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.

Cheryl Lee (NPI 1053611400)

Field	Value
Entity Type	Individual
Organization	Cheryl Lee
Address	475 Bradley Blvd
City	Richland
State	WA
ZIP	99352
Taxonomy	Ophthalmology Physician
NPI Enumerated	November 1, 2010

Payer Source	Total Paid
Medicare	$1.5M
Medicaid	$0

Key Findings

CHERYL LEE is an Ophthalmology Physician based in RICHLAND, WA with an NPI enumerated on 2010-11-01 (~16 years ago). Lifetime billing shows Total Medicare revenue: $1.5M and no Medicaid billing on file, indicating the provider operates effectively as a Medicare-focused practice rather than a dual-payer operation. The longevity of enrollment suggests an established outpatient practice footprint in the market.

Revenue is highly concentrated: the precomputed top 3 Medicare codes (J0178, 67028, 92134) account for 88.2% of this provider's total Medicare revenue, with J0178 alone representing 75.9% of Medicare dollars. This concentration indicates that a very small set of services drives nearly all billed Medicare revenue, which amplifies the business impact of reimbursement or utilization changes for those codes.

The code mix points to a retina-centered, procedure-heavy practice model: J0178 (aflibercept injection) has 1.7K claims and dominates revenue, supported by high volumes of intravitreal procedures (67028, 1.6K claims) and retinal imaging (92134, 1.5K claims). Office-based evaluation and management (92014, 436 claims; 99214 and 99213 combined) and surgical cataract work (66984: 80 claims) compose only a minority of revenue, implying the practice focuses on recurring injection visits and diagnostic imaging rather than primary care ophthalmology or high-volume cataract surgery.

Competitive standing is mixed across top codes: J0178 ranks #726 of 3204 providers nationally (77th percentile; typical, unremarkable volume), meaning the provider posts solid but not exceptional national volume for aflibercept injections. 67028 ranks #684 of 4255 (84th percentile; typical, unremarkable volume), which places intravitreal injection procedural volume above average but still characterized by the source data as within a typical range nationally.

Statistical outliers and relative strengths are evident in imaging and alternative drug use: 92134 ranks #1490 of 26868 providers (94th percentile; notably above typical national volume), signaling unusually high OCT imaging activity relative to peers and reinforcing a retina-focused workload. By contrast, J9035 (bevacizumab) shows 786 claims and ranks #123 of 1852 providers (93th percentile; typical, unremarkable volume) and is labeled in the source as typical despite its high percentile rank, indicating sizable but not atypical use of off-label bevacizumab in this provider's mix.

Clinical revenue mix suggests operational implications: recurring, high-frequency injection appointments (many small, procedure-focused encounters) likely dominate scheduling, staffing, and supply workflows given 1.7K J0178 claims and 1.6K 67028 claims. The lower contribution from E/M codes (92014, 99214, 99213) suggests fewer long, complex office-based evaluation visits relative to procedure throughput, which may shape staffing and facility needs toward procedure suites and imaging capacity.

Concentration risk and opportunity are both present: dependence on J0178 for 75.9% of Medicare revenue makes the practice sensitive to changes in aflibercept utilization, reimbursement, or clinical guidelines, while the notably high 92134 imaging volume (94th percentile) and established injection throughput present opportunities to expand retina-care pathways or ancillary services tied to retinal disease management. Given Total Medicare revenue: $1.5M and no Medicaid billing on file, payer diversification is limited and any strategic or reimbursement shifts in Medicare-covered retinal therapies would have outsized financial impact.

Medicare: Complete Services Breakdown

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,650	$690	$1.1M
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.	1,610	$90	$138.7K
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.	1,530	$30	$45.8K
J9035	Injection, bevacizumab, 10 mg	790	$50	$41.7K
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…	440	$90	$38.4K
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	80	$420	$33.8K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	220	$90	$20.2K
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…	220	$60	$13.3K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	310	$30	$8.8K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	30	$230	$6.9K

Showing 1–10 of 17

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Washington Distribution

Cheryl Lee — 1 of 17 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

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	21	90	470	$680	$597.2K
66984	177	460	50	$560	$97.5K
67028	18	110	550	$90	$72.9K
66821	175	260	50	$230	$20.4K
92014	106	790	110	$80	$16.8K
99214	2,432	10,860	100	$80	$13.6K
J9035	2	40	70	$50	$10.9K
92134	37	700	70	$30	$7.6K
99213	1,254	9,690	60	$60	$6.5K
92136	159	230	140	$20	$5.5K

Showing 1–10 of 17

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kentucky Medical Services Foundation, Inc	KY	Internal Medicine Physician	$0	$110.4M
Central Washington Health Services Association	WA	General Acute Care Hospital	$0	$63.5M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
The Aroostook Medical Center	ME	General Acute Care Hospital	$0	$38.5M
Wenatchee Valley Hospital	WA	General Acute Care Hospital	$0	$22.9M
Wenatchee Valley Hospital	WA	Multi-Specialty Clinic/Center	$0	$19.5M
Wenatchee Valley Hospital	WA	Rural Health Clinic/Center	$0	$14.1M
Kentucky Medical Services Foundation	KY	Nurse Practitioner	$0	$12.5M
Central Washington Health Services Association	WA	General Acute Care Hospital	$0	$10.9M
Wenatchee Valley Hospital	WA	Rural Health Clinic/Center	$0	$8.6M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kadlec Regional Medical Center	WA	General Acute Care Hospital	$0	$151.5M
Gill, Ritchie, Walker PLLC	WA	Ambulatory Surgical Clinic/Center	$0	$10.7M
City Of Richland	WA	Ambulance	$679.8K	$7.8M
Ortc, LLC	WA	Methadone Clinic	$0	$6.2M
Health First Urgent Care, PLLC	WA	Urgent Care Clinic/Center	$0	$5.2M
American Medical Response Ambulance Service Inc	WA	Ambulance	$1.1M	$3M
Total Renal Care Inc	WA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.8M
Tri-city Orthodontics, LLC	WA	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$2.9M
Alexey Ryskin	WA	Pain Medicine (Anesthesiology) Physician	$2.3M	$990
Sidney Smith	WA	Dermatology Physician	$2.1M	$0

Cheryl Lee — 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