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

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

Robert Wirthlin (NPI 1013973254)

Field	Value
Entity Type	Individual
Organization	Robert Wirthlin
Address	427 S Bernard St
City	Spokane
State	WA
ZIP	99204
Taxonomy	Ophthalmology Physician
NPI Enumerated	April 25, 2006

Payer Source	Total Paid
Medicare	$3.7M
Medicaid	$0

Key Findings

This provider is effectively single‑payer in the dataset: total Medicare revenue is $3.7M and there is no Medicaid billing on file, so Medicare accounts for the entirety of reported public‑payer revenue and any Medicaid exposure is absent. Analysts should treat this profile as concentrated on Medicare rather than a mixed‑payer outpatient practice.

Revenue is highly concentrated in a small set of services: the precomputed top 3 Medicare codes account for 85.1% of the provider's Medicare revenue, driven by J0178 ($1.7M, 45.3% of Medicare revenue), J2777 ($1.3M, 34.7%), and 67028 ($187.6K, 5.1%). This concentration indicates that a handful of retinal therapies and a related procedure dominate the practice’s billings.

The code mix points to a retina‑focused ophthalmology practice built around intravitreal pharmacologic therapy and imaging: the two largest revenue drivers are injectable biologics (J0178 and J2777) used for retinal disease, and there is heavy utilization of retinal imaging (92134). Surgical vitreoretinal codes such as 67042 ($26.4K) and 67108 ($17.9K) appear but represent a much smaller share of revenue, suggesting injections and imaging are the operational core.

Competitive standing for the leading injectables is above many peers but characterized in the source data as typical: J0178 ranks #343 of 3204 providers nationally (89th percentile; typical, unremarkable volume for this code) and J2777 ranks #139 of 2039 providers nationally (93th percentile; typical, unremarkable volume for this code). Those percentiles show the provider bills these drugs at materially higher-than-median volume nationally, yet the supplied labels describe the volumes as typical within their peer groups.

The provider exhibits contrasting unit economics across injectables: J2777 shows very high claim volume (43.9K claims) with a low average paid per claim ($29 avg paid/claim) producing $1.3M in revenue, whereas J0178 has far fewer claims (2.4K claims) but a much higher average paid per claim ($684 avg paid/claim) producing $1.7M. This pattern reflects reliance on both high‑throughput, lower‑unit‑payment drug administration and higher‑unit‑value injections as complementary revenue streams.

Imaging use is a statistical outlier in national context: 92134 has 2.7K claims and $80.5K revenue (2.2% of Medicare revenue) and is labeled an "extreme outlier, far above typical national volume" (rank #561 of 26868 providers nationally, 98th percentile). That level of OCT imaging suggests substantial investment in retinal diagnostic workflows and likely supports the high injection volumes.

Office evaluation and management codes and new‑patient comprehensive exams appear as modest contributors: 92014 ($42.2K, 469 claims), 99213 ($18.6K, 278 claims), and 99214 ($15.3K, 158 claims) each represent small shares of total Medicare revenue. This mix reinforces an operations model oriented toward procedure‑based retinal care rather than high volumes of general ophthalmology office visits.

The provider’s NPI has been enumerated since 2006-04-25 (~20 years ago), indicating a long tenure that may correspond with established referral relationships for retinal care in Spokane. Given the long enumeration and the concentrated Medicare footprint, payers and competitors should view this as an experienced, Medicare‑focused retinal practice with limited or no Medicaid participation to consider in network planning.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,430	$680	$1.7M
J2777	Injection, faricimab‑svoa, 0.1 mg	43,920	$30	$1.3M
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.	2,020	$90	$187.6K
J2778	Injection, ranibizumab, 0.1 mg	930	$180	$167.2K
J3490	Unclassified drugs	50	$1,830	$91.6K
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.	2,680	$30	$80.5K
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…	470	$90	$42.2K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	300	$120	$36K
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…	30	$910	$26.4K
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…	280	$70	$18.6K

Showing 1–10 of 22

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Washington Distribution

Robert Wirthlin — 3 of 22 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. state median

22 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2777	6	50	12,780	$30	$599.7K
J0178	5	90	470	$680	$597.2K
J2778	5	30	510	$180	$117.1K
J2781	13	10	650	$120	$88.6K
67028	6	110	550	$90	$72.9K
J3490	37	70	70	$50	$51.2K
67042	14	40	30	$1,190	$39.2K
67108	7	20	20	$1,180	$29.6K
67036	13	20	20	$1,140	$28.6K
92242	14	20	50	$210	$19.7K

Showing 1–10 of 22

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Spokane Eye Clinic Ps	WA	Multi-Specialty Clinic/Center	$0	$8M
Spokane Eye Clinic Ps	WA	Ambulatory Surgical Clinic/Center	$3M	$716.1K
Andrew Cheek	WA	Ophthalmology Physician	$3.5M	$0
Dallin Andersen	WA	Ophthalmology Physician	$3.4M	$0
Loren Jack	WA	Ophthalmology Physician	$3.4M	$0
Ryan Whitted	GA	Ophthalmology Physician	$2.5M	$0
Robert Welch	UT	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
Shelly Lee	WA	Ophthalmology Physician	$1.9M	$0
Jessica Weinstein	OR	Retina Specialist (Ophthalmology) Physician	$691.2K	$49.8K
Steven Day	WA	Ophthalmology Physician	$379.5K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence Health & Services - Wa	WA	General Acute Care Hospital	$0	$78.7M
Providence Health & Services Washington	WA	Pulmonary Disease Physician	$0	$78.6M
Multicare Health System	WA	General Acute Care Hospital	$0	$55.1M
New Horizon Care Center, Inc.	WA	Substance Abuse Rehabilitation Facility	$0	$20.2M
Spokane Addiction Recovery Centers	WA	Substance Abuse Rehabilitation Facility	$0	$19M
Spokane Emergency Care Physicians PLLC	WA	Emergency Medicine Physician	$0	$13.9M
Spokane Emergency Physicians, Ps	WA	Emergency Medicine Physician	$0	$13.1M
Providence Health & Services Washington	WA	Clinical Medical Laboratory	$1.6M	$9.3M
Laboratory Corporation Of America	WA	Clinical Medical Laboratory	$1.6M	$6.1M
Integra Imaging, Ps	WA	Diagnostic Radiology Physician	$0	$7.5M

Robert Wirthlin — 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