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

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

Steven Bailey (NPI 1114032687)

Field	Value
Entity Type	Individual
Organization	Steven Bailey
Address	3181 Sw Sam Jackson Park Rd
City	Portland
State	OR
ZIP	97239
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	August 21, 2006

Payer Source	Total Paid
Medicare	$1M
Medicaid	$0

Key Findings

STEVEN BAILEY is a retina specialist enumerated on 2006-08-21 (~20 years ago) practicing in PORTLAND, OR; the procedure mix (dominant intravitreal drug codes and retina imaging) is consistent with a clinic focused on ongoing medical management of retinal disease. Total Medicare revenue is $1M and there is no Medicaid billing on file, indicating the provider operates effectively as a Medicare-focused practice in the available data.

Revenue is highly concentrated in a small set of injection and office-visit codes: the precomputed top 3 Medicare codes by revenue account for 84.2% of this provider's total Medicare revenue, with J0178 representing 64.3%, 67028 representing 10.8%, and 99214 representing 9.1%. This concentration shows the practice derives most of its Medicare income from recurring anti-VEGF therapy and associated follow-up care.

J0178 (962 claims, $670 avg paid/claim, $644.5K revenue, 64.3% of total Medicare revenue) is the single largest revenue driver and indicates heavy reliance on aflibercept injections as the primary treatment modality. Nationally this provider ranks #1323 of 3204 for J0178 (59th percentile; typical, unremarkable volume), which characterizes the injection volume as moderate relative to other national retina providers.

The practice reports high volumes of evaluation-and-management and imaging services that support chronic care: 99214 (1.1K claims, $83 avg paid/claim, $91.1K revenue, 9.1% of total) and 92134 (1.8K claims, $26 avg paid/claim, $46.9K revenue, 4.7% of total). Notably, 99214 ranks #9049 of 479517 nationally (98th percentile; extreme outlier, far above typical national volume), and 92134 ranks #1221 of 26868 (95th percentile; notably above typical national volume), indicating unusually high office-visit and retinal imaging intensity versus national peers.

Secondary injection activity is present but smaller: J2778 (393 claims, $177 avg paid/claim, $69.6K revenue, 6.9% of total) is used less heavily and ranks #858 of 1208 (29th percentile; typical, unremarkable volume), suggesting aflibercept dominates over ranibizumab in this clinician’s anti-VEGF mix. A nontrivial use of compounded drugs appears as well: J7999 (466 claims, $71 avg paid/claim, $33.1K revenue, 3.3% of total) ranks #179 of 1333 (87th percentile; typical, unremarkable volume), pointing to some reliance on compounded therapies in the drug portfolio.

Competitive standing is mixed by measure: the provider is a modest-to-typical participant for high-revenue biologic injections (J0178 at the 59th percentile, 67028 at #1134 of 4255, 73th percentile; typical, unremarkable volume), but is a clear outlier on E/M and imaging intensity (99214 extreme outlier at the 98th percentile and 92134 notably above typical at the 95th percentile). This pattern suggests strong local throughput of follow-up visits and diagnostic imaging even if injection volumes are not top-tier nationally.

Given the single-payer footprint in the available data (Total Medicare revenue: $1M and Total Medicaid revenue: none), business and payer-negotiation risk is concentrated in Medicare rate changes and utilization trends for high-cost biologics. The practice’s economics therefore appear sensitive to shifts in anti-VEGF pricing, frequency-of-care guidelines, and Medicare reimbursement for high-volume E/M and imaging services.

Medicare: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	960	$670	$644.5K
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.	1,190	$90	$108.7K
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…	1,100	$80	$91.1K
J2778	Injection, ranibizumab, 0.1 mg	390	$180	$69.6K
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.	1,800	$30	$46.9K
J7999	Compounded drug, not otherwise classified	470	$70	$33.1K
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…	90	$60	$4.8K
99204	The provider sees a new 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 provider…	40	$110	$4.2K
92235	The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken…	10	$30	$360

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Oregon Distribution

Steven Bailey — 2 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. state median

9 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	25	60	840	$680	$623.7K
J2778	11	20	400	$180	$87.8K
67028	17	70	580	$90	$72.3K
J7999	14	50	270	$70	$23.4K
92235	32	30	60	$100	$11.1K
99214	26	6,070	80	$70	$10.3K
92134	16	390	80	$30	$8.1K
99213	1,928	5,480	60	$50	$5.7K
99204	971	2,750	30	$110	$4.4K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Professional Services	OR	General Practice Physician	$0	$55.6M
Legacy Clinics LLC	OR	Clinic/Center	$35.6K	$48.7M
University Professional Services	OR	Pharmacy	$0	$8.1M
Rene Choi	OR	Ophthalmology Physician	$2.2M	$0
Dong-wouk Park	WA	Retina Specialist (Ophthalmology) Physician	$1.9M	$0
Scott Mcclintic	OR	Ophthalmology Physician	$1.7M	$0
Ngoc-lam Nguyen	FL	Orthopaedic Surgery of the Spine Physician	$1.3M	$0
University Professional Services	OR	General Practice Physician	$0	$988.2K
John Campbell	OR	Retina Specialist (Ophthalmology) Physician	$885.9K	$0
Andrew Henning	OR	Family Nurse Practitioner	$675.9K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Oregon Health & Science University	OR	General Acute Care Hospital	$0	$70.6M
Oregon Health & Science University	OR	Clinic/Center	$0	$52.1M
Shriners Hospitals For Children	OR	Children's Hospital	$0	$3.9M
Portland Dbt Institute, Inc.	OR	Cognitive & Behavioral Psychologist	$0	$3.7M
Housecall Providers, PC	OR	Family Medicine Physician	$0	$2M
Pediatric Orthotic And Prosthetic Services - Northwest, LLC	OR	Prosthetic/Orthotic Supplier	$0	$1.2M
Housecall Providers Services, LLC	OR	Community Based Hospice Care Agency	$0	$953.5K
Mind Solutions LLC	OR	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$952.2K
Merina Thomas	OR	Retina Specialist (Ophthalmology) Physician	$640.5K	$0
Nieraj Jain	OR	Ophthalmology Physician	$387.4K	$0

Steven Bailey — Billing Profile & Reimbursement Data

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Steven Bailey — 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