DAVID LEACH is an ophthalmology physician with a long Medicare enrollment history, enumerated on 2006-12-06 (~20 years ago), indicating established practice presence in MOSCOW, ID that likely serves a stable Medicare patient panel. His lifetime Medicare revenue is $616.6K with no Medicaid billing on file, making his public payer footprint effectively single-payer (Medicare-only) based on available claims data. Revenue concentration is high: the top 3 Medicare codes by revenue account for 69.5% of total Medicare revenue, signaling dependence on a small set of services for the majority of billed dollars. The single largest revenue driver is J0178 (injection, aflibercept) at $260.1K or 42.2% of Medicare revenue, showing the practice performs a substantial volume of intravitreal anti-VEGF therapy as a core service line. Surgical cataract extraction with IOL insertion (66984) and comprehensive established patient visits (92014) are the other top contributors, at $97K (15.7%) and $71.9K (11.7%) respectively, which together with J0178 define a mixed surgical and medical retina/clinic practice model focused on cataract surgery and intravitreal injections. Competitive standing across his top codes is mixed: J0178 volume is described as "typical, unremarkable" (32nd percentile nationally), 66984 is typical but at the 72nd percentile nationally, while 92014 is "notably above typical" (95th percentile), indicating above-average clinic visit volume but only modest market share in aflibercept injections. Additional services such as intravitreal injection as an isolated procedure (67028), YAG capsulotomy (66821), and diagnostic imaging (92134, 92136, 92133) comprise meaningful secondary revenue streams, consistent with comprehensive ophthalmology practice support services rather than a high-volume, specialized injection center. The absence of any Medicaid billing suggests this provider either does not contract with or does not see a measurable Medicaid population; contracting or referral strategies and payer mix should be reviewed if Medicaid access or captive market share is a concern for network planning or population health initiatives. National percentile descriptors provided by the data (e.g., "notably above typical", "typical, unremarkable") support that the provider is an established, well-utilized general ophthalmologist in Medicare but not a dominant national outlier for most high-revenue procedures, with service mix concentrated in cataract surgery, comprehensive exams, and anti-VEGF injections.