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    OpenPayerNPI Medicare & MedicaidMichael Osman
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    Michael Osman — Billing Profile & Reimbursement Data

    NPI 1821062803 · Sterling, VA · Retina Specialist (Ophthalmology) Physician

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    Michael Osman is a retina specialist (ophthalmology) physician provider located in Sterling, Virginia. This profile covers 18 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationMichael Osman
    Address21351 Ridgetop Cir
    CitySterling
    StateVA
    ZIP20166
    TaxonomyRetina Specialist (Ophthalmology) Physician
    NPI EnumeratedFebruary 15, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$3.2M
    Medicaid$0

    Key Findings

    This provider bills almost exclusively to Medicare with lifetime Medicare revenue of $3.2M and no Medicaid billing on file, making the practice effectively single‑payer in the available data. The provider’s NPI was enumerated 2006-02-15 (~20 years ago), indicating an established practice duration that aligns with sustained Medicare billing activity.

    Revenue is highly concentrated: the top three Medicare codes (J0178, 92014, J2777) together account for 85.7% of total Medicare revenue. In dollar terms those codes are J0178 $2.1M (67.1%), 92014 $431.6K (13.7%), and J2777 $154.9K (4.9%), so fluctuations in utilization or reimbursement for these specific services would materially move practice revenue.

    Clinical mix and service-line implications point to a medical retina practice with procedure-driven throughput: J0178 (aflibercept) is the dominant revenue driver and J2777 (faricimab) also appears, showing a heavy focus on intravitreal anti-VEGF therapy. High volumes of established comprehensive exams (92014) and retinal imaging (92134) support a model of frequent follow-up visits and imaging-guided injection workflows rather than a primarily surgical retina practice.

    Throughput intensity is high for injection and diagnostic services: J0178 has 3.1K claims, 92014 has 4.4K claims, and 92134 has 4.1K claims, reflecting sustained, high-frequency visit and injection volume. Those claim counts, paired with the dollar shares above, indicate an operational model built around recurring intravitreal treatments with accompanying evaluation and imaging.

    Competitive standing by code shows the provider is a national outlier on several top-line services: 92014 ranks #10 of 35415 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code), 92134 ranks #115 of 26868 providers (100th percentile; extreme outlier), and J0178 ranks #172 of 3204 providers (95th percentile; notably above typical national volume). These rankings suggest the provider is a major volume player for both high-touch clinical visits and retina imaging/injection services compared with national peers.

    Several codes are flagged as extreme outliers beyond the top three, which signals specialized procedural emphasis: 92202 ranks #5 of 2327 providers (100th percentile; extreme outlier) and 67145 ranks #2 of 861 providers (100th percentile; extreme outlier). Such concentrated, high-percentile activity in extended ophthalmoscopy and laser prophylaxis implies niche procedural capabilities that exceed typical peer volumes.

    The wider code mix shows procedural breadth beyond injections: injectable/intravitreal procedure code 67028 ($153.6K, 1.5K claims), fluorescein angiography 92235 ($19.6K, 177 claims), and laser treatment codes 67228 ($18.7K, 71 claims) and 67210 ($6.5K, 15 claims) are all present, indicating the practice delivers both diagnostic imaging and therapeutic laser services in addition to anti‑VEGF injections. This mix supports capability for in‑office diagnostics and some laser interventions alongside high-volume injection care.

    From a payer-risk and contracting perspective, dependence on a small set of drug and follow-up visit codes heightens financial sensitivity: J0178 alone represents $2.1M (67.1% of Medicare revenue), so changes in drug pricing, utilization patterns, or coverage policy for aflibercept would disproportionately impact overall Medicare revenue. The absence of Medicaid revenue also limits diversification of payer risk in this data set and may be relevant during network negotiations or coverage-policy reviews.

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    18 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J0178Injection, aflibercept, 1 mg3,070$690$2.1M
    92014An 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…4,360$100$431.6K
    J2777Injection, faricimab‑svoa, 0.1 mg5,340$30$154.9K
    67028The 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.1,520$100$153.6K
    92134The 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.4,140$30$136.5K
    92202The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece…3,460$10$44.9K
    67145The provider prevents the detachment of the retina in the presence of small tears or thinning of the edges (lattice degeneration) by applying an intense light (such as a laser) to create scar tissue…150$190$27.9K
    92235The 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…180$110$19.6K
    67228In 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…70$260$18.7K
    99204The 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…140$130$18.3K

    Showing 1–10 of 18

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    18 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J017812801,400$690$1.1M
    J2777456013,200$30$517.1K
    6702832901,000$90$107.1K
    920143870170$80$32.8K
    9921410,77912,890140$80$21K
    J90355660170$50$19.9K
    6721091020$370$14.5K
    92134368070$30$9.7K
    92202160230$10$8.1K
    9223545040$110$7.3K

    Showing 1–10 of 18

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    The Retina Group Of Washington, PLLCMDOphthalmology Physician$0$19.5M
    Virginia Oncology AssociatesVAHematology & Oncology Physician$0$6.2M
    Rohit LakhanpalMDRetina Specialist (Ophthalmology) Physician$6.1M$0
    Gordon ByrnesVARetina Specialist (Ophthalmology) Physician$4.9M$0
    Daniel BerinsteinMDRetina Specialist (Ophthalmology) Physician$4.3M$0
    Alexander MelamudVARetina Specialist (Ophthalmology) Physician$4.2M$0
    Michael LaiMDRetina Specialist (Ophthalmology) Physician$4.2M$0
    Jordana FeinVARetina Specialist (Ophthalmology) Physician$4.2M$0
    Eric WeichelMDOphthalmology Physician$4.1M$0
    Gayatri ReillyMDRetina Specialist (Ophthalmology) Physician$4.1M$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    1st Americare LLCVAHome Health Agency$0$13.6M
    Joanna BarnettVAOptometrist$40.1K$2.4M
    Mohammed BaraziVARetina Specialist (Ophthalmology) Physician$1.4M$0
    Ayman BoutrosVAOphthalmology Physician$964.5K$0
    Laeeq ButtVAInternal Medicine Physician$942.5K$0
    Randall PeytonVAOrthopaedic Surgery Physician$670.5K$0
    Darrell ReisnerVAOphthalmology Physician$367.9K$0
    Lisa JohnsonVASpecialist$336.5K$0
    Maude BertovichVAPhysical Therapist$268.9K$0
    Antonio PastorVAInfectious Disease Physician$212.5K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Virginia Distribution
    Michael Osman — 5 of 18 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Virginia