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Dr. Tamer  Mahmoud  Md image

Dr. Tamer Mahmoud Md

2100 Erwin Rd
Durham NC 27705
919 848-8111
Medical School: Other - 1992
Accepts Medicare: Yes
Participates In eRX: Yes
Participates In PQRS: Yes
Participates In EHR: Yes
License #:
NPI: 1588604458
Taxonomy Codes:
207W00000X

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Awards & Recognitions

About Us

Practice Philosophy

Conditions

Dr. Tamer Mahmoud is associated with these group practices

Procedure Pricing

HCPCS Code Description Average Price Average Price
Allowed By Medicare
HCPCS Code:67042 Description:Vit for macular hole Average Price:$5,052.00 Average Price Allowed
By Medicare:
$1,420.16
HCPCS Code:67113 Description:Repair retinal detach cplx Average Price:$4,168.69 Average Price Allowed
By Medicare:
$1,484.46
HCPCS Code:67028 Description:Injection eye drug Average Price:$814.33 Average Price Allowed
By Medicare:
$96.53
HCPCS Code:67028 Description:Injection eye drug Average Price:$813.00 Average Price Allowed
By Medicare:
$106.59
HCPCS Code:92235 Description:Eye exam with photos Average Price:$488.00 Average Price Allowed
By Medicare:
$128.85
HCPCS Code:76512 Description:Ophth us b w/non-quant a Average Price:$364.04 Average Price Allowed
By Medicare:
$86.74
HCPCS Code:99205 Description:Office/outpatient visit new Average Price:$364.69 Average Price Allowed
By Medicare:
$190.64
HCPCS Code:99204 Description:Office/outpatient visit new Average Price:$290.94 Average Price Allowed
By Medicare:
$153.15
HCPCS Code:J2778 Description:Ranibizumab injection Average Price:$534.93 Average Price Allowed
By Medicare:
$400.09
HCPCS Code:92134 Description:Cptr ophth dx img post segmt Average Price:$172.00 Average Price Allowed
By Medicare:
$42.58
HCPCS Code:92235 Description:Eye exam with photos Average Price:$160.00 Average Price Allowed
By Medicare:
$44.06
HCPCS Code:92226 Description:Special eye exam subsequent Average Price:$125.00 Average Price Allowed
By Medicare:
$22.51
HCPCS Code:92225 Description:Special eye exam initial Average Price:$125.00 Average Price Allowed
By Medicare:
$25.00
HCPCS Code:99214 Description:Office/outpatient visit est Average Price:$195.91 Average Price Allowed
By Medicare:
$99.49
HCPCS Code:92134 Description:Cptr ophth dx img post segmt Average Price:$113.00 Average Price Allowed
By Medicare:
$27.28
HCPCS Code:92250 Description:Eye exam with photos Average Price:$84.00 Average Price Allowed
By Medicare:
$22.47
HCPCS Code:J3590 Description:Unclassified biologics Average Price:$40.00 Average Price Allowed
By Medicare:
$40.00

HCPCS Code Definitions

67028
Intravitreal injection of a pharmacologic agent (separate procedure)
76512
Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan)
67028
Intravitreal injection of a pharmacologic agent (separate procedure)
67042
Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (eg, for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil)
67113
Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degrees), with vitrectomy and membrane peeling, may include air, gas, or silicone oil tamponade, cryotherapy, endolaser photocoagulation, drainage of subretinal fluid, scleral buckling, and/or removal of lens
99214
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
92235
Fluorescein angiography (includes multiframe imaging) with interpretation and report
99205
Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.
92134
Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; retina
92226
Ophthalmoscopy, extended, with retinal drawing (eg, for retinal detachment, melanoma), with interpretation and report; subsequent
92134
Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; retina
92225
Ophthalmoscopy, extended, with retinal drawing (eg, for retinal detachment, melanoma), with interpretation and report; initial
99204
Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
92250
Fundus photography with interpretation and report
92235
Fluorescein angiography (includes multiframe imaging) with interpretation and report
J2778
Injection, ranibizumab, 0.1 mg
J3590
Unclassified biologics

