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

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

Richard Kaplan (NPI 1679991616)

Field	Value
Entity Type	Individual
Organization	Richard Kaplan
Address	888 White Plains Rd Ste 202
City	Trumbull
State	CT
ZIP	06611
Taxonomy	Ophthalmology Physician
NPI Enumerated	April 6, 2014

Payer Source	Total Paid
Medicare	$800.1K
Medicaid	$0

Key Findings

This provider’s billing picture is effectively single‑payer: total Medicare revenue is $800.1K and there is no Medicaid billing on file, so Medicare dominates observed revenues and any analyses of payer mix should treat the practice as heavily Medicare‑dependent. The absence of Medicaid transactions limits insight into low‑income patient exposure and state‑program revenue dynamics for this NPI.

Revenue is highly concentrated in a very small set of codes: the top 3 Medicare codes (J0178, J2777, 99214) account for 85.8% of the provider’s total Medicare revenue. In particular J0178 contributes $460.3K (57.5% of Medicare revenue), J2777 contributes $175.7K (22.0%), and 99214 contributes $50.7K (6.3%), showing that the practice’s financial performance is driven by a few high‑value services.

The code mix indicates a retina‑focused ophthalmology practice organized around intravitreal drug therapy and associated diagnostics and visits: J0178 (aflibercept) and J2777 (faricimab) together generate the majority of revenue, 67028 (intravitreal injection) appears as a procedure code supporting those drug administrations, and 92134 (retinal OCT) is present as a high‑use imaging code. This combination (drug J‑codes + injection procedure + OCT + evaluation and management) is consistent with a clinic that delivers recurrent intravitreal injections and ongoing macular disease management.

Competitive standing for the main injectable drugs is modest rather than dominant: J0178 ranks #1662 of 3204 providers nationally (48th percentile; typical, unremarkable volume) and J2777 ranks #1380 of 2039 providers nationally (32th percentile; typical, unremarkable volume), so the provider’s anti‑VEGF and related biologic billing sits near the middle-to-lower range of peers rather than among top regional or national centers. These ranks suggest routine clinical volume for these drugs rather than unusually high market share.

Certain non‑drug services show relatively strong percentile placement versus national peers, signaling above‑average use of diagnostics and E/M: 92134 (OCT) is #2047 of 26868 (92th percentile; typical, unremarkable volume) and 99214 (established patient E/M) is #47085 of 479517 (90th percentile; typical, unremarkable volume). Additionally, 99204 (new patient high‑level E/M) ranks #15629 of 227068 (93th percentile; typical, unremarkable volume), indicating the practice also reports comparatively high use of higher‑level office visits and retinal imaging even while its drug ranks remain middling.

Operationally, the practice’s revenue profile is sensitive to biologic utilization and reimbursement: J0178 alone accounts for $460.3K of the $800.1K Medicare revenue and, together with J2777, these two codes supply nearly 80% of revenue. Because these are drug J‑codes with substantial share of revenue, changes in drug pricing, utilization, or payer coverage policies would have an outsized impact on overall Medicare income for this provider.

The provider has an established registration history, with the NPI enumerated on 2014-04-06 (~12 years ago), indicating a multi‑year service presence in the Trumbull, CT market. That tenure, combined with high percentile placement for OCT and E/M services, suggests an ongoing outpatient practice pattern focused on continuity care for retinal disease.

The lack of any Medicaid billing on file is a notable gap in payer diversification: there is no Medicaid revenue reported and therefore no observable footprint in state program billing. For payers and network planners, this indicates the provider is effectively concentrated on Medicare patients and private‑pay or commercially insured patients (if present), which may affect network adequacy considerations and access for Medicaid populations in the area.

Medicare: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	670	$680	$460.3K
J2777	Injection, faricimab‑svoa, 0.1 mg	6,060	$30	$175.7K
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…	510	$100	$50.7K
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.	460	$100	$46.9K
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.	1,090	$30	$34.7K
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…	130	$130	$16.6K
J9035	Injection, bevacizumab, 10 mg	80	$50	$4.5K
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…	30	$100	$2.7K
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…	20	$120	$2.5K
76512	The provider uses B–scan ultrasound imaging, with or without a non–qualitative A–scan superimposed, to examine the intraocular and orbital structures.	50	$40	$2.1K

Showing 1–10 of 13

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Connecticut Distribution

Richard Kaplan — 1 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Connecticut

Full comparison — all codes billed, vs. state median

13 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	26	40	830	$690	$713.1K
J2777	21	30	8,190	$30	$340.4K
67028	30	50	540	$100	$66.4K
92014	506	580	100	$90	$18.6K
92235	27	30	40	$110	$14.8K
99214	343	6,480	90	$90	$14.2K
J9035	20	30	130	$50	$10.4K
99213	5,831	6,440	70	$60	$8.1K
92134	28	320	60	$30	$7.7K
99204	68	2,660	30	$120	$4.6K

Showing 1–10 of 13

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
New York Eye & Ear Infirmary	NY	Special Hospital	$0	$38.9M
Connecticut Retina Consultants LLC	CT	Ophthalmology Physician	$0	$8.3M
Jonathan Feistmann	NY	Ophthalmology Physician	$2.7M	$3.1M
Brian Campolattaro	NY	Pediatric Ophthalmology and Strabismus Specialist Physician Physician	$122.7K	$4.2M
Brooke Nesmith	KS	Retina Specialist (Ophthalmology) Physician	$3.7M	$0
Llewelyn Rao	OH	Retina Specialist (Ophthalmology) Physician	$3.7M	$0
Juan Romero	NY	Ophthalmology Physician	$3.1M	$441.8K
Vatsal Doshi	NJ	Retina Specialist (Ophthalmology) Physician	$2.2M	$130
Louis Angioletti	NY	Retina Specialist (Ophthalmology) Physician	$2.2M	$31.6K
Eric Fitz	NY	Ophthalmology Physician	$2.2M	$1.3K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Coordinated Transportation Solutions, Inc.	CT	Transportation Broker	$0	$94.1M
Fairfield County Healthcare Associates	CT	Pediatrics Physician	$0	$16.5M
Progressive Diagnostics, LLC	CT	Clinical Medical Laboratory	$222.3K	$6M
Childrens Dentistry Of Trumbull, PC	CT	Pediatric Dentistry	$0	$4M
Nephrology Associates, PC	CT	Nephrology Physician	$0	$2.4M
Trumbull Pediatrics PC	CT	General Practice Physician	$0	$1.7M
Town Of Trumbull	CT	Ambulance	$494.9K	$1.1M
Trumbull Public Schools	CT	Local Education Agency (LEA)	$0	$1.4M
Raphael Capasso	CT	Optometrist	$0	$1.2M
Connecticut In Home Assistance LLC	CT	Chore Provider	$0	$1.1M

Richard Kaplan — 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