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    OpenPayerNPI Medicare & MedicaidJames Benjamin
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    James Benjamin — Billing Profile & Reimbursement Data

    NPI 1932562352 · West Chester, PA · Ophthalmology Physician

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    James Benjamin is a ophthalmology physician provider located in West Chester, Pennsylvania. 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
    OrganizationJames Benjamin
    Address845 W Chester Pike
    CityWest Chester
    StatePA
    ZIP19382
    TaxonomyOphthalmology Physician
    NPI EnumeratedApril 2, 2016

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

    Payer SourceTotal Paid
    Medicare$2.3M
    Medicaid$0

    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 mg2,190$690$1.5M
    J2777Injection, faricimab‑svoa, 0.1 mg8,480$30$245.9K
    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…2,270$100$226.6K
    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.1,460$100$138.4K
    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.3,060$30$101K
    J2778Injection, ranibizumab, 0.1 mg120$180$22.1K
    92012For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…130$70$8.9K
    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…40$200$8.6K
    J9035Injection, bevacizumab, 10 mg120$50$6.7K
    99214The 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…70$100$6.6K

    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
    J017828140830$690$865.1K
    J277869701,030$190$417.1K
    J2777461007,950$30$360.2K
    6702842180600$90$87.5K
    J799980110100$120$33.3K
    9201451,570130$80$21K
    9921414,65523,230100$80$14.5K
    9201233493080$60$14K
    J9035216080$50$8.7K
    92134281,32060$30$8.4K

    Showing 1–10 of 18

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Guri BronnerPAOphthalmology Physician$3.8M$2.4K
    Jeremy AikeyPAOphthalmology Physician$2.3M$0
    Anton KolomeyerNJOphthalmology Physician$1.8M$910
    Joshua GreenePARetina Specialist (Ophthalmology) Physician$509.7K$3K
    Richard PrincePAOphthalmology Physician$413.5K$0
    Paul KeenanVAOphthalmology Physician$370.2K$0
    Jeffrey GordonPAOphthalmology Physician$314.4K$0
    Ignatius HneleskiPAOphthalmology Physician$291.2K$0
    Lindsay MachenPAOphthalmology Physician$266.8K$0
    Raymond JonesPAOphthalmology Physician$245.7K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Gaudenzia IncPASubstance Use Disorder Rehabilitation Clinic/Center$0$18.4M
    Bayada Home Health Care, Inc.PAHome Health Agency$0$15.9M
    Daniel ToocheckPAOptometrist$403.2K$27.5K
    Shabih KhanPAInternal Medicine Physician$372.1K$2.4K
    Maria HigginsPAOptometrist$308.2K$290
    Michelle LopezPAClinical Psychologist$183K$0
    Thrift Drug IncPACommunity/Retail Pharmacy$134.1K$0
    Rosamund LehmannPAEmergency Medicine Physician$132K$0
    Laura HammondPASpeech-Language Pathologist$93.5K$0
    Jeffrey ChamberlainPAChiropractor$92.6K$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. Pennsylvania Distribution
    James Benjamin — 2 of 18 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Pennsylvania