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

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

Ahmed El-sanhouri (NPI 1740429810)

Field	Value
Entity Type	Individual
Organization	Ahmed El-sanhouri
Address	2001 Coolidge Road
City	East Lansing
State	MI
ZIP	48823
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	February 13, 2009

Payer Source	Total Paid
Medicare	$2.5M
Medicaid	$0

Key Findings

This provider is effectively a Medicare-only biller: Total Medicare revenue is $2.5M and there is no Medicaid billing on file. The absence of any Medicaid claims makes the provider functionally single-payer at the state level for the data available.

Medicare revenue is highly concentrated: the precomputed top three Medicare codes (J0178, 67028, 99213) account for 87.6% of this provider's total Medicare revenue. In absolute terms J0178 accounts for $1.8M (73.4%), 67028 for $206.8K (8.3%), and 99213 for $147.1K (5.9%), indicating a small set of services drive nearly all revenue.

The code mix and top revenue drivers point to a procedure-centric retina practice focused on intravitreal pharmacotherapy and frequent office follow-up. J0178 (aflibercept injections) is the dominant revenue source and, together with high volumes of 67028 (intravitreal injection) and imaging/E/M codes, indicates routine in‑office injection clinic operations and chronic disease management of posterior-segment retinal disease.

Competitive standing by code is mixed: J0178 generates the largest share of revenue ($1.8M) but ranks #269 of 3204 nationally (92th percentile; typical, unremarkable volume), while 67028 ranks #254 of 4255 (94th percentile; notably above typical national volume). This pattern suggests the provider’s aflibercept revenue is large in dollar terms but the injection volume is within a broad, typical national range, whereas the separate 67028 injection code shows above-typical procedural activity versus peers.

Several service lines show extreme national concentration: 99213 ranks #472 of 457151 (100th percentile; extreme outlier, far above typical national volume) and 92134 ranks #202 of 26868 (99th percentile; extreme outlier, far above typical national volume). These high ranks for a low-complexity E/M and for retinal imaging suggest an unusually large number of routine visits and OCT imaging studies relative to national peers, consistent with a high-volume follow-up and imaging workflow.

Billing for J3590 (unclassified biologics) is unusually concentrated: 1.5K claims generated $102.8K (4.1% of Medicare revenue) and the code ranks #4 of 631 nationally (100th percentile; extreme outlier). The very high national rank for an unclassified biologics code is notable among the provider’s top-25 codes and may reflect systematic use of a catch-all biologics code in the practice’s drug billing mix.

Surgical and procedural retina activity is present but limited relative to injection and imaging volumes: 67042 (pars plana vitrectomy) appears with 24 claims and $20.8K (0.8% of Medicare revenue) and 67228 (panretinal/ focal laser) appears with 46 claims and $11.7K (0.5%). These lower-volume surgical entries indicate occasional operative interventions in addition to the dominant injection-and-imaging outpatient work.

The provider has an established billing history: NPI was enumerated 2009-02-13 (~17 years ago), which—combined with sustained Medicare revenues and the concentrated, procedure-heavy code mix—suggests a long-running, stable retina specialty practice focused on outpatient injections, imaging, and follow-up care.

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
J0178	Injection, aflibercept, 1 mg	2,640	$690	$1.8M
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.	2,300	$90	$206.8K
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…	2,370	$60	$147.1K
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.	3,600	$30	$104.4K
J3590	Unclassified biologics	1,490	$70	$102.8K
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…	260	$100	$25.5K
67042	In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina…	20	$870	$20.8K
67228	In retinopathy, tiny new vessels grow profusely and fibrous tissue proliferates in between the layers of the retina, which may extend into the optic nerve and vitreous, clear gel that fills the space…	50	$260	$11.7K
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…	130	$90	$11.2K
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	$110	$8.9K

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. Michigan Distribution

Ahmed El-sanhouri — 6 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. state median

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	4	110	680	$690	$630.2K
67028	4	160	440	$90	$57.6K
J3590	1	80	140	$80	$19.6K
67042	5	30	20	$1,030	$18.6K
99214	5,541	15,470	80	$80	$11.4K
92235	6	100	40	$100	$7.8K
92134	3	820	60	$30	$7.1K
67228	2	30	30	$250	$6.7K
99213	4	14,810	60	$60	$6.6K
99215	3,286	4,420	30	$110	$6K

Showing 1–10 of 17

Related Providers

Other providers that share a Tax Identification Number (TIN) with Ahmed El-sanhouri, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
O'neil Biscette	MI	Retina Specialist (Ophthalmology) Physician	$1.7M	$0
Scott Piette	MI	Glaucoma Specialist (Ophthalmology) Physician	$341.9K	$0
John Mackovjak	MI	Ophthalmology Physician	$257.9K	$0
Jenn Liu	MI	Ophthalmology Physician	$147.1K	$0
Craig Lewis	MI	Ophthalmic Plastic and Reconstructive Surgery Physician	$138.5K	$0
Anjulie Gang	MI	Ophthalmology Physician	$131.4K	$0

Nearby Providers

Other providers in the same ZIP code as Ahmed El-sanhouri, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cypress Home Care, Inc.	MI	Home Health Agency	$0	$9.1M
Pine Hollow Partner LLC	MI	Nurse Practitioner	$0	$7.1M
Michigan State University	MI	Behavior Analyst	$0	$5.6M
Edward W. Sparrow Hospital Association	MI	Urgent Care Clinic/Center	$0	$5.4M
Ashim Aggarwal	MI	Ophthalmology Physician	$1.3M	$0
Michigan Surgical Center,llc	MI	Ambulatory Surgical Clinic/Center	$1.1M	$157.2K
Richard Pittsley	MI	Rheumatology Physician	$765.8K	$0
Julia Hobson	MI	Diagnostic Radiology Physician	$367.1K	$0
Rafid Yousif	MI	Urology Physician	$202.4K	$0
Anurag Tikaria	MI	Nephrology Physician	$171K	$0

Ahmed El-sanhouri — 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