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NPI 1952789018 · Providence, RI · Retina Specialist (Ophthalmology) Physician
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Scott Greenberg is a retina specialist (ophthalmology) physician provider located in Providence, Rhode Island. This profile covers 17 Medicare and 1 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 | Scott Greenberg |
| Address | 101 Plain St Ste 101 |
| City | Providence |
| State | RI |
| ZIP | 02903 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | May 9, 2015 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.8M |
| Medicaid | $1.6K |
SCOTT GREENBERG’s Medicare billing is heavily concentrated in intravitreal anti-VEGF therapy, with J0178 (aflibercept) alone representing 1.3M in Medicare revenue and 69.2% of the provider’s Medicare total; J2778 (ranibizumab) and J2777 (faricimab) are the other large injectable contributors. The code mix and descriptions (multiple high-volume injectable drug codes plus vitreous injection code 67028) are consistent with a retina specialist practice focused on procedural intravitreal injections and ongoing treatment of retinal disease.
The provider’s Medicare revenue is highly concentrated: the precomputed top 3 Medicare codes account for 82.6% of Medicare revenue, while Medicaid billing is effectively mono-coded—the precomputed top 3 Medicaid codes account for 100.0% of its Medicaid revenue. This concentration signals operational dependence on a small set of high-revenue drug-injection codes for Medicare and a negligible, narrowly defined Medicaid footprint.
Payer mix is effectively single-payer Medicare: lifetime Medicare revenue is $1.8M versus total Medicaid revenue of $1.6K, indicating Medicaid represents a vanishing share of billed revenue. For network planning and reimbursement negotiation, this provider’s commercial/Medicaid impact will be marginal compared with its Medicare activity.
Competitive standing on the top Medicare drug is modest nationally: J0178 has 1.8K claims, $685 avg paid/claim, $1.3M revenue and ranks #604 of 3204 providers nationally (81th percentile; labeled typical, unremarkable volume). Although J0178 drives the lion’s share of revenue, its national rank places the provider in the mid-to-upper range of volume rather than as a dominant national outlier.
The practice reports notably above-typical volumes for retinal imaging and established ophthalmology visits: 92014 shows 950 claims and $89.3K revenue (rank #1848 of 35415, 95th percentile; notably above typical), and 92134 shows 2.1K claims and $66.6K revenue (rank #963 of 26868, 96th percentile; notably above typical). These elevated percentiles for 92014 and 92134 indicate a steady stream of follow-up and diagnostic imaging consistent with an active retina clinic managing chronic retinal disease.
Medicaid activity is concentrated in retinal imaging: all Medicaid revenue ($1.6K) is from 92134 (82 claims, $20 avg paid/claim), and the provider ranks #19 of 24 in-state for that code (22th percentile; typical, unremarkable volume). In-state Medicaid presence is small and below many peers, underscoring the provider’s limited custodial role for Medicaid-covered retinal imaging.
Tenure in the CMS system is established: the NPI was enumerated 2015-05-09 (~11 years ago), indicating the provider has an approximately 11-year claims history to assess trends and utilization patterns. That tenure supports observing stable procedural and imaging volumes rather than a short-term or new entrant pattern.
Other injectable and procedural codes appear at typical national volumes rather than as outliers—J2778 (699 claims, $123K, ranks #570 of 1208, 53th percentile), J2777 (4.1K claims, $120.1K, ranks #1656 of 2039, 18th percentile), J9035 (155 claims, $8.2K, ranks #806 of 1852, 56th percentile), and 67028 (1.3K claims, $116.3K, ranks #1029 of 4255, 76th percentile). This mix shows use of multiple anti-VEGF agents and standard retinal procedures without extreme deviation from peer practice patterns nationally.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
17 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1,840 | $690 | $1.3M |
| J2778 | Injection, ranibizumab, 0.1 mg | 700 | $180 | $123K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 4,140 | $30 | $120.1K |
| 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. | 1,280 | $90 | $116.3K |
| 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… | 950 | $90 | $89.3K |
| 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. | 2,080 | $30 | $66.6K |
| 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. | 140 | $110 | $15.1K |
| J9035 | Injection, bevacizumab, 10 mg | 160 | $50 | $8.2K |
| 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… | 20 | $250 | $5.9K |
| 67145 | The 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… | 20 | $190 | $4.3K |
Showing 1–10 of 17
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
17 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 2 | 10 | 670 | $690 | $601.6K |
| J2777 | 5 | 10 | 5,790 | $30 | $158K |
| J2778 | 1 | 10 | 460 | $180 | $78.7K |
| 67028 | 1 | 20 | 610 | $90 | $58.9K |
| 92014 | 5 | 190 | 120 | $80 | $16.3K |
| 99214 | 1,817 | 1,950 | 100 | $80 | $11.7K |
| J9035 | 9 | 20 | 160 | $50 | $9.5K |
| 99213 | 1,728 | 1,950 | 70 | $60 | $7.4K |
| 92134 | 2 | 120 | 50 | $30 | $6.6K |
| 67228 | 1 | 10 | 20 | $250 | $5.9K |
Showing 1–10 of 17
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.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 80 | $20 | $1.6K |
How this provider's Medicaid billing volume and revenue compare to other Rhode Island providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Rhode Island median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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. | 19 | 20 | 560 | $50 | $61.6K |
Other providers in the same ZIP code as Scott Greenberg, ranked by combined Medicare and Medicaid revenue.
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