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

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

Joseph Schwartz (NPI 1770586752)

Field	Value
Entity Type	Individual
Organization	Joseph Schwartz
Address	31455 Winterplace Pkwy
City	Salisbury
State	MD
ZIP	21804
Taxonomy	Ophthalmology Physician
NPI Enumerated	May 24, 2005

Payer Source	Total Paid
Medicare	$4.2M
Medicaid	$0

Key Findings

This provider is effectively a Medicare-only biller: Total Medicare revenue is $4.2M and there is no Medicaid billing on file, so payer-mix analysis and network negotiations should treat Medicare as the dominant and nearly exclusive payer exposure. The absence of Medicaid activity means state Medicaid competitive comparisons are not applicable for this NPI.

Revenue is highly concentrated in a very small set of services: the precomputed top three Medicare codes (J0178, J2777, 99214) account for 77.4% of this provider's total Medicare revenue. Those three appear individually as J0178: $1.9M (45.2%), J2777: $964K (23.2%), and 99214: $370.6K (8.9%), so payers should expect most dollar risk to be tied to intravitreal pharmacologic therapy and higher-complexity E/M visits.

The code mix and descriptive codes indicate a retina-focused ophthalmology practice that combines high-volume intravitreal injections with advanced imaging and surgical capability. High-revenue injection codes such as J0178 (aflibercept) and J2777 (faricimab) dominate revenue, while imaging codes 92134, 92250 and angiography 92235 are also present at notable volume, supporting a clinic workflow centered on retinal disease management and treatment.

Competitive standing is strong for several services at the national level: 99214 ranks #73 of 479517 (100th percentile; extreme outlier), indicating exceptionally high E/M visit volume compared with peers, while J0178 ranks #241 of 3204 (93th percentile; notably above typical national volume). By contrast, J2777 ranks #247 of 2039 (88th percentile; typical, unremarkable volume), so the provider is a national outlier on office/retina imaging/E/M activity and a high-volume but more typical participant for some newer anti-VEGF agents.

The provider performs retinal procedures beyond injections, showing surgical capability for complex retinal disease: 67028 (vitreous injection as isolated procedure) appears with 2.5K claims and $218.2K revenue (5.3% of Medicare revenue) and codes for retinal repair such as 67113 and 67042 are present (67113: 26 claims, $28.1K; 67042: 29 claims, $25.8K), which signals readiness to manage advanced retinal pathology in addition to delivering injections and imaging. These surgical lines are present but represent a smaller share of revenue compared with injection and E/M services.

Measured reimbursements per claim vary widely across the top codes, affecting revenue drivers: J0178 reports $692 avg paid/claim versus J2777 at $29 avg paid/claim and J2778 at $183 avg paid/claim, while 99214 averages $93 paid/claim. This mix shows that a single high-cost drug code (J0178) plus high-volume, low-unit-cost drug use (J2777) together drive a disproportionate share of dollars, and payers should consider both unit price and volume when modeling spend.

The NPI has long tenure in Medicare enrollment (enumerated 2005-05-24, ~21 years ago), which, together with multiple extreme-outlier code ranks (for example 99214 and 92250), suggests an established, high-throughput retinal practice rather than a newly entered or sporadically billing clinician. Longevity plus outlier volumes imply stable referral/attendance patterns that may persist absent major operational changes.

For payers and analysts, the absence of Medicaid activity is operationally important: this provider represents near-exclusive Medicare exposure and should be evaluated primarily through Medicare utilization, prior authorization, and drug-management strategies. Given the high concentration in a few codes (77.4% in the top three) and extreme percentile ranks on key services, targeted audits of coding patterns and contracting terms for intravitreal agents and high-complexity E/M visits are likely to yield the most actionable insights.

Medicare: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,710	$690	$1.9M
J2777	Injection, faricimab‑svoa, 0.1 mg	33,240	$30	$964K
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…	3,990	$90	$370.6K
J2778	Injection, ranibizumab, 0.1 mg	1,280	$180	$233.5K
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.	2,480	$90	$218.2K
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.	3,500	$30	$108.6K
67210	The provider destroys a lesion of the retina using a laser beam that heats up the tissue.	210	$410	$87.3K
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…	630	$90	$56.2K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	1,500	$30	$42.1K
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…	330	$110	$36.4K

Showing 1–10 of 20

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Maryland Distribution

Joseph Schwartz — 7 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. state median

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	17	100	950	$690	$887.3K
J2777	11	70	8,520	$30	$487.3K
J2778	17	50	650	$180	$207.8K
67028	5	120	700	$100	$101.5K
92014	146	620	210	$90	$44K
67113	3	10	20	$1,170	$31.7K
67042	7	30	20	$1,060	$25.4K
99214	4	10,270	150	$90	$24.1K
67210	1	20	30	$430	$21K
92235	14	90	70	$110	$19.5K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Delaware Eye Care Center PA	DE	Ophthalmology Physician	$0	$5.2M
James Rial	MD	Ophthalmology Physician	$4.7M	$510
Paul Lagonigro	MD	Ophthalmology Physician	$3.5M	$0
Amir Guerami	CA	Ophthalmology Physician	$1.9M	$0
David Kouba	OH	Dermatology Physician	$1.9M	$0
Albert Li	NY	Retina Specialist (Ophthalmology) Physician	$1M	$329K
Scott Shay	GU	Vascular & Interventional Radiology Physician	$1.2M	$0
David Zelman	NY	Diagnostic Radiology Physician	$580.2K	$563.4K
Lee Resta	VA	Hematology & Oncology Physician	$1.1M	$0
Amelia Wnorowski	MD	Diagnostic Radiology Physician	$1.1M	$1.9K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wraparound Maryland, Inc	MD	Case Management Agency	$0	$18.4M
Go-getters, Inc.	MD	Community/Behavioral Health Agency	$0	$14.7M
Board Of Education Of Wicomico County	MD	Local Education Agency (LEA)	$0	$14.6M
Healthport	MD	Community/Behavioral Health Agency	$0	$10.9M
Chesapeake Pediatric & Adolescent Associates, PA	MD	Pediatric Adolescent Medicine Physician	$0	$6.6M
Healthport	MD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.5M
Coastal Hospice Inc	MD	Community Based Hospice Care Agency	$0	$5.3M
Children's Medical Group Of Salisbury, PA	MD	Pediatrics Physician	$0	$5M
Konlian,o'neill & Associates, P.A.	MD	Rehabilitation Practitioner	$0	$5M
John Butler	MD	Ophthalmology Physician	$4.3M	$0

Joseph Schwartz — Billing Profile & Reimbursement Data

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Joseph Schwartz — 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