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    OpenPayerNPI Medicare & MedicaidScott Simpson
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    Scott Simpson — Billing Profile & Reimbursement Data

    NPI 1083656334 · Meridian, ID · Ophthalmology Physician

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    Scott Simpson is a ophthalmology physician provider located in Meridian, Idaho. This profile covers 7 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationScott Simpson
    Address3715 E Overland Road
    CityMeridian
    StateID
    ZIP83642
    TaxonomyOphthalmology Physician
    NPI EnumeratedJune 12, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$478.9K
    Medicaid$0

    Key Findings

    This provider's Medicare activity is concentrated in retina-focused procedures and high-volume established-patient visits: J0178 (aflibercept injection) accounts for $244.6K or 51.1% of Medicare revenue, 92014 (established comprehensive eye exam) accounts for $104K or 21.7%, and J2777 (faricimab) contributes $55.7K or 11.6%; the top three codes together represent 84.4% of the provider's total Medicare revenue. The code mix (intravitreal drug injections J0178 and J2777, retina imaging 92134, and frequent established-patient exams 92014) is consistent with an ophthalmology practice that manages chronic posterior-segment disease and delivers frequent in-office injections and follow-up visits. The scale of lifetime Medicare revenue is modest at $478.9K, indicating a relatively small independent practice footprint in Medicare dollars despite the high concentration in a few high-value services. The provider appears effectively single‑payer from a claims perspective: no Medicaid billing is on file, so Medicare represents essentially the entire public-payer footprint and creates concentrated exposure to Medicare reimbursement dynamics. Competitive standing is mixed by code: 92014 ranks notably above typical national volume (97th percentile), signaling strong office visit throughput relative to peers, while J0178 and J2777 are described as typical, unremarkable volumes nationally, indicating the provider is not a dominant national injector for those drugs. Several other procedure codes (92134, 67028, J9035) contribute smaller shares and are also labeled typical, unremarkable volume, so aside from high visit volume the provider does not display multiple national outlier positions. The provider's NPI was enumerated on 2006-06-12 (~20 years ago), indicating long tenure in the Medicare program, which supports the interpretation that current patterns reflect an established clinical workflow rather than a short-term billing anomaly. The revenue concentration (84.4% in the top three codes and 51.1% from a single code J0178) suggests operational and financial sensitivity to changes in reimbursement, utilization of these drugs, or shifts in clinical practice that affect intravitreal injection volume or drug selection.

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    7 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J0178Injection, aflibercept, 1 mg350$700$244.6K
    92014An 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…1,250$80$104K
    J2777Injection, faricimab‑svoa, 0.1 mg1,920$30$55.7K
    92134The 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.1,130$30$30.6K
    67028The 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.330$80$27.1K
    92004The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.100$100$9.7K
    J9035Injection, bevacizumab, 10 mg130$60$7.4K

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    7 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J01781920670$690$541.7K
    J277713108,640$30$454.7K
    670281930470$90$66.6K
    920141230120$70$15.5K
    J9035410100$50$6.4K
    921341019060$30$5.9K
    920042618030$80$4.4K

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Norco, Inc.IDDurable Medical Equipment & Medical Supplies$0$41M
    Joint School District No. 2IDLocal Education Agency (LEA)$0$34.2M
    Chatterbox Speech & Language CenterIDSpeech-Language Pathologist$0$10.6M
    St. Fillan's, LLCIDIn Home Supportive Care Agency$0$10.5M
    Southern Idaho Health Partners LLCIDGeneral Practice Physician$0$9.2M
    Gem State Developmental Center LLCIDDevelopmentally Disabled Services Day Training Agency$0$9.1M
    Addus Healthcare, Inc.IDIn Home Supportive Care Agency$0$6.1M
    Northwest Neurobehavioral Health, LLCIDClinical Social Worker$0$5.2M
    Idaho Pediatric Therapy Clinic PLLCIDPhysical Therapist$0$3.1M
    Cpapnow IncIDDurable Medical Equipment & Medical Supplies$0$3.1M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

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    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Idaho Distribution
    Scott Simpson — 2 of 7 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Idaho