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NPI 1881613297 · Elmhurst, IL · Ophthalmology Physician
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Saad Ahmad is a ophthalmology physician provider located in Elmhurst, Illinois. This profile covers 23 Medicare and 17 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Saad Ahmad |
| Address | 152 N Addison Ave |
| City | Elmhurst |
| State | IL |
| ZIP | 60126 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | July 18, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.3M |
| Medicaid | $2.4M |
SAAD AHMAD’s billing mix is concentrated in retina and intravitreal drug services: Medicare revenue is led by J2777 (faricimab) with $1.4M (42.6% of Medicare revenue) and sizable J2781 (pegcetacoplan) and J3490 drug billing, while Medicaid revenue is dominated by procedure 67028 (intravitreal injection) with $1.5M (61.3% of Medicaid revenue) and large J9035 (bevacizumab) volume. The presence of multiple intravitreal drug codes and high-volume retinal imaging codes (92134, 92235, 92250) points to a high-throughput retina/injection clinic with on‑site diagnostic imaging.
Revenue concentration is pronounced on both payers: the top three Medicare codes account for 62.2% of total Medicare revenue and the top three Medicaid codes account for 81.9% of total Medicaid revenue. This degree of concentration indicates that a handful of drug administration and injection/procedure codes drive most of the provider’s payer revenue, making reimbursement changes for these services likely to have outsized financial impact.
Payer mix and scale: the provider reports $3.3M in lifetime Medicare revenue versus $2.4M in lifetime Medicaid revenue, so Medicare is the larger single source of lifetime payer revenue on file. Both payers, however, show heavy reliance on retinal injection services, so clinical capacity and coding for intravitreal therapies matter across the payer mix.
National competitive standing on Medicare shows above‑typical to extreme activity for several retina codes: J2777 ranks #113 of 2039 providers nationally (95th percentile; notably above typical national volume) and J2781 ranks #25 of 490 (95th percentile; notably above typical national volume). In addition, evaluation & management code 99214 has 2.4K claims and ranks in the 100th percentile nationally (extreme outlier), indicating very high outpatient visit volume relative to peers and a substantial ambulatory practice footprint.
State-level dominance in Medicaid is clear for injection services: 67028 ranks #1 of 120 in-state (100th percentile; extreme outlier) and J9035 ranks #1 of 78 in-state (100th percentile; extreme outlier), showing this provider is the leading in-state biller for intravitreal injection and bevacizumab administration. Several ancillary imaging codes (92235 and 92250) also rank at or near the top in-state, reinforcing a vertically integrated retina service line that pairs injections with diagnostic imaging.
Operational signal from utilization patterns: very high claim counts for intravitreal injection codes (e.g., 48.5K claims for J2777 on Medicare and 7.1K claims for 67028 on Medicaid) together with high volumes of imaging codes (92134, 92235, 92250) imply routine, clinic-based injection sessions supported by in-house diagnostic testing. This mix suggests workflow and capacity characteristics more like a retina specialty clinic than a general ophthalmology-only practice.
Statistical outlier labels support focused expertise rather than incidental billing: multiple codes are flagged as 'extreme outlier' or 'notably above typical' across payers (Medicare: 92235 and 92250 are in the 98th–99th percentiles and labeled extreme outliers; Medicaid: 67028 and J9035 are 100th percentile extreme outliers). These labels signal that the provider’s volume profile is concentrated well above peer norms for retina‑focused procedures and drug administration.
