Loading...
NPI 1992192884 · Boston, MA · Ophthalmology Physician
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Adam Chin is a ophthalmology physician provider located in Boston, Massachusetts. This profile covers 18 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 | Adam Chin |
| Address | 50 Staniford St Ste 600 |
| City | Boston |
| State | MA |
| ZIP | 02114 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | April 19, 2015 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.4M |
| Medicaid | $870 |
This provider’s revenue is overwhelmingly Medicare-driven: total Medicare revenue is $3.4M compared with total Medicaid revenue of $867, so the practice is effectively a Medicare-centric operation with negligible Medicaid dollars on file. The Medicaid footprint is limited to 26 claims for 92134 that produced $858, demonstrating minimal scale in the state program and little Medicaid diversification of revenue sources.
Revenue concentration on Medicare is high: the precomputed top-3 Medicare codes account for 83.8% of the provider’s Medicare revenue, indicating most compensation is tied to a narrow set of drug and injection services. That concentration suggests the business model is heavily dependent on those high-revenue, procedure/drug codes rather than a broad mix of evaluation-and-management visits or ancillary services.
The practice’s top Medicare revenue driver is J0178 (aflibercept): 3.4K claims, $691 avg paid/claim, $2.4M revenue (69.8% of Medicare revenue), and it ranks #118 of 3204 (96th percentile; notably above typical national volume for this code). This dominance of J0178 indicates the clinic operates a high-volume intravitreal anti-VEGF injection service—typical of retina-focused care for wet AMD or similar retinal vascular disease.
The other two Medicare top-3 codes reinforce an injection-centric specialty mix: J2777 (faricimab) generated $259.3K (7.7% of Medicare revenue) and 67028 (intravitreal injection as a separate procedure) generated $215K (6.4% of Medicare revenue) with 67028 ranking #348 of 4255 (92th percentile; notably above typical national volume for this code). Together these codes (J0178, J2777, 67028) show a procedural workflow centered on frequent injections and procedure-only visits rather than predominantly high-volume E/M office-based care.
Clinical workflow and follow-up intensity are visible in diagnostic and E/M volumes: 92134 appears with 4K Medicare claims and $129K (3.8% of Medicare revenue) and ranks #128 of 26868 (100th percentile; extreme outlier), while 92014 has 1.9K claims and $179.5K (5.3% of Medicare revenue) and ranks #317 of 35415 (99th percentile; extreme outlier). These extreme outlier positions for retina imaging and comprehensive established-patient exams are consistent with a high-throughput injection clinic that performs frequent imaging and follow-up visits.
Medicaid activity is concentrated entirely in one code: 92134 accounts for 100.0% of the provider’s Medicaid revenue ($858) and ranks #113 of 132 in-state (15th percentile; typical, unremarkable volume for this code). This contrast—nationally extreme outlier in Medicare for 92134 versus modest in-state Medicaid ranking—underscores that the provider’s high imaging volumes are driven by Medicare patients rather than Medicaid beneficiaries.
From a competitive-standing perspective, the provider is a substantial national-scale participant for select retinal services: the Medicare rankings for J0178 (#118/3204, 96th percentile) and 92134 (100th percentile; extreme outlier) position the clinician well above most peers nationally for those codes, whereas some drug codes like J2777 sit at more typical volumes (47th percentile; typical, unremarkable volume for this code). In-state Medicaid rankings are modest, so any local network negotiations or Medicaid-focused contracting would reflect limited existing Medicaid volume.
The NPI was enumerated on 2015-04-19 (~11 years ago), indicating an established presence in the market; combined with $3.4M lifetime Medicare revenue and the concentrated injection/imaging code mix, the profile is consistent with a sustained, procedure-focused ophthalmology/retina practice. The heavy reliance on a few high-revenue injection codes gives the practice operational leverage around anti-VEGF service lines but also makes its Medicare revenue stream sensitive to changes in reimbursement or utilization for those specific codes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
18 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 3,410 | $690 | $2.4M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 8,940 | $30 | $259.3K |
| 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. | 2,110 | $100 | $215K |
| 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… | 1,870 | $100 | $179.5K |
| 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. | 4,030 | $30 | $129K |
| J2778 | Injection, ranibizumab, 0.1 mg | 630 | $180 | $115.4K |
| J9035 | Injection, bevacizumab, 10 mg | 520 | $50 | $28.1K |
| 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… | 370 | $70 | $24.8K |
| 92012 | For 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… | 260 | $70 | $17.3K |
| 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. | 150 | $110 | $16.1K |
Showing 1–10 of 18
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 Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 5 | 90 | 790 | $690 | $826.5K |
| J2777 | 21 | 50 | 7,080 | $30 | $343.1K |
| J2778 | 13 | 30 | 560 | $180 | $200.7K |
| Q5124 | 10 | 10 | 800 | $160 | $186K |
| 67028 | 10 | 120 | 570 | $100 | $80.7K |
| 92014 | 22 | 1,070 | 160 | $90 | $30.1K |
| 67042 | 19 | 30 | 20 | $1,170 | $25.7K |
| J9035 | 13 | 80 | 250 | $50 | $19.7K |
| 99214 | 13,003 | 15,410 | 110 | $80 | $15.6K |
| 92012 | 127 | 560 | 90 | $70 | $12.4K |
Showing 1–10 of 18
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
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. | 30 | $30 | $860 |
How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Massachusetts 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. | 113 | 130 | 430 | $10 | $39.3K |
Other providers in the same ZIP code as Adam Chin, ranked by combined Medicare and Medicaid revenue.
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.