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

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

Carl Regillo (NPI 1740248038)

Field	Value
Entity Type	Individual
Organization	Carl Regillo
Address	4060 Butler Pike
City	Plymouth Meeting
State	PA
ZIP	19462
Taxonomy	Ophthalmology Physician
NPI Enumerated	May 3, 2006

Payer Source	Total Paid
Medicare	$6.5M
Medicaid	$0

Key Findings

CARL REGILLO is an ophthalmology physician with an NPI enumerated ~20 years ago (2006-05-03), indicating long-standing Medicare participation and an established clinical practice in Plymouth Meeting, PA. The tenure suggests experience managing Medicare workflows and a sustained service footprint in ophthalmic care.

This provider’s Medicare activity is strongly medicine-centered around intravitreal injections and retina imaging: the top three Medicare codes (J0178, J2778, Q5128) together account for 68.2% of total Medicare revenue. That concentration indicates the practice is primarily delivering high-volume retinal pharmacotherapy (multiple anti-VEGF agents and a biosimilar) rather than being a general ophthalmology clinic with broadly distributed E/M revenue.

Revenue concentration is pronounced: J0178 alone represents $2.2M (34.5% of Medicare revenue), while J2778 and Q5128 contribute $1.1M (17.3%) and $1.1M (16.4%) respectively. Relying on a small set of high-revenue injection codes suggests business sensitivity to drug mix, reimbursement changes, or utilization trends in retinal therapies.

Payer mix is effectively single-payer for publicly reimbursed services: lifetime Medicare revenue is $6.5M and there is no Medicaid billing on file. This provider should be considered dependent on Medicare volume for public-pay revenue and may not serve a Medicaid population or bill Medicaid under this NPI.

Competitive standing on Medicare for retina services is strong: the provider ranks in the top percentiles for several injection and retina-imaging codes (J0178 at the 96th percentile, J2778 at the 97th percentile, Q5128 at the 97th percentile, and 92134 at the 100th percentile), indicating markedly higher-than-typical national volumes for intravitreal anti-VEGF administration and retinal OCT imaging. These rankings point to a major national-level volume footprint for these specific services rather than a modest local practice.

Several codes are identified as statistical outliers, underscoring atypical specialization: 67028 and 92012 are labeled “extreme outlier” and the provider ranks in the 99th–100th percentiles nationally for these codes, reinforcing that procedural injections and intermediate eye exams are delivered at volumes far above typical peers. Those outlier labels suggest concentrated operational capacity for procedural retina work paired with high exam throughput.

Other billed services are relatively limited or typical in volume: common E/M and additional procedure codes such as 92014, 67042, and J2781 show notable or typical placement (92014 at the 93rd percentile; J2781 at the 87th percentile), indicating the practice performs some comprehensive exams and other intravitreal therapies but these are secondary to the dominant anti-VEGF/biosimilar injection mix.

Operational implications for payers and network planners include a high reliance on drug administration revenue and imaging: given that injections (J0178, J2778, Q5128) and OCT (92134) are the primary revenue drivers, payer negotiations, site-of-service policies, and prior authorization approaches for intravitreal agents or biosimilars are likely to materially affect this provider’s revenue stream. Monitoring utilization shifts among J0178, J2778, Q5128, and emerging injection codes would be important for forecasting spend.

Medicare: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	3,230	$690	$2.2M
J2778	Injection, ranibizumab, 0.1 mg	5,930	$190	$1.1M
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	4,890	$220	$1.1M
J2777	Injection, faricimab‑svoa, 0.1 mg	24,300	$30	$704.7K
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.	3,660	$100	$380.2K
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…	3,660	$70	$249.2K
J3490	Unclassified drugs	120	$1,750	$206.6K
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.	5,570	$30	$172.5K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	1,370	$120	$163.8K
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…	850	$100	$80.3K

Showing 1–10 of 19

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Pennsylvania Distribution

Carl Regillo — 4 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. state median

19 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	14	140	830	$690	$865.1K
Q5128	7	20	3,830	$220	$838.7K
J2778	11	70	1,030	$190	$417.1K
J2777	15	100	7,950	$30	$360.2K
J2781	5	20	690	$120	$109.1K
67028	7	180	600	$90	$87.5K
J7999	36	110	100	$120	$33.3K
67042	10	50	20	$1,100	$31.9K
J3490	26	110	60	$70	$27.9K
92014	103	1,570	130	$80	$21K

Showing 1–10 of 19

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Nemours Foundation	DE	Multi-Specialty Clinic/Center	$0	$172M
The Nemours Foundation	FL	Children's Hospital	$0	$104.9M
The Nemours Foundation	DE	Children's Hospital	$0	$104M
The Nemours Foundation	FL	Multi-Specialty Clinic/Center	$0	$46.2M
Nemours Children's Health, Downtown Orlando, Specialty Care	FL	Multi-Specialty Clinic/Center	$0	$44.4M
Nemours Children's Health, Jacksonville, Specialty Care	FL	Multi-Specialty Clinic/Center	$0	$23.6M
Sedigheh Ebadi	FL	Pediatrics Physician	$0	$10.1M
Children's Health Alliance, LLC	FL	Pediatrics Physician	$0	$9.6M
Alok Bansal	CA	Ophthalmology Physician	$3M	$4.7M
David Reed	MA	Retina Specialist (Ophthalmology) Physician	$7.7M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gemma Services	PA	Psychiatric Residential Treatment Facility	$0	$23.8M
Access Services Inc	PA	Community/Behavioral Health Agency	$0	$8.3M
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
Allen Ho	PA	Ophthalmology Physician	$6.4M	$0
Yoshihiro Yonekawa	PA	Ophthalmology Physician	$6.4M	$0
James Vander	PA	Ophthalmology Physician	$6.3M	$0

Carl Regillo — 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