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

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

Frederick Prall (NPI 1740375534)

Field	Value
Entity Type	Individual
Organization	Frederick Prall
Address	12794 Hamilton Crossing Blvd
City	Carmel
State	IN
ZIP	46032
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	October 4, 2006

Payer Source	Total Paid
Medicare	$3.3M
Medicaid	$0

Key Findings

This provider is effectively single‑payer: lifetime Medicare revenue is $3.3M and there is no Medicaid billing on file. The absence of any Medicaid claims indicates the practice’s patient mix and revenue stream are dominated by Medicare beneficiaries rather than dual- or Medicaid-heavy panels.

Revenue is highly concentrated in a small number of drugs and procedures: the precomputed top 3 Medicare codes by revenue account for 80.5% of this provider's total Medicare revenue, led by J0178 ($2.2M, 67.8%), followed by J2777 ($219.2K, 6.6%) and 67028 ($199.4K, 6.0%). This concentration signals that a few high-cost intravitreal therapies and the associated injection procedure are the main drivers of cash flow.

The code mix is characteristic of a retina specialty practice focused on intravitreal anti-VEGF and related retina services: J0178 (aflibercept) dominates revenue, supported by J2777 (faricimab) and biosimilar ranibizumab codes Q5128 and Q5124 (combined revenue $312.4K). Procedural and imaging codes such as 67028 (2.4K claims, $199.4K) and 92134 (3.2K claims, $87.5K) show a throughput model centered on repeated injections plus diagnostic imaging.

On competitive standing for major revenue codes the provider ranks well above peers: J0178 ranks #137 of 3204 providers nationally (96th percentile) and 67028 ranks #203 of 4255 providers nationally (95th percentile), both described as notably above typical national volume. These ranks indicate the provider is a high-volume national participant for aflibercept administration and for standalone intravitreal injections.

Certain imaging activity is an outlier relative to peers: 92134 appears as an extreme outlier, ranking #314 of 26868 providers nationally (99th percentile) with 3.2K claims and $87.5K in revenue. That level of OCT diagnostic imaging suggests unusually high follow-up and monitoring intensity alongside the injection-based treatment pattern.

The practice also bills meaningful amounts for biosimilars and ancillary injectable codes, reflecting therapeutic breadth within retinal pharmacotherapy: Q5128 ($186.3K, 5.7%) and Q5124 ($126.1K, 3.8%) are present alongside J2777 ($219.2K, 6.6%), while J3490 shows $59.1K (1.8%) of unclassified drug billing. These entries indicate use of multiple branded and biosimilar agents rather than exclusive reliance on a single product.

Operational tenure is long and supports an established referral footprint: the NPI was enumerated on 2006-10-04 (≈20 years ago), consistent with a mature retina practice that has likely built repeat-treatment workflows for chronic intravitreal therapy. That longevity aligns with the high volumes observed for injection and imaging codes.

From a payer-strategy perspective, this profile signals dependency on Medicare reimbursement for high-cost injectables and on repeat procedural throughput: with $3.3M in Medicare revenue, no Medicaid revenue, and 80.5% of Medicare revenue concentrated in the top three codes, payer contracting or reimbursement changes for these drugs or injection services could materially affect revenue. Analysts should treat this provider as a Medicare‑centric, high-volume retina injector when modeling network capacity or drug-utilization trends.

Medicare: Complete Services Breakdown

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

24 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	3,240	$690	$2.2M
J2777	Injection, faricimab‑svoa, 0.1 mg	7,560	$30	$219.2K
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.	2,430	$80	$199.4K
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	830	$230	$186.3K
Q5124	Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg	760	$170	$126.1K
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.	3,240	$30	$87.5K
J3490	Unclassified drugs	40	$1,560	$59.1K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	270	$120	$32.4K
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…	520	$60	$29.5K
92235	The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken…	230	$100	$21.7K

Showing 1–10 of 24

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 24 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Indiana Distribution

Frederick Prall — 3 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. state median

24 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	5	60	830	$690	$868.8K
J2777	16	40	6,750	$30	$395.6K
Q5128	3	10	570	$240	$175.2K
Q5124	1	10	530	$170	$86.9K
67028	7	80	550	$80	$78.6K
J2781	5	10	320	$120	$41.9K
J3590	20	50	220	$60	$24.5K
92235	8	40	90	$100	$15.8K
99214	2,684	10,540	110	$80	$15.5K
J3490	20	40	50	$180	$12.8K

Showing 1–10 of 24

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rodney Bucher	IN	Retina Specialist (Ophthalmology) Physician	$3.4M	$0
Mark Kaehr	IN	Retina Specialist (Ophthalmology) Physician	$2.7M	$0
Ramana Moorthy	IN	Retina Specialist (Ophthalmology) Physician	$2.7M	$0
Rita Singh-parikshak	IN	Ophthalmology Physician	$1.5M	$0
Paul Cacchillo	IN	Ophthalmology Physician	$429.8K	$0
Gian Paolo Giuliari Gonzalez	OH	Ophthalmology Physician	$346.5K	$0
Hui Bae Lee	IN	Ophthalmic Plastic and Reconstructive Surgery Physician	$193.5K	$0
Richard Burgett	IN	Ophthalmic Plastic and Reconstructive Surgery Physician	$129.3K	$0
Derek Sprunger	IN	Pediatric Ophthalmology and Strabismus Specialist Physician Physician	$20.7K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aspire Indiana Inc.	IN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$26.2M
Landmark Recovery Of Carmel LLC	IN	Substance Abuse Rehabilitation Facility	$0	$26.2M
Little Star Center, Inc.	IN	Early Intervention Provider Agency	$0	$22.7M
Arrow Consultation Services, Inc.	IN	Developmentally Disabled Services Day Training Agency	$0	$10.5M
Indiana University Health North Hospital Inc	IN	General Acute Care Hospital	$0	$6.9M
Option Care Enterprises, Inc.	IN	Home Infusion Therapy Pharmacy	$0	$5.2M
Impact Physician Group, Indiana LLC	IN	Internal Medicine Physician	$0	$4.2M
Westmed, LLC	IN	Durable Medical Equipment & Medical Supplies	$0	$4M
Chinthala, PC	IN	Psychiatry Physician	$0	$3.9M
American Health Network Of Indiana, LLC	IN	Clinical Medical Laboratory	$2.2M	$1.6M

Frederick Prall — 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