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NPI 1700886439 · Harvey, IL · Retina Specialist (Ophthalmology) Physician
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Sohail Hasan is a retina specialist (ophthalmology) physician provider located in Harvey, Illinois. This profile covers 21 Medicare and 2 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 | Sohail Hasan |
| Address | 71 W 156th St |
| City | Harvey |
| State | IL |
| ZIP | 60426 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | July 22, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.4M |
| Medicaid | $34.2K |
Practice is strongly procedure-driven with a retina focus: Medicare billing is concentrated in intravitreal pharmacotherapies and retina diagnostics, led by J2778 (6.8K claims, $1.2M revenue), J0178 (702 claims, $473.1K revenue) and Q5128 (1.9K claims, $416.2K revenue). High volumes for retinal imaging (92134: 5K claims, $154.5K) and procedure codes for injections/operative retina (67028: 2.5K claims, $229.9K; 67042: 15 claims, $14.3K) indicate the provider operates a high-throughput retina service line managing chronic retinal disease and intravitreal therapy.
Medicare revenue is heavily concentrated in a small number of drugs and injection services: the top 3 Medicare codes by revenue account for 62.3% of the provider's Medicare revenue, and those top codes are J2778 (36.2%), J0178 (13.8%) and Q5128 (12.2%). This concentration points to dependency on anti-VEGF and related intravitreal treatments as the primary revenue drivers.
Medicaid billing is nearly entirely focused on intravitreal injection and retinal imaging: the top 3 Medicaid codes account for 100.0% of Medicaid revenue, with 67028 representing $29.7K (87.2%) and 92134 representing $4.4K (12.8%). The Medicaid mix mirrors Medicare clinically but is much smaller in scale, indicating limited Medicaid patient volume for the same service lines.
The provider's revenue mix is effectively Medicare-dominant: lifetime Medicare revenue is $3.4M versus lifetime Medicaid revenue of $34.2K, so Medicare accounts for the overwhelming majority of billed revenue and this practice should be considered functionally single-payer in scale. Strategic or network decisions that target Medicare beneficiaries will therefore have the largest financial impact.
National competitive standing is strong for multiple retina services: J2778 ranks #21 of 1208 providers nationally and is described as notably above typical national volume, while office-based ophthalmology evaluation 92014 (3.2K claims, $293.5K) and retinal imaging 92134 (5K claims, $154.5K) are labeled as extreme outlier, far above typical national volume, indicating dominant throughput relative to most peers. In addition, 99213 ranks highly (#2307 of 457151) and is an extreme outlier, showing above-typical ambulatory visit volume for established patients.
In-state (Medicaid) competitive position is modest: 67028 ranks #81 of 120 providers in-state (characterized as typical, unremarkable volume) and 92134 ranks #127 of 250 in-state (typical, unremarkable volume). These ranks indicate that while the provider is a high-volume Medicare retina operator nationally, the provider is a mid-level participant in the Illinois Medicaid market for the same services.
Tenure and operational continuity are long-standing: the provider's NPI was enumerated on 2005-07-22 (~21 years ago), indicating two decades of billing history and likely established referral relationships and clinical workflows in the Harvey, IL market. This longevity supports the observed high procedural volumes and sustained Medicare revenue base.
Several individual codes are statistical outliers that imply high clinical throughput and a procedure-centric model: codes flagged as extreme outlier — including 92014, 92134, 99213, 99204 and 92202 — indicate volumes far above typical national levels for both comprehensive exams and retinal diagnostics. Conversely, some injectable codes show divergent patterns (for example J2777 has 11.1K claims but a low avg paid/claim $28 yielding $310.8K revenue), suggesting differences in unitization or payment rates across injectable products that materially affect revenue despite high claim counts.
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 |
|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 6,810 | $180 | $1.2M |
| J0178 | Injection, aflibercept, 1 mg | 700 | $670 | $473.1K |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 1,950 | $210 | $416.2K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 11,100 | $30 | $310.8K |
| 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… | 3,230 | $90 | $293.5K |
| 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. | 2,500 | $90 | $229.9K |
| 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. | 4,980 | $30 | $154.5K |
| 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… | 1,470 | $70 | $107K |
| 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… | 400 | $90 | $37.9K |
| 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… | 260 | $130 | $35K |
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 | 69 | 140 | 700 | $690 | $688.4K |
| J2777 | 36 | 90 | 9,180 | $30 | $451K |
| J2778 | 1 | 20 | 540 | $180 | $214.9K |
| Q5128 | 1 | 10 | 270 | $210 | $141.7K |
| 67028 | 2 | 190 | 400 | $90 | $64.4K |
| J7312 | 18 | 30 | 240 | $160 | $45.1K |
| 92014 | 3 | 1,420 | 130 | $80 | $24.7K |
| J9035 | 125 | 130 | 140 | $60 | $24.6K |
| 67042 | 33 | 50 | 20 | $870 | $21.8K |
| 99214 | 2,681 | 18,540 | 110 | $80 | $17.1K |
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.
2 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. | 230 | $130 | $29.7K |
| 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. | 490 | $10 | $4.4K |
How this provider's Medicaid billing volume and revenue compare to other Illinois providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Illinois median
2 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. | 81 | 120 | 540 | $160 | $166.3K |
| 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. | 127 | 250 | 510 | $20 | $20.1K |
Other providers in the same ZIP code as Sohail Hasan, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Family Christian Health Center | IL | Federally Qualified Health Center (FQHC) | $0 | $34.1M |
| New Choice Intervention, Inc. | IL | Mental Health Clinic/Center (Including Community Mental Health Center) | $0 | $15.2M |
| Mathew Maccumber | IL | Retina Specialist (Ophthalmology) Physician | $2.7M | $1.1M |
| Joseph Civantos | IL | Retina Specialist (Ophthalmology) Physician | $2.7M | $537.4K |
| Vivek Chaturvedi | IL | Retina Specialist (Ophthalmology) Physician | $2.3M | $918.3K |
| Kourous Rezaei | IL | Retina Specialist (Ophthalmology) Physician | $2.7M | $0 |
| Naryan Sabherwal | IL | Retina Specialist (Ophthalmology) Physician | $1.2M | $949.6K |
| Andy Lin | IL | Clinical Cardiac Electrophysiology Physician | $660K | $451.4K |
| Michael Romberg | IL | Surgery Physician | $431.3K | $621.7K |
| Ripple Doshi | IL | Cardiovascular Disease Physician | $509.9K | $455K |
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