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

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

James Osher (NPI 1942448618)

Field	Value
Entity Type	Individual
Organization	James Osher
Address	1945 Cei Dr
City	Blue Ash
State	OH
ZIP	45242
Taxonomy	Ophthalmology Physician
NPI Enumerated	February 3, 2009

Payer Source	Total Paid
Medicare	$3.7M
Medicaid	$0

Key Findings

This provider reports $3.7M in lifetime Medicare revenue and has no Medicaid billing on file, making their Medicare business the effectively sole public-payer footprint on record. The absence of any Medicaid claims indicates a single-payer skew in public coverage data rather than a mixed Medicare/Medicaid panel.

Revenue is highly concentrated in a small set of procedure and drug codes: the precomputed top three Medicare codes (J0178, J2777, 67028) account for 86.4% of the provider's total Medicare revenue, with J0178 alone representing 60.1% of Medicare revenue. That level of concentration indicates the practice is heavily dependent on a narrow set of high-revenue retinal therapies.

The code mix signals a retina-focused, procedure-driven practice centered on intravitreal injections and retinal procedures: J0178 (aflibercept injections, 3.2K claims, $2.2M revenue) and J2777 (faricimab, 25.2K claims, $730.8K revenue) are the dominant revenue drivers, and 67028 (isolated intravitreal injection, 2.8K claims, $234.3K revenue) is also a material contributor. High volumes of 92134 (4K claims, $113.2K revenue) further support a medical-retina workflow that combines frequent imaging with serial intravitreal therapies.

Competitive standing versus national Medicare peers is strong for retinal procedures and imaging: J0178 ranks #151 of 3204 providers nationally (95th percentile; notably above typical national volume) and 67028 ranks #126 of 4255 providers nationally (97th percentile; notably above typical national volume), indicating above-average national volume in core injection procedures. 92134 ranks #126 of 26868 providers nationally (100th percentile; extreme outlier), marking the provider as an unusually high-volume user of retinal imaging relative to peers.

There are notable statistical outliers in the clinician's biologic and imaging billing: J3590 (unclassified biologics) accounts for $162K (4.4% of Medicare revenue) and ranks #9 of 631 providers nationally (99th percentile; extreme outlier), and 92134 is also flagged as an extreme outlier. These unusual rank positions suggest atypically high use of unclassified biologic codes and imaging that may warrant operational or coding review to understand product mix and documentation.

General ophthalmology and E/M services appear secondary to procedure revenue: 92014 (comprehensive established exam) and 99214/99213 together account for modest shares (each around 1.0–1.2% of Medicare revenue), indicating the practice emphasizes procedure-based retinal care over routine office visits in its Medicare billing profile. This split suggests clinical throughput is organized around injection visits and retinal imaging rather than a large general ophthalmology panel.

The provider has an established enrollment history, with an NPI enumerated on 2009-02-03 (~17 years ago), which supports interpretation of these high volumes as the output of a long-standing practice rather than a newly scaled operation. Tenure combined with concentrated procedure volumes is consistent with an experienced retinal specialist or clinic that has built steady referral and treatment workflows.

From a payer and contract perspective, the practice’s heavy reliance on a few high-revenue retinal drug and injection codes (notably J0178 at 60.1% and J2777 at 20.0%) creates exposure to changes in drug utilization patterns, reimbursement rates, or utilization management for intravitreal biologics. For payers and network planners, this profile identifies the provider as a high-capacity retina injector with concentrated service lines and little to no Medicaid exposure on record.

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	3,200	$690	$2.2M
J2777	Injection, faricimab‑svoa, 0.1 mg	25,200	$30	$730.8K
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.	2,760	$90	$234.3K
J3590	Unclassified biologics	1,220	$130	$162K
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.	4,040	$30	$113.2K
67042	In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina…	60	$870	$48.6K
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…	560	$80	$43.8K
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…	490	$90	$43.7K
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…	620	$60	$37.8K
J7312	Injection, dexamethasone, intravitreal implant, 0.1 mg	130	$160	$19.9K

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. Ohio Distribution

James Osher — 5 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. state median

16 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	3	100	840	$680	$729K
J2777	8	70	9,480	$30	$353.3K
67028	4	150	470	$90	$64K
J7312	20	20	240	$160	$41.7K
J3590	3	100	200	$100	$30K
67042	5	50	20	$960	$29.7K
92014	86	1,390	100	$70	$12.9K
99214	1,186	20,010	100	$70	$11.7K
67210	4	10	30	$340	$10.4K
99213	432	20,000	70	$50	$6.6K

Showing 1–10 of 16

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of Cincinnati Physicians Company, LLC	OH	Family Medicine Physician	$0	$65.2M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
West Chester Hospital LLC	OH	General Acute Care Hospital	$0	$19.5M
Cei Physicians Psc LLC	OH	Ophthalmology Physician	$0	$8.5M
Kettering Independent Medical Group Inc	OH	Orthopaedic Surgery Physician	$0	$8.4M
Cei Physicians Psc LLC	OH	Ophthalmologic Surgery Clinic/Center	$4.1M	$1M
Bruce Buerk	OH	Retina Specialist (Ophthalmology) Physician	$3.4M	$0
Juan Lebron	OH	Retina Specialist (Ophthalmology) Physician	$2.7M	$0
Kendall Wannamaker	NC	Ophthalmology Physician	$2.7M	$0
Hang Pham	OH	Ophthalmology Physician	$2.6M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Maxim Healthcare Services, Inc.	OH	Home Health Agency	$0	$63.6M
Bethesda Hospital Inc	OH	General Acute Care Hospital	$0	$57M
Hospice Of Cincinnati Incorporated	OH	Community Based Hospice Care Agency	$0	$54M
Carestar, Inc.	OH	Case Management Agency	$0	$43.1M
Counseling Source Inc	OH	Mental Health Counselor	$0	$41M
Mercy Health Physicians Cincinnati, LLC	OH	Family Medicine Physician	$0	$27.9M
Qualified Emergency Specialists Inc	OH	Emergency Medicine Physician	$0	$18.9M
Crossroads Hospice Of Cincinnati	OH	Community Based Hospice Care Agency	$0	$14.6M
A Best Home Care,inc.	OH	Home Health Agency	$0	$10.4M
Mercy Health Physicians Cincinnati Specialty Care LLC	OH	Surgery Physician	$0	$7.1M

James Osher — 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