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NPI 1689977720 · Sayre, PA · Ophthalmology Physician
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Jedediah Mcclintic is a ophthalmology physician provider located in Sayre, Pennsylvania. This profile covers 21 Medicare and 3 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Jedediah Mcclintic |
| Address | 1 Guthrie Sq |
| City | Sayre |
| State | PA |
| ZIP | 18840 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | December 13, 2010 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.2M |
| Medicaid | $18.9K |
This provider is an ophthalmology physician with a long Medicare/Medicaid billing history, having an NPI enumerated on 2010-12-13 (~16 years ago), indicating sustained participation in public programs and an established clinical presence in SAYRE, PA. The tenure supports an expectation of stable referral relationships and an established patient panel for retina-related services.
Medicare dominates this provider’s public-payer mix: Total Medicare revenue is $3.2M versus Total Medicaid revenue of $18.9K, so Medicare is the overwhelmingly primary payer in scale for this practice. The small Medicaid footprint indicates the provider is effectively single-payer at scale with respect to public program revenue.
Revenue concentration on Medicare is high and focused: the precomputed top 3 Medicare codes by revenue account for 76.3% of the provider’s total Medicare revenue, which signals dependency on a narrow set of treatments or procedures. The top Medicare revenue drivers are J0178 (injection, aflibercept), J2777 (injection, faricimab-svoa) and J3490 (unclassified drugs), suggesting a retina/medical retina service line concentrated on intravitreal pharmacotherapy.
The specific Medicare code mix shows treatment-focused retina care: high revenue from J0178 (51.3% of Medicare revenue) and J2777 (17.9% of Medicare revenue) indicates routine administration of anti-VEGF and newer intravitreal agents as the core business activity, with ancillary imaging and E/M services present but much smaller by revenue. This pattern is consistent with a physician practice that primarily delivers intravitreal injections and retinal drug therapy rather than surgical cataract or broad multispecialty ophthalmology.
Competitive standing on key Medicare drug codes is mixed. For J0178 the provider ranks #362 of 3204 (89th percentile), and for J2777 ranks #537 of 2039 (74th percentile), both characterized as typical or unremarkable volume but above many peers—indicating the provider is a meaningful regional participant in anti-VEGF administration though not a national high-volume outlier. Conversely, the provider is an extreme outlier for office visit code 99214 on Medicare (ranks #5033 of 479517; 99th percentile, described as "extreme outlier, far above typical national volume"), which suggests unusually high E/M billing volume relative to the national ophthalmology population and may reflect heavy follow-up or management intensity for the established patient panel.
Medicaid activity is concentrated and modest: the precomputed top 3 Medicaid codes account for 100.0% of Medicaid revenue, with 67028 (intravitreal injection) generating 68.8% and 92134 (retinal imaging) 21.7% of Medicaid revenue. In-state ranks (67028: #52/99, 92134: #73/183) place the provider near the middle of state peers for these services, indicating typical Medicaid participation in intravitreal injections and retinal imaging but not market leadership in the state.
There are notable procedure-level outliers on Medicare imaging codes: 92134 (retinal OCT) has 2.6K claims and ranks #633 of 26868 providers nationally (98th percentile) and is labeled an "extreme outlier, far above typical national volume." This indicates the provider performs retinal imaging at a far higher rate than most peers, consistent with a retina-focused practice that pairs high-volume injections with high-frequency imaging for monitoring.
Drug mix diversity includes high-cost unclassified and novel agents: J3490 (unclassified drugs) contributes $231.6K (7.2% of Medicare revenue) with an average paid/claim of $2316 and ranks in the typical range among peers, while J0179, J2781 and J7312 also appear in the top Medicare codes, reflecting use of multiple branded intravitreal therapies. This diversity implies active adoption of newer and specialty intravitreal agents alongside standard anti-VEGF therapy, which has implications for drug procurement, inventory, and payer contract negotiation.
Operational implications for payers and contracting: given the practice’s reliance on intravitreal injections and high-volume OCT imaging (concentrated Medicare revenue and small Medicaid revenue), payers should treat this provider as a high-utilizer of retina drug and monitoring services. Contracting or utilization-management strategies focused on intravitreal drug administration patterns, site-of-care policies, and imaging utilization would address the largest drivers of public-payer spend for this NPI.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
21 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2,380 | $690 | $1.6M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 19,800 | $30 | $574.2K |
| J3490 | Unclassified drugs | 100 | $2,320 | $231.6K |
| J0179 | Injection, brolucizumab-dbll, 1 mg | 680 | $250 | $168.1K |
| 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. | 1,840 | $90 | $163.4K |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 1,140 | $120 | $136.8K |
| 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… | 1,350 | $90 | $120.2K |
| 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. | 2,560 | $30 | $76.8K |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 250 | $160 | $40.1K |
| 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… | 150 | $120 | $17.2K |
Showing 1–10 of 21
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
21 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 25 | 140 | 830 | $690 | $865.1K |
| J2777 | 20 | 100 | 7,950 | $30 | $360.2K |
| J0179 | 1 | 10 | 540 | $250 | $133.2K |
| J2781 | 6 | 20 | 690 | $120 | $109.1K |
| 67028 | 33 | 180 | 600 | $90 | $87.5K |
| J7312 | 10 | 10 | 280 | $160 | $50.7K |
| J3490 | 34 | 110 | 60 | $70 | $27.9K |
| 66821 | 278 | 420 | 50 | $230 | $18.3K |
| 99214 | 86 | 23,230 | 100 | $80 | $14.5K |
| 92235 | 37 | 70 | 40 | $100 | $10K |
Showing 1–10 of 21
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 310 | $40 | $13K |
| 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. | 410 | $10 | $4.1K |
| 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… | 90 | $20 | $1.8K |
How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Pennsylvania median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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. | 52 | 100 | 330 | $70 | $85.4K |
| 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… | 5,356 | 8,160 | 210 | $60 | $68.4K |
| 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. | 73 | 180 | 290 | $20 | $24.8K |
Other providers in the same ZIP code as Jedediah Mcclintic, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Robert Packer Hospital | PA | General Acute Care Hospital | $0 | $13.8M |
| Greater Valley Emergency Medical Services Inc. | PA | Land Ambulance | $512.8K | $1.5M |
| Didier Alipui | PA | Surgery Physician | $901.5K | $161.9K |
| Shing Chin | PA | Radiation Oncology Physician | $935.2K | $0 |
| Godfred Eyiah-mensah | PA | General Practice Physician | $355.9K | $138.3K |
| Pramod Deshmukh | PA | Cardiovascular Disease Physician | $391K | $7.9K |
| Ferrol Lee | PA | Endocrinology, Diabetes & Metabolism Physician | $138.3K | $154.6K |
| Mason Stilwell | PA | Adult Reconstructive Orthopaedic Surgery Physician | $242.5K | $580 |
| Steven Rinehouse | PA | Diagnostic Radiology Physician | $180.9K | $26.1K |
| Sudhakar Sattur | PA | Interventional Cardiology Physician | $178.8K | $19.3K |
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