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

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

Matthew Benz (NPI 1689771545)

Field	Value
Entity Type	Individual
Organization	Matthew Benz
Address	4460 Bissonnet St Ste 200
City	Bellaire
State	TX
ZIP	77401
Taxonomy	Ophthalmology Physician
NPI Enumerated	September 20, 2006

Payer Source	Total Paid
Medicare	$5.7M
Medicaid	$0

Key Findings

This provider is highly concentrated in intravitreal anti-VEGF and related retinal services: J0178 (aflibercept) alone accounts for $3.4M and 59.7% of the provider's Medicare revenue, and the precomputed top 3 codes account for 73.7% of total Medicare revenue. The code mix — large volumes of J0178, Q5128 (ranibizumab biosimilar), and other injection codes — indicates the practice is operating as a high-volume retina/medical retina service line focused on frequent intraocular drug administration and follow-up care.

Revenue concentration is extreme: total Medicare revenue is $5.7M and a single drug code (J0178) makes up the majority of that income at $3.4M (59.7%). With the top 3 Medicare codes responsible for 73.7% of all Medicare revenue, the practice faces material dependence on a small set of high-cost drug and injection services.

Payer mix is effectively single-payer Medicare: the record shows $5.7M in total Medicare revenue and no Medicaid billing on file. Because there is no Medicaid activity reported, any analysis of state Medicaid competitiveness or utilization patterns is not applicable for this provider.

The provider is a long-tenured enumerant: NPI was registered 2006-09-20 (~20 years ago), indicating roughly two decades of Medicare participation and suggesting an established local referral footprint and operational stability in ophthalmology services. Tenure supports interpretation of the high cumulative Medicare revenue as the product of sustained, focused practice rather than a short-term billing spike.

Several codes position this provider as a national outlier in volume for specific services: J0178 ranks #29 of 3204 providers nationally (99th percentile; extreme outlier), 92014 ranks #307 of 35415 providers nationally (99th percentile; extreme outlier), and 92134 ranks #289 of 26868 providers nationally (99th percentile; extreme outlier). These ranks indicate unusually high throughput for both anti-VEGF injections and retinal imaging/established-patient exams relative to national peers.

Other drug and injection codes reinforce a heavy anti-VEGF and biologics mix: Q5128 ($360.9K, 6.4%) ranks #78 of 373 (79th percentile; typical, unremarkable volume) and J2781 ($358.2K, 6.3%) ranks #14 of 490 (97th percentile; notably above typical national volume). The presence of multiple high-revenue drug codes and unclassified drug codes (J3490, J3590) totaling material revenue suggests the practice uses a mix of branded biologics, biosimilars, and occasionally unclassified billing for certain products.

There are contrasts between claim counts, average payment, and revenue that are operationally relevant: J2777 shows 4K claims but only $116.6K revenue (2.1%) and ranks in the 18th percentile nationally, while other codes with fewer claims (e.g., J0178 with 4.9K claims) generate much higher average payment and dominate revenue. This pattern implies variability in payer reimbursement per drug code and that high claim volume does not necessarily translate to high revenue share for each HCPCS.

Several ancillary procedure and imaging codes are also prominent and align with a high-throughput retinal practice: 67028 ($265.3K, 4.7%) ranks #164 of 4255 (96th percentile; notably above typical national volume) and 92014 ($171.5K, 3.0%) is an extreme outlier by rank. Together with high-volume 92134 imaging, these codes reflect a workflow that combines frequent drug delivery, diagnostic imaging, and established-patient exam follow-up rather than a surgical-heavy ophthalmology practice.

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	4,900	$690	$3.4M
J3490	Unclassified drugs	240	$1,830	$433K
J3590	Unclassified biologics	180	$1,980	$363.6K
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	1,650	$220	$360.9K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	2,990	$120	$358.2K
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.	2,550	$100	$265.3K
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…	1,890	$90	$171.5K
J2777	Injection, faricimab‑svoa, 0.1 mg	4,020	$30	$116.6K
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.	3,300	$30	$98.9K
J2778	Injection, ranibizumab, 0.1 mg	440	$150	$67.8K

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. Texas Distribution

Matthew Benz — 3 of 18 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. state median

18 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	1	210	610	$690	$694.9K
J2777	109	140	7,470	$30	$479.2K
J2778	53	80	630	$180	$345.3K
Q5128	12	50	770	$220	$263.7K
J3590	4	40	70	$1,640	$162.7K
J2781	5	50	720	$120	$131.9K
67028	17	290	510	$90	$73K
J3490	25	350	60	$480	$54.4K
92235	55	160	60	$100	$21.3K
92014	27	2,700	100	$80	$21K

Showing 1–10 of 18

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ryan Olson	FL	Anatomic Pathology & Clinical Pathology Physician	$12.8M	$80
Charles Wykoff	TX	Ophthalmology Physician	$6.2M	$0
David Brown	TX	Ophthalmology Physician	$5.7M	$0
Richard Lane	TX	Retina Specialist (Ophthalmology) Physician	$4.8M	$0
Tien Wong	TX	Ophthalmology Physician	$4.5M	$0
Jay Wang	FL	Medical Oncology Physician	$4.5M	$0
Joseph Sedrak	TX	MOHS-Micrographic Surgery Physician	$4.4M	$0
Ankoor Shah	TX	Ophthalmology Physician	$3.7M	$0
Jeremiah Brown	TX	Retina Specialist (Ophthalmology) Physician	$3.7M	$0
Sarah Holy	TX	Retina Specialist (Ophthalmology) Physician	$3.5M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kingsley Home Care Inc	TX	Home Health Agency	$0	$22.7M
Adaku Iwu	TX	Family Nurse Practitioner	$3.3M	$0
Rishabh Date	TX	Ophthalmology Physician	$2.9M	$0
Emmanuel Chang	TX	Retina Specialist (Ophthalmology) Physician	$2.2M	$0
Arash Kimyai-asadi	TX	MOHS-Micrographic Surgery Physician	$2.2M	$0
Leonard Goldberg	TX	MOHS-Micrographic Surgery Physician	$2.1M	$0
Paul Stewart	TX	Retina Specialist (Ophthalmology) Physician	$2.1M	$0
Effie Rahman	TX	Ophthalmology Physician	$2M	$0
Kenneth Fan	TX	Ophthalmology Physician	$2M	$0
Linsey Ittyipe	TX	Family Nurse Practitioner	$1.2M	$0

Matthew Benz — Billing Profile & Reimbursement Data

Sign up for Matthew Benz — Billing Profile & Reimbursement Data policy alerts

Matthew Benz — Billing Profile & Reimbursement Data

Sign up for Matthew Benz — 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