology Physician	$2.8M	$0
Collin Ohning	MD	Retina Specialist (Ophthalmology) Physician	$2.7M	$0
Chris Bergstrom	GA	Ophthalmology Physician	$2M	$0
James Hall	SC	Retina Specialist (Ophthalmology) Physician	$1.9M	$0
Pauline Merrill	SC	Ophthalmology Physician	$1.3M	$165.2K
Gregory Christensen	SC	Ophthalmology Physician	$1.3M	$0
William Johnson	SC	Ophthalmology Physician	$390.8K	$0
Peter Goodwin	SC	Ophthalmology Physician	$383.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vhs Childrens Hospital Of Michigan Inc	MI	Children's Hospital	$0	$180.4M
University Pediatricians	MI	Pediatrics Physician	$0	$106.9M
University Physician Group	MI	Internal Medicine Physician	$0	$87.4M
Vhs Harper-hutzel Hospital Inc	MI	General Acute Care Hospital	$0	$76.6M
The Children's Center Of Wayne Co., Inc.	MI	Community/Behavioral Health Agency	$0	$74.3M
Vhs Detroit Receiving Hospital Inc	MI	General Acute Care Hospital	$0	$60.6M
Medical Center Emergency Services	MI	Emergency Medical Services (Emergency Medicine) Physician	$0	$44.1M
Barbara Ann Karmanos Cancer Hospital	MI	General Acute Care Hospital	$0	$42.5M
Detroit Central City Community Mental Health Inc.	MI	Federally Qualified Health Center (FQHC)	$0	$29.2M
Vhs University Laboratories Inc	MI	Clinical Medical Laboratory	$677.7K	$26.3M

Daniel Apple — Billing Profile & Reimbursement Data

Sign up for Daniel Apple — Billing Profile & Reimbursement Data policy alerts

Daniel Apple — Billing Profile & Reimbursement Data

Sign up for Daniel Apple — 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