Medical Malpractice Cases

None Found

Medical Board Sanctions

None Found

Referrals

NPI
Doctor Name
Specialty
Count
1417981093
Optometry
868
1043224058
Ophthalmology
367
1023065612
Ophthalmology
364
1295819167
Cardiovascular Disease (Cardiology)
301
1568407781
Cardiovascular Disease (Cardiology)
243
1588611123
Internal Medicine
187
1790793578
Cardiovascular Disease (Cardiology)
162
1275585796
Diagnostic Radiology
161
1114962313
Pathology
153
1629152517
Anesthesiology
136
*These referrals represent the top 10 that Dr. Mahmoud has made to other doctors

Publications

Assessment of Foveal Microstructure and Foveal Lucencies Using Optical Coherence Tomography Radial Scans Following Macular Hole Surgery. - American journal of ophthalmology
To evaluate the foveal microstructure using high-density (24-line) radial scans and their correlation with visual recovery following macular hole surgery.Retrospective, consecutive, interventional case series.Forty-five eyes of 43 patients with ≥6 months follow-up following surgery were analyzed. Preoperative predictive measures evaluated included basal hole and minimum linear diameters. Outcome measures included best-corrected visual acuity (BCVA), postoperative foveal lucency horizontal and vertical size, external limiting membrane, and ellipsoid zone defect.Mean basal hole diameter was 642 ± 330 μm and minimum linear diameter was 277 ± 161 μm. BCVA (logMAR) improved from 0.67 ± 0.23 to 0.31 ± 0.16 at 12 months (P < .001). Foveal lucency horizontal and vertical sizes (μm) improved from 97 ± 81 and 33 ± 18 at 1 month to 26 ± 33 and 19 ± 18, respectively (P < .05) at 12 months. External limiting membrane recovered in all cases at 1 month. Mean ellipsoid zone defect (μm) reduced from 136 ± 164 at 1 month to 32 ± 33 at 12 months (P < .05). Preoperative basal hole diameter correlated with horizontal foveal lucency size at all time points (P < .05). Horizontal foveal lucency size at 1 month correlated (P < .05) with BCVA at 6 and 12 months. Basal hole diameter ≥700 μm (71% sensitivity and 70% specificity) and minimum linear diameter ≥330 μm (71% sensitivity and 70% specificity) were predictive of foveal lucency development. Cataract surgery did not influence foveal lucency resolution and no holes reopened.Using radial scans, 71% of eyes demonstrated a foveal lucency at 1 month, whose size correlated with visual recovery. Preoperative basal hole diameter was predictive of foveal lucency development and size.Copyright © 2015 Elsevier Inc. All rights reserved.
Skin Flap Necrosis After Mastectomy With Reconstruction: A Prospective Study. - Annals of surgical oncology
Rates of mastectomy with immediate reconstruction are rising. Skin flap necrosis after this procedure is a recognized complication that can have an impact on cosmetic outcomes and patient satisfaction, and in worst cases can potentially delay adjuvant therapies. Many retrospective studies of this complication have identified variable event rates and inconsistent associated factors.A prospective study was designed to capture the rate of skin flap necrosis as well as pre-, intra-, and postoperative variables, with follow-up assessment to 8 weeks postoperatively. Uni- and multivariate analyses were performed for factors associated with skin flap necrosis.Of 606 consecutive procedures, 85 (14 %) had some level of skin flap necrosis: 46 mild (8 %), 6 moderate (1 %), 31 severe (5 %), and 2 uncategorized (0.3 %). Univariate analysis for any necrosis showed smoking, history of breast augmentation, nipple-sparing mastectomy, and time from incision to specimen removal to be significant. In multivariate models, nipple-sparing, time from incision to specimen removal, sharp dissection, and previous breast reduction were significant for any necrosis. Univariate analysis of only moderate or severe necrosis showed body mass index, diabetes, nipple-sparing mastectomy, specimen size, and expander size to be significant. Multivariate analysis showed nipple-sparing mastectomy and specimen size to be significant. Nipple-sparing mastectomy was associated with higher rates of necrosis at every level of severity.Rates of skin flap necrosis are likely higher than reported in retrospective series. Modifiable technical variables have limited the impact on rates of necrosis. Patients with multiple risk factors should be counseled about the risks, especially if they are contemplating nipple-sparing mastectomy.
Retained Intraocular Perfluoro-n-octane After Valved Cannula Pars Plana Vitrectomy for Retinal Detachment. - Ophthalmic surgery, lasers & imaging retina
