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

Why is the Medicaid comparison limited to New Jersey 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. New Jersey (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.

Thomas Margolis (NPI 1730153461)

Field	Value
Entity Type	Individual
Organization	Thomas Margolis
Address	1500 Tilton Rd
City	Northfield
State	NJ
ZIP	08225
Taxonomy	Ophthalmology Physician
NPI Enumerated	February 17, 2006

Payer Source	Total Paid
Medicare	$2.5M
Medicaid	$0

Key Findings

This provider’s Medicare footprint is the clear primary payer relationship: Total Medicare revenue is $2.5M while there is no Medicaid billing on file, so the practice is effectively single‑payer with Medicare exposure only. The top three Medicare codes account for a large majority of revenue — the precomputed share for the top three is 80.1% — indicating concentrated dependence on a few high‑revenue services.

Revenue concentration is highly focused on intravitreal drug administration and unclassified drug billing: J2777 accounts for $1M (41.1% of Medicare revenue), J0178 accounts for $794.4K (31.6% of Medicare revenue), and J3490 accounts for $187.9K (7.5% of Medicare revenue). Those three codes alone form the 80.1% top‑3 concentration, underscoring that a small set of drug/procedure codes drives most Medicare reimbursement.

The code mix and descriptions indicate an ophthalmology practice concentrated on retinal therapeutics and injections: high revenue from J2777 (faricimab) and J0178 (aflibercept) together with procedure code 67028 and intravitreal pegcetacoplan J2781 point to routine administration of intravitreal biologics and related retinal care. This clinical mix suggests the operation is built around recurring treatment visits for retinal disease rather than primary care or broad multispecialty outpatient services.

Competitive standing by code is mixed: for J2777 the provider ranks #207 of 2039 (90th percentile) but is labeled as "typical, unremarkable volume," indicating an upper‑decile national placement on that drug without being an outlier; J0178 ranks #1125 of 3204 (65th percentile, "typical, unremarkable volume") and J3490 ranks #725 of 2838 (74th percentile, "typical, unremarkable volume"). Overall, the provider is not a dominant national player across many codes but holds relatively stronger presence on J2777 and a solid, if not exceptional, position on other retinal drug codes.

Operational activity shows substantial procedure and imaging throughput: 67028 is billed 1.2K times ($127.7K revenue) and 92134 has 1.9K claims ($62.1K revenue) with 92134 described as "notably above typical national volume" and ranked in the 96th percentile. High counts for 67028 and 92134 alongside elevated E/M billing (99214 and 99213) point to sustained, recurring clinic visits and diagnostic imaging consistent with active management of retinal patients.

Several E/M and imaging codes are statistical high performers: 99214 (731 claims, $70.9K, 95th percentile), 92134 (1.9K claims, $62.1K, 96th percentile), and 99213 (682 claims, $47.7K, 97th percentile) are all described as "notably above typical national volume," which implies above‑average patient follow‑up and diagnostic workload relative to national peers. By contrast, many of the drug codes are described as "typical, unremarkable volume," indicating the practice mixes some above‑average general ophthalmology activity with typical levels of drug administration overall.

The provider’s NPI has been enumerated since 2006-02-17 (~20 years ago), indicating an established practice tenure; combined with a $2.5M lifetime Medicare revenue base concentrated in retinal therapeutics, this suggests a stable, long‑running ophthalmology practice that has focused over time on intravitreal therapies. That tenure supports the interpretation that current code mix reflects a mature service line rather than a recent shift or temporary surge in activity.

Payer and revenue risk considerations follow from the concentration pattern: reliance on a few high‑revenue drug codes (notably J2777 and J0178) and the absence of Medicaid billing create single‑payer concentration risk and sensitivity to Medicare reimbursement changes for those specific drugs and intravitreal procedures. Analysts evaluating contract negotiations or network strategy should note both the high dependence on Medicare and the limited diversification of payer mix when assessing this provider’s financial resilience.

Medicare: Complete Services Breakdown

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2777	Injection, faricimab‑svoa, 0.1 mg	35,640	$30	$1M
J0178	Injection, aflibercept, 1 mg	1,160	$690	$794.4K
J3490	Unclassified drugs	110	$1,770	$187.9K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	1,190	$120	$142.2K
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.	1,230	$100	$127.7K
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…	730	$100	$70.9K
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.	1,940	$30	$62.1K
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…	680	$70	$47.7K
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	290	$70	$20.4K
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…	80	$140	$10.9K

Showing 1–10 of 17

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New Jersey Distribution

Thomas Margolis — 2 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

Full comparison — all codes billed, vs. state median

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	31	90	880	$690	$693.6K
J2777	2	60	8,820	$30	$319K
67028	34	100	810	$100	$91.1K
J2781	4	20	570	$120	$88.8K
92014	899	1,130	160	$100	$34.9K
J3490	36	120	70	$230	$30.2K
99214	1,025	13,640	130	$90	$23.6K
92012	247	800	140	$70	$18.5K
J9035	20	60	80	$50	$14.2K
99213	751	14,090	100	$70	$13.1K

Showing 1–10 of 17

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Omesh Gupta	PA	Ophthalmology Physician	$7.1M	$80
Mitchell Fineman	PA	Ophthalmology Physician	$7M	$0
Michael Klufas	PA	Ophthalmology Physician	$7M	$0
Richard Kaiser	PA	Ophthalmology Physician	$6.6M	$0
Allen Chiang	PA	Ophthalmology Physician	$6.6M	$0
Carl Regillo	PA	Ophthalmology Physician	$6.5M	$0
Allen Ho	PA	Ophthalmology Physician	$6.4M	$0
Yoshihiro Yonekawa	PA	Ophthalmology Physician	$6.4M	$0
James Vander	PA	Ophthalmology Physician	$6.3M	$0
Marc Spirn	PA	Ophthalmology Physician	$6.3M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Reliance Medical Group LLC	NJ	Specialist	$0	$9.4M
Naim Nazha	NJ	Medical Oncology Physician	$2.8M	$0
Scott Foxman	NJ	Ophthalmology Physician	$2M	$0
Brett Foxman	NJ	Ophthalmology Physician	$1.6M	$0
Jaime Epstein	NJ	Mental Health Counselor	$140.9K	$1.4M
Daniel Connors	NJ	Ophthalmology Physician	$1.5M	$0
James Dalzell	NJ	Radiation Oncology Physician	$1.1M	$0
David Feng	NJ	Specialist	$798.8K	$0
Francis Previti	NJ	Surgery Physician	$434.6K	$0
M Seplow	NJ	Psychiatry Physician	$383.5K	$0

Thomas Margolis — Billing Profile & Reimbursement Data

Sign up for Thomas Margolis — Billing Profile & Reimbursement Data policy alerts

Thomas Margolis — Billing Profile & Reimbursement Data

Sign up for Thomas Margolis — 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