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

Why is the Medicaid comparison limited to South Carolina 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. South Carolina (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.

Francisco Folgar (NPI 1801060454)

Field	Value
Entity Type	Individual
Organization	Francisco Folgar
Address	1101 Clarity Rd
City	Mount Pleasant
State	SC
ZIP	29464
Taxonomy	Ophthalmology Physician
NPI Enumerated	April 15, 2008

Payer Source	Total Paid
Medicare	$2.3M
Medicaid	$0

Key Findings

This provider’s Medicare business is highly concentrated in intravitreal pharmacologic treatments: J0178 accounts for 57.7% of the provider’s Medicare revenue and J2777 and 67028 add 14.4% and 7.3% respectively, with the precomputed top-3 share totaling 79.4% of Medicare revenue. The raw claim counts and average paid/claim figures (J0178: 1.9K claims, $690 avg paid/claim; J2777: 11.4K claims, $29 avg paid/claim; 67028: 1.9K claims, $88 avg paid/claim) indicate the practice is dependent on repeated office-based retinal injections and related isolated intravitreal procedures as its primary revenue drivers.

Operationally, the code mix and high volumes for retinal imaging and comprehensive exams point to a retina-focused ambulatory ophthalmology practice with robust diagnostics and follow-up care on site. Codes 92134 (3.3K claims, $28 avg paid/claim) and 92014 (1.5K claims, $73 avg paid/claim) together show the provider pairs high injection volume with in‑office imaging and comprehensive visits, supporting a workflow centered on recurrent treatment and monitoring rather than episodic surgery.

Payer mix is effectively single‑payer Medicare: lifetime Medicare revenue is $2.3M while there is no Medicaid billing on file. The absence of Medicaid activity means any payer-strategy or network negotiations should be planned around Medicare dynamics and commercial arrangements rather than Medicaid participation.

Competitive standing by code is mixed: for the top revenue drug J0178 the provider ranks #573 of 3204 nationally (82th percentile) and is described as a typical, unremarkable volume for that code, while for J2777 the provider ranks #910 of 2039 (55th percentile) also described as typical. In contrast, the provider is an extreme outlier on several diagnostic and exam services—92134 ranks #286 of 26868 (99th percentile) and 92014 ranks #619 of 35415 (98th percentile)—indicating unusually high imaging and comprehensive exam throughput relative to national peers.

Although injection codes dominate revenue, surgical retina codes appear at low volume relative to injections, suggesting the practice performs few major vitreoretinal surgeries. For example, 67041 shows 24 claims and $20.3K revenue and 67036 shows 24 claims and $14.9K revenue, which, together with the high injection and imaging counts, support a profile of an office-based injection and monitoring center with limited surgical throughput.

There is some product mix among intravitreal therapies beyond aflibercept: J7312 (dexamethasone implant) and J9035 (bevacizumab) appear in the top codes with $60.8K and $57.5K in revenue respectively, indicating use of both steroid implants and compounding off-label agents in addition to the higher-revenue branded agents. This variety can reflect clinical flexibility in treatment options and potential differences in reimbursement dynamics across products.

From a risk/opportunity perspective, the practice’s heavy reliance on a small number of high-revenue codes (top-3 = 79.4% of Medicare revenue) concentrates revenue exposure to changes in intravitreal drug utilization or reimbursement. Strategic attention to preserving injection volumes and negotiating drug acquisition/reimbursement terms will have outsized impact on overall revenue stability.

The provider is an established enumerant with an NPI registration date of 2008-04-15 (~18 years ago), which aligns with the sustained, procedure-focused revenue pattern and high imaging/exam volumes; this tenure supports continuity of care and an entrenched patient base for recurring intravitreal treatment schedules.

Medicare: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,920	$690	$1.3M
J2777	Injection, faricimab‑svoa, 0.1 mg	11,400	$30	$330.7K
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.	1,900	$90	$167.2K
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…	1,500	$70	$109.5K
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…	980	$100	$93K
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.	3,300	$30	$92.5K
J7312	Injection, dexamethasone, intravitreal implant, 0.1 mg	390	$160	$60.8K
J9035	Injection, bevacizumab, 10 mg	1,050	$60	$57.5K
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	$840	$20.3K
67036	The provider removes vitreous fluid from the eye to access the posterior segment of the eye and introduce surgical instruments through incisions in the pars plana.	20	$620	$14.9K

Showing 1–10 of 16

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Carolina Distribution

Francisco Folgar — 2 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. state median

16 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	17	50	970	$690	$1.1M
J2777	23	40	15,960	$30	$594.7K
67028	14	50	1,140	$90	$110.3K
J7312	2	10	320	$150	$51K
67036	6	20	20	$1,110	$40.1K
J9035	8	40	200	$50	$26.1K
92014	10	540	160	$80	$24.3K
99214	422	7,860	160	$80	$23.2K
67041	3	10	20	$990	$20.8K
92012	157	240	110	$60	$14.2K

Showing 1–10 of 16

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Private Diagnostic Clinic, PLLC	NC	General Practice Physician	$0	$46.5M
Tamer Mahmoud	MI	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
Deanna Lyttle	SC	Ophthalmology Physician	$2.5M	$0
Michael Allingham	NC	Retina Specialist (Ophthalmology) Physician	$1.7M	$0
Jonathan Cook	NC	Dermatology Physician	$1.6M	$0
John Hyatt	OR	Retina Specialist (Ophthalmology) Physician	$1.6M	$0
Eleonora Lad	NC	Retina Specialist (Ophthalmology) Physician	$1.4M	$0
Lowrey King	SC	Ophthalmology Physician	$1.3M	$0
Effy Ojuok	NJ	Ophthalmology Physician	$1.3M	$0
Dilraj Grewal	IL	Ophthalmology Physician	$1.1M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Coastal Therapy Services, Inc.	SC	Speech-Language Pathologist	$0	$6.8M
The Southeastern Spine Institute Ambulatory Surgery Center, LLC	SC	Ambulatory Surgical Clinic/Center	$4M	$0
Bloom Children's Therapy	SC	Pediatric Occupational Therapist	$0	$3.5M
Christopher Michaelis	SC	Emergency Medicine Physician	$3.3M	$0
Carolina Family Care, Inc	SC	Clinical Medical Laboratory	$1.8M	$1.3M
East Cooper Community Hospital, Inc.	SC	General Acute Care Hospital	$0	$3M
Allergy & Asthma Consultants, LLP	SC	Allergy & Immunology Physician	$0	$2.6M
Amanda Acree	SC	Clinical Social Worker	$0	$2.3M
Charleston Radiologists PA	SC	Diagnostic Radiology Physician	$0	$2M
Path Finders Team Services	SC	Early Intervention Provider Agency	$0	$2M

Francisco Folgar — 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