To investigate cases of retained intraocular perfluoro-n-octane (PFO) after pars plana vitrectomy (PPV) for retinal detachment (RD).Retrospective, noncomparative case series of six eyes with retained intraocular PFO after RD repair. Clinical data were supplemented with an experimental silicone eye model.A cluster of six cases of retained intraocular PFO after PPV for RD repair were noted shortly after transitioning to valved cannulas. PFO was noted in the anterior chamber (AC) and/or vitreous and removed with AC paracentesis, AC wash-out, and/or PPV. A silicone eye model demonstrated that PFO levels are maintained anterior to cannula insertion with valved cannulas only.The authors hypothesize that anterior PFO fill using valved cannulas can lead to sequestration within the AC, zonules, ciliary sulcus, ciliary teeth, and/or capsular bag. They suggest vigilance in not overfilling PFO, particularly when transitioning to use of valved cannulas, to minimize the risk of intraocular retention.Copyright 2015, SLACK Incorporated.
SAFETY PROFILE OF OCRIPLASMIN FOR SYMPTOMATIC VITREOMACULAR ADHESION: A Comprehensive Analysis of Premarketing and Postmarketing Experiences. - Retina (Philadelphia, Pa.)
After the recent approval of ocriplasmin by the Food and Drug Administration, postmarketing safety concerns have been raised by the vitreoretinal community. The American Society of Retina Specialists Therapeutic Surveillance Committee was commissioned to monitor postmarketing drug-related and device-related adverse events. The purpose of this report is to analyze the postmarketing safety experience in the context of available premarketing safety data.Periodic aggregate safety reports consisting of premarketing, or clinical trial, data (n = 999 injections) and postmarketing reports through July 16, 2013 (n = 4,387 injections), were retrospectively analyzed by the TSC. The aggregate data were analyzed to classify adverse events, and the postmarketing safety data for each event type were compared with the premarketing data.Eight categories of adverse events were identified. Acute reduction in visual acuity attributable to either worsening of macular pathology or development of subretinal fluid, electroretinogram changes, dyschromatopsia, retinal tears and detachments, lens subluxation or phacodonesis, impaired pupillary reflex, and retinal vessel findings were reported in both the premarketing and postmarketing experiences. Ellipsoid zone (inner segment/outer segment) findings were only reported in the postmarketing experience. Rates of postmarketing reports were lower than in the premarketing data. Adverse events were generally transient, and characteristics of these adverse events were generally similar between the premarketing and postmarketing experience.Postmarket analyses are limited by significant underreporting, and in the case of ocriplasmin as a first in-class drug, they may not have captured safety events that have only more recently been identified. Nonetheless, postmarket analyses can identify the scope of potential safety events based on real-world experiences. Ocriplasmin administration should be guided by an appropriate and informed risk-benefit discussion with the patient. Ongoing active postmarket surveillance by all practitioners will continue to be critical to better understand this safety profile.
Postmarketing analysis of aflibercept-related sterile intraocular inflammation. - JAMA ophthalmology
Aflibercept-related sterile inflammation, an event that is poorly understood, has been the subject of ongoing postmarketing reports.To analyze cases of aflibercept-related sterile inflammation reported to the American Society of Retina Specialists (ASRS) Therapeutic Surveillance Committee (TSC), an independent task force formed to monitor drug- and device-related safety events.A retrospective review of 56 cases in 55 patients was performed of all cases of sterile inflammation after aflibercept injection that were voluntarily reported by 12 practices throughout the United States to the ASRS TSC from December 1, 2011, through February 12, 2014.Cases of aflibercept-related sterile inflammation were analyzed for baseline and demographic information, presenting symptoms and findings, visual acuity changes, injection technique, and management details.Among 56 reported cases of sterile inflammation, mean time to onset was 3.5 days (median, 2 days; range, 0-30 days). Most cases consisted of initial loss of vision and intraocular inflammation without prominent redness, severe pain, or hypopyon. Thirty-seven cases (66%) were treated with topical corticosteroids and/or observation alone. Mean time to resolution was 28.6 days (median, 28 days; range, 4-84 days). Although final vision was overall unchanged, some patients developed permanent vision loss, which may have resulted from inflammation and/or progression of the underlying disease. Age older than 80 years was associated with worse visual outcomes. No difference in