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

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

Henry Semple (NPI 1790779486)

Field	Value
Entity Type	Individual
Organization	Henry Semple
Address	2880 Dauphin St
City	Mobile
State	AL
ZIP	36606
Taxonomy	Ophthalmology Physician
NPI Enumerated	September 8, 2005

Payer Source	Total Paid
Medicare	$2M
Medicaid	$0

Key Findings

This provider’s billed revenue is effectively single-payer: Total Medicare revenue is $2M and there is no Medicaid billing on file, so Medicare dominates the observable public-payor footprint for this NPI. Analysts should treat Medicare performance as the primary driver of overall public-payor economics for this provider.

Revenue is highly concentrated in a small set of drug/injection codes: the precomputed top three Medicare codes account for 87.4% of this provider's total Medicare revenue, with J0178 producing $1.4M revenue (69.2% of this provider's total Medicare revenue), J2777 producing $221K revenue (10.9%), and J2778 producing $148.4K revenue (7.3%). This concentration indicates the practice’s Medicare revenue is dominated by a few high-revenue ophthalmic injectable products.

The code mix and descriptions point to an injection-centered ophthalmology practice: J0178 (2K claims, $692 avg paid/claim), J2777 (7.6K claims, $29 avg paid/claim), and J2778 (820 claims, $181 avg paid/claim) are anti-VEGF/ocular injectables, and the practice also bills 67028 (1.3K claims, $82 avg paid/claim) for isolated intravitreal injections. Elevated imaging support is present as well — 92134 has 2.2K claims ($28 avg paid/claim) and $61.6K revenue — consistent with a workflow that combines diagnostic retinal imaging with high-volume therapeutic injections.

Despite the very large share of revenue from J0178, the provider’s national ranks for these drugs do not indicate top-tier national dominance: J0178 ranks #521 of 3204 providers (84th percentile; labeled typical, unremarkable volume), J2777 ranks #1211 of 2039 (40th percentile; typical), and J2778 ranks #501 of 1208 (59th percentile; typical). In short, the practice is heavily reliant on a small set of high-revenue drugs but sits in a mid-to-high volume peer segment rather than being an elite national outlier for those codes.

Two non-drug codes show distinctive statistical signals that shape operational interpretation: 92134 is at the 97th percentile (described as notably above typical national volume) with 2.2K claims and $61.6K revenue, and 99213 is an extreme outlier at the 98th percentile (902 claims, $56 avg paid/claim, $50.5K revenue). These findings indicate above-typical use of retinal imaging and very high visit volume for established patients relative to peers, supporting a high-throughput, follow-up–intensive injection service line.

The practice’s revenue profile is drug-reimbursement–dependent: J0178 carries a high average paid/claim ($692 avg paid/claim) and accounts for the bulk of Medicare dollars here. That concentration in a single high-cost injectable creates sensitivity of overall Medicare revenue to pricing or usage changes for that drug class rather than to procedural or E/M revenue streams.

The provider has long tenure on federal files: NPI enumerated (registered) 2005-09-08 (~21 years ago). Combined with steady Medicare billing patterns dominated by injections and imaging, this suggests a well-established, office-based ophthalmology practice in Mobile, AL with a sustained Medicare patient base.

No Medicaid billing on file means there is effectively zero observable Medicaid exposure to evaluate competitive standing within state Medicaid networks. This limits conclusions about the provider’s market position among Medicaid patients and suggests analysts should not assume meaningful Medicaid revenue or participation without supplemental state or private-payer data.

Medicare: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,030	$690	$1.4M
J2777	Injection, faricimab‑svoa, 0.1 mg	7,620	$30	$221K
J2778	Injection, ranibizumab, 0.1 mg	820	$180	$148.4K
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.	1,310	$80	$107K
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.	2,200	$30	$61.6K
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…	900	$60	$50.5K
67041	In this procedure, the provider removes scar tissue from the retinal membrane that obscures vision. He removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical…	20	$830	$12.5K
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…	140	$80	$10.6K
J9035	Injection, bevacizumab, 10 mg	190	$50	$9.7K
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…	20	$100	$2.1K

Showing 1–10 of 13

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Alabama Distribution

Henry Semple — 3 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. state median

13 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	7	40	920	$690	$706.2K
J2777	10	20	7,140	$30	$267.9K
67028	16	40	990	$90	$82.5K
J2778	1	10	290	$180	$69.9K
J9035	29	40	410	$50	$24.5K
67041	7	10	20	$950	$18K
99214	3,309	7,330	120	$80	$16.8K
99213	86	6,470	80	$50	$7.9K
92134	16	410	50	$30	$6.4K
99204	2,433	3,750	30	$100	$4.8K

Showing 1–10 of 13

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Premier Health Management, Inc.	AL	Ophthalmology Physician	$0	$3M
Mark Douglas	AL	Ophthalmology Physician	$2.1M	$0
Stuart Ball	AL	Ophthalmology Physician	$1.3M	$0
Mark Gacek	AL	Otolaryngology Physician	$244.7K	$0
Curtis Graf	AL	Ophthalmology Physician	$242.9K	$0
Ryan Burton	AL	Ophthalmology Physician	$240.4K	$0
Joseph Turner	AL	Ophthalmology Physician	$239.7K	$0
Jay Brown	AL	Ophthalmology Physician	$211.9K	$0
Charles Salisbury	AL	Ophthalmology Physician	$199.6K	$0
Charles Mosteller	AL	Ophthalmology Physician	$197.9K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mobile Bay Dental, LLC	AL	General Practice Dentistry	$0	$3.6M
Scott Freeman	AL	MOHS-Micrographic Surgery Physician	$2.9M	$0
Lifeguard Ambulance Service LLC	AL	Land Ambulance	$414.6K	$2.2M
Rehab Medical, LLC	AL	Durable Medical Equipment & Medical Supplies	$0	$1.9M
Mobile Bay Vision, LLC	AL	Optometrist	$0	$1.8M
Surgicare Of Mobile Ltd	AL	Ambulatory Surgical Clinic/Center	$1.5M	$101.9K
Sleep Management, L.L.C.	AL	Oxygen Equipment & Supplies (DME)	$0	$1.5M
Odyssey Healthcare Operating B, LP	AL	Community Based Hospice Care Agency	$0	$1.4M
Lincare Inc.	AL	Oxygen Equipment & Supplies (DME)	$0	$1.4M
Vital Smiles Alabama PC	AL	Health Maintenance Organization	$0	$1.3M

Henry Semple — Billing Profile & Reimbursement Data

Sign up for Henry Semple — Billing Profile & Reimbursement Data policy alerts

Henry Semple — Billing Profile & Reimbursement Data

Sign up for Henry Semple — 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