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Market snapshot

J0178 in ME CY2024

Medicare Part B FFS · CY2024 · as published by CMS

J0178 — Injection, aflibercept, 1 mg

Billing groups
7
Named-group FFS services
10,018
FFS of Medicare
41%
Services YoY
-17.6%
FFS enrollment -4.0%
Estimated all-Medicare volume FFS + estimated MA estimate
~23,477 services

10,018 observed fee-for-service (43%) · ~13,459 estimated Medicare Advantage. Scaled from the observed floor by each state’s fee-for-service share (FFS share as of 2024) — scaled estimate — assumes MA utilization mirrors FFS; not an observation. How we scale

Named-group submitted charges
$13.5M
Named-group allowed amount
$8.3M
Named-group Medicare payments
$6.5M
Avg charge / svc
$1,349
Avg allowed / svc
$825
Avg payment / svc
$652
Average charge per group
$973 7 groups · avg submitted charge / service $1,751
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by J0178 services, CY2024
#Physician group City Specialty Providers J0178 svcs Submitted charges Avg charge Medicare $ locked column Share* Phone
1 MAINE EYE CENTER PA PORTLAND OPHTHALMOLOGY 18 4,122 $6,079,950 $1,475 premium 31.1% (207) 774-8277
2 MAINE EYE CARE ASSOCIATES WATERVILLE OPTOMETRY 8 1,716 $1,801,800 $1,050 premium 12.9% (207) 873-2731
3 EYECARE MEDICAL GROUP PORTLAND OPHTHALMOLOGY 10 1,412 $2,472,412 $1,751 premium 10.6% (207) 828-2020
4 RIVERSIDE EYE CENTER, PA LEWISTON OPHTHALMOLOGY 4 1,340 $1,675,000 $1,250 premium 10.1% (207) 786-2500
5 VISION CARE OF MAINE LLC BANGOR OPHTHALMOLOGY 8 821 $892,252 $1,087 premium 6.2% (207) 945-6200
6 EYESIGHT OPHTHALMIC SERVICES PLLC PORTSMOUTH OPHTHALMOLOGY 17 505 $491,400 $973 premium 3.8% (603) 436-1773
7 ATLEE GLEATON EYE CARE PA AUGUSTA OPTOMETRY 5 102 $105,060 $1,030 premium 0.8% (207) 622-3185

*Share of the state's disclosed Medicare-FFS services for the primary code, counted once per clinician. "St" is the state the volume was billed from: a group appears in each state where its clinicians bill Medicare, with that state's volume and share ("City" is the group's registered location). Group figures sum clinicians affiliated with exactly one group; clinicians in several groups are listed in each group's drill-down but not volume-attributed to any single group, so shares reflect attributable volume. See Methods.

Comparing against an all-payer estimate?

These are exact counts from Medicare fee-for-service claims — roughly a third to half of most procedure markets, depending on payer mix. Modeled all-payer databases project the remainder statistically; we publish the audited floor and label it as such. Same market, different denominator. How the numbers reconcile →