visual outcome was detected in patients with sterile inflammation undergoing topical therapy alone vs invasive procedures (vitreous biopsy and/or intravitreal antibiotic administration and/or vitrectomy).With the largest number of reported cases of aflibercept-related sterile inflammation to our knowledge, this analysis suggests typical findings and an often favorable prognosis of this event. Analysis of real-world, postmarketing data has limitations, and these findings should be considered as hypothesis-generating assessments rather than a definitive reflection of this event or its typical course. Distinguishing sterile inflammation and infectious endophthalmitis at the time of presentation may often be difficult, and cautious evaluation and management of these patients are warranted. The ASRS TSC encourages active postmarketing surveillance by all physicians.
The Effect of Adjuvant Trastuzumab on Locoregional Recurrence of Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer Treated with Mastectomy. - Annals of surgical oncology
Human epidermal growth factor receptor 2 (HER2) overexpression was associated with locoregional recurrence (LRR) in the preadjuvant trastuzumab era. This study aimed to examine the effect of trastuzumab on LRR in mastectomy patients and whether it varied with postmastectomy radiation (PMRT).From the authors' institutional database, 501 women with stages I-III HER2-positive breast cancer who underwent mastectomy from 1998 to 2007 were identified. A landmark analysis was performed to compare two cohorts: 170 women who received trastuzumab and 281 who did not. Kaplan-Meier methods were used to estimate locoregional recurrence-free survival (LRRFS). A propensity score analysis was used to balance the treatment groups with respect to multiple covariates. Analogous methods were used to study the effect of PMRT.The women in the trastuzumab group were more likely to be node positive and to receive systemic therapy or PMRT (p < 0.01). The 5-year LRRFS was 98 % in the trastuzumab troup versus 94 % in the no trastuzumab group [hazard ratio (HR) 0.31; 95 % confidence interval (CI) 0.09-1.09; p = 0.07]. After adjustment for multiple covariates, including receipt of chemotherapy and PMRT, trastuzumab decreased LRR rates (HR 0.21; 95 % CI 0.04-0.94; p = 0.04). Among the women who received PMRT, trastuzumab reduced the 5-year LRR rate (0 vs 5 %; p = 0.06). Among those who did not receive PMRT, trastuzumab did not significantly decrease LRR (3 vs 6 %; p = 0.26).High rates of locoregional control (5-year rate, 98 %) were observed among patients who received trastuzumab and mastectomy ± PMRT. Trastuzumab decreased LRR in HER2-positive women who received mastectomy and PMRT, suggesting that the largest benefit is seen in a higher-risk subset of patients.
Propolis enhances the effectiveness of praziquantel in experimental schistosomiasis: biochemical and histopathological study. - Parasitology research
Despite the wide current use of praziquantel (PZQ) in treatment of schistosomiasis, low cure rates have been recorded in many studies. The aim of this study was directed to evaluate the curative effect of propolis (Pps) alone or in combination with PZQ on biochemical, immunological, parasitological, and histological changes associated with experimental schistosomiasis in mice. Schistosoma mansoni-infected mice were divided into two experimental sets, each with four subgroups: (i) untreated, (ii) treated with Pps/day p.o for 4 weeks, (iii) treated with PZQ p.o 2 × 500 mg/kg bd wt, and (iv) treated with Pps + PZQ as in group ii and iii; all treatments started on the 8th week postinfection, in addition to uninfected group as control for the previous groups. Treatment of infected mice with Pps, although failed to eradicate the worm, significantly reduced the hepatic granuloma number, their lymphocytic infiltration and aggregation, hepatic and splenic myeloperoxidase (MPO) activity and plasma, and liver and thymus nitric oxide (NOx) levels together with normalization of plasma proteins and alleviation of oxidative stress in the examined tissues as evidenced by reduction of malondialdehyde (MDA) and normalization of glutathione (GSH). Promising results were obtained when Pps was given in combination with PZQ, where the anti-schistosomal activity of PZQ was markedly potentiated with complete alleviation and amelioration of the histological and biochemical alteration associated with schistosomiasis. This study highlights the potential usefulness of Pps as an adjunct to PZQ in schistosomiasis.
Subretinal hemorrhage. - Developments in ophthalmology
