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

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

David Westrich (NPI 1114051661)

Field	Value
Entity Type	Individual
Organization	David Westrich
Address	360 S Mount Auburn Rd
City	Cape Girardeau
State	MO
ZIP	63703
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	March 15, 2007

Payer Source	Total Paid
Medicare	$3.3M
Medicaid	$0

Key Findings

DAVID WESTRICH is a retina-focused ophthalmology practice with a heavy procedural mix dominated by intravitreal injections and high-volume diagnostic exams. The three largest Medicare revenue drivers — J0178 ($1.6M revenue, 49.3%), J2777 ($412.4K revenue, 12.4%), and 92012 ($290.6K revenue, 8.7%) — reflect outpatient retina care concentrated on anti-VEGF/antibody therapy and intermediate established-patient eye exams.

Revenue is highly concentrated: the precomputed top three Medicare codes account for 70.4% of this provider's total Medicare revenue, and J0178 alone represents 49.3% of Medicare payments. With total Medicare revenue of $3.3M and no Medicaid billing on file, the provider’s financial footprint is essentially single-payer Medicare-driven.

The payer mix is effectively single-payer: Medicare accounts for $3.3M in lifetime revenue while there is none recorded for Medicaid, so analysts should treat this entity as Medicare-concentrated with little to no Medicaid exposure. That absence of Medicaid billing may limit comparisons to in-state Medicaid activity or suggest limited participation in Medicaid networks.

Competitive standing is mixed across services: 92012 ranks #1 of 17177 providers nationally (100th percentile) and is described as an extreme outlier, indicating exceptional national volume for intermediate established-patient eye exams. By contrast, J0178 (aflibercept) ranks #352 of 3204 (89th percentile) and is labelled typical/unremarkable for national volume, so the practice is not dominant nationally for this high-revenue drug despite it driving a large share of revenue.

The practice demonstrates a diversified intravitreal drug mix with both high-revenue and high-claim contributors. J2777 shows very high claim volume (14.2K claims) but a low average paid/claim ($29), J0179 (brolucizumab) contributes $148.8K across 600 claims, and J9035 (bevacizumab) contributes $130.6K while ranking as an extreme outlier (99th percentile) — together these patterns indicate routine use of multiple biologic agents rather than reliance on a single medication.

Surgical and procedural retina activity is material: 67028 (intravitreal injection as an isolated procedure) accounts for $275.9K (8.3% of Medicare revenue) with 3.2K claims and ranks #74 of 4255 providers (98th percentile, notably above typical national volume). Less frequent but higher‑paid surgical codes such as 67041 and 67042 appear on the profile as well, confirming that the practice undertakes both office-based injections and some operative vitreoretinal procedures.

High utilization of retinal imaging and specialized ophthalmoscopy supports an intensive diagnostic workflow. Codes like 92134 (4.3K claims, $112K revenue) rank #99 of 26868 (100th percentile, extreme outlier) and 92202 (5.5K claims, $55.2K revenue) ranks #1 of 2327 (100th percentile, extreme outlier), indicating the practice performs large volumes of OCT/retinal imaging and extended ophthalmoscopy which likely underpin its injection and management throughput.

The provider has a long-tenured Medicare enrollment (NPI enumerated 2007-03-15, ~19 years ago), consistent with sustained Medicare billing ($3.3M lifetime revenue) and the extensive procedural volumes reported. That tenure, combined with multiple extreme outlier ranks across exams and imaging, suggests an established retina practice that functions as a high-throughput clinical center for older adults on Medicare.

Medicare: Complete Services Breakdown

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

30 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,410	$680	$1.6M
J2777	Injection, faricimab‑svoa, 0.1 mg	14,220	$30	$412.4K
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	5,010	$60	$290.6K
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.	3,250	$90	$275.9K
J0179	Injection, brolucizumab-dbll, 1 mg	600	$250	$148.8K
J9035	Injection, bevacizumab, 10 mg	2,290	$60	$130.6K
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…	1,660	$80	$126.3K
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.	4,310	$30	$112K
92202	The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece…	5,520	$10	$55.2K
67041	In this procedure, the provider removes scar tissue from the retinal membrane that obscures vision. He removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical…	30	$820	$24.7K

Showing 1–10 of 30

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 30 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Missouri Distribution

David Westrich — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. state median

30 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	4	60	820	$690	$683.3K
J2777	19	50	11,730	$30	$388.9K
J0179	1	10	290	$240	$85.2K
67028	1	80	600	$90	$69.7K
J2781	5	10	650	$120	$65.4K
67042	26	30	20	$1,070	$26.8K
J9035	1	40	170	$60	$21.8K
66821	173	220	50	$210	$21.2K
92014	3	730	120	$80	$18K
67041	1	10	10	$1,080	$17.3K

Showing 1–10 of 30

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tatyana Metelitsina	MO	Retina Specialist (Ophthalmology) Physician	$1.1M	$0
Eric Mann	IL	Ophthalmology Physician	$950.6K	$0
John Kinder	MO	Ophthalmology Physician	$495.8K	$0
Derrall Parker	MO	Ophthalmology Physician	$455.5K	$0
Todd Lumsden	MO	Ophthalmology Physician	$441.3K	$0
Bradley Stuckenschneider	MO	Ophthalmology Physician	$390.1K	$0
Byron Santos-flores	MO	Ophthalmology Physician	$63.3K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Counseling Center	MO	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$91.4M
Saint Francis Medical Center	MO	General Acute Care Hospital	$0	$56.4M
Semo Alliance For Disability Independence, Inc.	MO	Attendant Care Provider	$0	$27.3M
Regency Management, Inc	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$18M
Blue Sky Cimmunity Services	MO	Developmentally Disabled Services Day Training Agency	$0	$14M
Saint Francis Medical Center	MO	Internal Medicine Physician	$0	$11.7M
Semo Alliance For Disability Independence	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$9.3M
Crown Hospice Inc	MO	Community Based Hospice Care Agency	$0	$8.3M
Cape Radiology Group, P.C.	MO	Diagnostic Radiology Physician	$0	$5.5M
Doctors Park Surgery Inc	MO	Ambulatory Surgical Clinic/Center	$1.2M	$0

David Westrich — 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