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

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

Marc Mathias (NPI 1073774121)

Field	Value
Entity Type	Individual
Organization	Marc Mathias
Address	12605 E 16th Ave
City	Aurora
State	CO
ZIP	80045
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	June 20, 2008

Payer Source	Total Paid
Medicare	$181.9K
Medicaid	$0

Medicare: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	1,070	$80	$81.5K
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…	1,100	$50	$59.5K
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.	1,920	$20	$34.5K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	60	$70	$3.9K
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,…	130	$20	$2.3K
92083	The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for an extended…	10	$20	$270

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Colorado Distribution

Marc Mathias — 2 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
67028	26	80	670	$100	$73.3K
92014	6	670	100	$80	$15.2K
92134	16	440	60	$30	$7.8K
92004	135	480	30	$90	$4.4K
92083	316	370	40	$40	$2.7K
92250	110	480	60	$30	$2.6K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Physicians Incorporated	CO	Internal Medicine Physician	$0	$190.8M
Children's Hospital Colorado	CO	Children's Hospital	$0	$114.9M
Denver Health And Hospital Authority	CO	General Practice Physician	$0	$95M
Denver Health And Hospital Authority	CO	General Acute Care Hospital	$0	$77.1M
Uch-mhs	CO	General Acute Care Hospital	$0	$69M
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$68.5M
University Of Colorado Hospital Authority	CO	General Acute Care Hospital	$0	$58.1M
Denver Health And Hospital Authority	CO	Ambulance	$3.4M	$46.3M
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$40.3M
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$29.4M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prosthetic & Orthotic Group Pediatric Specialists - Colorado LLC	CO	Prosthetic/Orthotic Supplier	$0	$7.3M
University Physicians Incorporated	CO	Clinical Medical Laboratory	$0	$6.7M
Children's Optical, LLC	CO	Pediatric Optometrist	$0	$6.4M
Rmchs Management	CO	Pediatric Dentistry	$0	$4.4M
University Physicians Incorporated	CO	Clinical Medical Laboratory	$271.4K	$3.4M
Marisa Lau	CO	Ophthalmology Physician	$2M	$0
Jorge Monge Urrea	CO	Hematology & Oncology Physician	$1.9M	$18.9K
University Physicians Incorporated	CO	Clinical Medical Laboratory	$509.9K	$886.9K
Rachel Chen	CO	Retina Specialist (Ophthalmology) Physician	$1M	$0
Jeffrey Olson	CO	Ophthalmology Physician	$983.2K	$0

Marc Mathias — Billing Profile & Reimbursement Data

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Marc Mathias — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References