Large submacular hemorrhage (SMH) is a devastating complication of neovascular age-related macular degeneration (AMD) that cannot be effectively managed with anti-vascular endothelial growth factor injections alone. While SMH is not common, AMD patients with existing coagulopathies or taking anticoagulant medications are particularly susceptible. Today, various techniques are available for the management of SMH, including pneumatic displacement with or without intravitreal tissue plasminogen activator (tPA), pars plana vitrectomy with subretinal tPA and gas tamponade, and submacular surgery with vitrectomy and retinotomy for clot extraction. While no consensus exists, the preferred technique is often determined by the extent or duration of the hemorrhage and surgeon preference. This chapter reviews treatment options for managing SMH, as well as the current evidence for supporting their use.© 2014 S. Karger AG, Basel
Effect of anti-vascular endothelial growth factor therapy on choroidal thickness in diabetic macular edema. - American journal of ophthalmology
To determine the effect of anti-vascular endothelial growth factor (VEGF) therapy on choroidal thickness in eyes with diabetic macular edema (DME).A retrospective, cohort analysis of 59 eyes from 59 patients with DME without prior anti-VEGF therapy.Choroidal thickness was measured using semiautomated segmentation of enhanced depth imaging optical coherence tomography images at 0.5-mm intervals from 2.5 mm nasal to 2.5 mm temporal to the fovea. Changes in choroidal thickness with and without anti-VEGF treatment over 6 months were compared. Best-corrected visual acuity and central foveal thickness were analyzed to evaluate the association of choroidal thickness with functional and anatomic outcomes.Of the 59 eyes with DME, 26 eyes were observed without treatment, whereas 33 underwent intravitreal anti-VEGF therapy (mean number of injections, 2.73) over 6 months. In untreated eyes, there was no significant change in best-corrected visual acuity (P = .098), central foveal thickness (P = .472), or choroidal thickness at all measurements along the macula (P = .057 at the fovea). In eyes treated with anti-VEGF injections, choroidal thickness decreased significantly at the fovea (246.6 to 224.8 μm; P < .001) and at 0.5 mm nasal (240.9 to 221.9 μm; P = .002) and 0.5 mm temporal (249.3 to 224.8 μm; P = .011) to the fovea. The decrease in subfoveal choroidal thickness after anti-VEGF treatment was not associated with the cumulative number of anti-VEGF injections (R(2) = 0.031; P = .327) or to changes in best-corrected visual acuity (R(2) = 0.017; P = .470) or central foveal thickness (R(2) = 0.040; P = .263).Central choroidal thickness decreases after anti-VEGF therapy for DME after 6 months, but may not be associated with functional or anatomic outcomes in eyes with DME.Copyright © 2014 Elsevier Inc. All rights reserved.
Discerning the kinetics of autoimmune manifestations in a model of Sjögren's syndrome. - Molecular immunology
Ectopic follicles are non-encapsulated organized lymphoid structures that form at sites of inflammation and presumably contribute to the activation and differentiation of cells with autoreactive potential within target tissues. As such, directed targeting of ectopic follicles in settings of autoimmunity may provide a means to specifically inhibit the activation of autoreactive cells without impairing protective immune responses ongoing in peripheral lymphoid tissues. NOD·H2h4 mice are a non-diabetic strain of NOD mice which develop a Sjögren's syndrome-like disease which includes the formation of ectopic follicles in the salivary gland and characteristic Sjögren's autoantibodies. The goal of these studies was to better characterize the formation of ectopic follicles in this model and to explore their contribution to autoimmunity. Our studies show that by 8 weeks of age, young NOD·H2h4 mice spontaneously develop an abundance of splenic germinal centers, prior to the emergence of lymphocyte infiltration in the salivary gland tissue. Ectopic follicle formation in the salivary gland begins to appear in these mice between 12 and 16 weeks of age. Interestingly, anti-Ro and anti-La autoantibodies precede the development of ectopic follicles in young NOD·H2h4 mice. In contrast, production of anti-dsDNA antibodies is delayed and largely coincides with the formation of ectopic follicles in these mice. These data suggest that tertiary lymphoid structures may arise from the trafficking of activated T and B cells to sites of inflammation in non-lymphoid tissues. Furthermore, local presentation of autoantigens may then promote the expansion of autoreactive cells with specificities distinct from those generated in the splenic micro-environment.Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

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2100 Erwin Rd Durham, NC 27705
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