Tenure and market presence: the NPI was enumerated on 2006-07-18 (~20 years ago), indicating long-standing activity in the market. Combined longevity and the provider’s high relative ranks on specific retina codes suggest an established, high-volume regional operator whose financial performance and negotiating leverage will be heavily influenced by intravitreal drug reimbursement and access to retinal imaging services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
23 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 48,540 | $30 | $1.4M |
| J3490 | Unclassified drugs | 220 | $1,770 | $382.8K |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 2,210 | $120 | $264.8K |
| 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… | 2,430 | $100 | $245K |
| 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. | 2,010 | $90 | $184.8K |
| J0178 | Injection, aflibercept, 1 mg | 240 | $700 | $168.9K |
| J7313 | Injection, fluocinolone acetonide, intravitreal implant (iluvien), 0.01 mg | 460 | $340 | $156.9K |
| J7314 | Injection, fluocinolone acetonide, intravitreal implant (yutiq), 0.01 mg | 230 | $410 | $96.4K |
| 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… | 840 | $110 | $93.5K |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 590 | $160 | $92.3K |
Showing 1–10 of 23
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 23 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
23 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 110 | 140 | 700 | $690 | $688.4K |
| J2777 | 3 | 90 | 9,180 | $30 | $451K |
| J7313 | 1 | 10 | 460 | $340 | $156.7K |
| J7314 | 1 | 10 | 230 | $410 | $96.5K |
| J2781 | 1 | 10 | 600 | $120 | $86.8K |
| 67028 | 17 | 190 | 400 | $90 | $64.4K |
| J7312 | 3 | 30 | 240 | $160 | $45.1K |
| 92014 | 694 | 1,420 | 130 | $80 | $24.7K |
| J9035 | 34 | 130 | 140 | $60 | $24.6K |
| 67042 | 10 | 50 | 20 | $870 | $21.8K |
Showing 1–10 of 23
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
17 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 7,060 | $210 | $1.5M |
| J9035 | Injection, bevacizumab, 10 mg | 5,570 | $70 | $373.1K |
| 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… | 2,660 | $40 | $117K |
| 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. | 4,730 | $20 | $89.8K |
| 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… | 200 | $380 | $74.9K |
| J0178 | Injection, aflibercept, 1 mg | 130 | $500 | $64K |
| 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… | 1,230 | $40 | $52.7K |
| 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,… | 1,520 | $30 | $44K |
| 65800 | In this procedure, the provider drains fluid from the anterior chamber of the eye and also removes thin, watery fluid that fills the space between the cornea and the iris, known as the aqueous.… | 170 | $210 | $36.4K |
| 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… | 1,110 | $30 | $31.1K |
Showing 1–10 of 17
How this provider's Medicaid billing volume and revenue compare to other Illinois providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Illinois median
17 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 27 | 50 | 200 | $1,100 | $391.2K |
| 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 | 120 | 540 | $160 | $166.3K |
| 65800 | In this procedure, the provider drains fluid from the anterior chamber of the eye and also removes thin, watery fluid that fills the space between the cornea and the iris, known as the aqueous.… | 2 | 10 | 670 | $150 | $101K |
| 67210 | The provider destroys a lesion of the retina using a laser beam that heats up the tissue. | 6 | 10 | 100 | $310 | $83.8K |
| 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… | 388 | 1,230 | 450 | $40 | $54.1K |
| 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… | 1,168 | 14,680 | 300 | $50 | $48.7K |
| 92004 | The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits. | 658 | 1,110 | 310 | $50 | $45.3K |
| 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… | 3 | 10 | 70 | $340 | $44.6K |
| J9035 | Injection, bevacizumab, 10 mg | 1 | 80 | 290 | $60 | $43.4K |
| 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,… | 44 | 310 | 140 | $30 | $25.5K |
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Other providers in the same ZIP code as Saad Ahmad, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Superior Air-ground Ambulance Service, Inc | IL | Land Ambulance | $16.1M | $90.5M |
| Shield - Denver Health Care Center, Inc. | IL | Parenteral & Enteral Nutrition Supplies (DME) | $0 | $100.7M |
| Rehabtech Supply, LLC | IL | Durable Medical Equipment & Medical Supplies | $0 | $89M |
| Home Medical Express Inc. | IL | Oxygen Equipment & Supplies (DME) | $0 | $22M |
| Trilab, LLC | IL | Clinical Medical Laboratory | $718K | $19.3M |
| Total Spectrum, LLC | IL | Behavior Analyst | $0 | $8.5M |
| Alvaro Candel | IL | Anatomic Pathology & Clinical Pathology Physician | $61.8K | $6.4M |
| Kevin Patel | IL | Ophthalmology Physician | $2.3M | $589K |
| Metro Paramedic Service Inc | IL | Land Ambulance | $625.5K | $1.5M |
| Kevin Kovach | IL | Ophthalmology Physician | $561.8K | $1.1M |
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