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

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

Joseph Mackey (NPI 1114124575)

Field	Value
Entity Type	Individual
Organization	Joseph Mackey
Address	1011 West Second Street
City	Bloomington
State	IN
ZIP	47403
Taxonomy	Ophthalmology Physician
NPI Enumerated	June 29, 2007

Payer Source	Total Paid
Medicare	$2M
Medicaid	$0

Key Findings

This provider’s Medicare footprint is concentrated and procedural: total Medicare revenue is $2M with the top three Medicare codes by revenue accounting for 85.3% of that total, indicating the practice is highly focused on a few high-value ophthalmology services rather than a broad mix of low‑revenue E/M visits. The code mix (J0178, 66984, J3490) aligns with retina/injection therapies and cataract surgery, suggesting the operation centers on intravitreal biologic injections and cataract procedure volume as its primary service lines.

J0178 (aflibercept injection) is the dominant revenue driver for this provider, generating $1.4M and representing 67.0% of Medicare revenue. Nationally the provider ranks #544 of 3204 (83rd percentile) on J0178, which the source labels as typical/unremarkable volume; this positions the provider as a meaningful local user of anti-VEGF therapy without being an extreme national outlier.

66984 (complex cataract/lens insertion after extracapsular cataract removal) is the second-largest revenue source at $247.4K (12.2% of Medicare revenue), and the provider ranks #2419 of 15965 nationally (85th percentile) for this code. That percentile indicates above‑typical but still within expected national practice for cataract procedure volume, reinforcing that the practice combines surgical cataract care with injection-based retina services.

J3490 (unclassified drugs) accounts for $122.1K (6.0% of Medicare revenue) and the provider ranks at the 50th percentile nationally (#1408 of 2838) for this code, characterized as typical/unremarkable. The presence of substantial J3490 revenue alongside a dominant biologic injection code suggests occasional use of billable miscoded or miscellaneous drugs billed under J3490 rather than a large diversified pharmaceutical portfolio.

Non-procedural evaluation and management codes (99213 and 99214) together contribute a modest share of revenue ($35.7K and $32.7K respectively) but show high national percentiles (99213 at the 96th percentile, 99214 at the 85th percentile). This pattern indicates that while office visits are not the main revenue source, the provider bills relatively high volumes of established-patient office visits compared with peers, consistent with ongoing follow-up care for surgical and intravitreal treatment patients.

Operationally this appears to be a long‑tenured ophthalmology practice: the NPI was enumerated on 2007-06-29 (~19 years ago), which supports experience and an established referral base for cataract surgery and retina injections. That tenure combined with a concentrated revenue mix suggests a stable, procedure-focused practice model.

Payer mix is effectively single-payer from the available data: Medicaid billing is absent (no Medicaid billing on file) while Medicare accounts for measurable revenue ($2M). The lack of Medicaid activity implies the provider’s patient panel, reimbursement strategy, or contracting may be oriented primarily toward Medicare beneficiaries and commercially insured patients rather than state Medicaid programs.

Competitive standing by code shows mixed positioning: for several diagnostic and procedure codes the provider ranks in high national percentiles (for example 66821 at the 96th percentile and 92136 at the 97th percentile), indicating notably above‑typical volumes in post‑cataract laser capsulotomy and IOL biometry. At the same time, key retina procedure J0178 is described as typical/unremarkable nationally, so the provider is a meaningful but not extreme national player in anti‑VEGF therapy.

There are no clear statistical red flags in the supplied descriptors; most codes are labeled typical/unremarkable or notably above typical rather than extreme outliers. The revenue concentration (85.3% from the top three codes) is high but consistent with a specialized ophthalmology practice that focuses on injections and cataract surgery rather than broad primary-care style billing.

Medicare: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,980	$690	$1.4M
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…	690	$360	$247.4K
J3490	Unclassified drugs	60	$2,110	$122.1K
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.	1,030	$80	$82K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	310	$210	$66.9K
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…	620	$60	$35.7K
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…	390	$80	$32.7K
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.	1,130	$30	$31.7K
92136	The provider uses a noninvasive method to measure the patient’s eye or eyes to get information that the provider then uses to calculate the appropriate power for an intraocular lens (IOL). Selecting…	720	$30	$21.5K
66982	The provider inserts an intraocular lens prosthesis after extracapsular cataract extraction using complex techniques and devices. He may perform this by means of an iris expansion device, providing…	30	$480	$15.3K

Showing 1–10 of 16

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Indiana Distribution

Joseph Mackey — 2 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. state median

16 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	12	60	830	$690	$868.8K
66984	35	450	50	$480	$87.5K
67028	28	80	550	$80	$78.6K
66982	62	120	30	$600	$29.4K
66821	20	240	60	$200	$23.1K
92235	34	40	90	$100	$15.8K
99214	1,622	10,540	110	$80	$15.5K
J3490	13	40	50	$180	$12.8K
99213	331	10,820	80	$50	$7.6K
92136	17	160	190	$20	$7.1K

Showing 1–10 of 16

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Frank Hrisomalos	IN	Retina Specialist (Ophthalmology) Physician	$2.2M	$0
Integ Health System, P.C.	IN	Ambulatory Surgical Clinic/Center	$1.8M	$403.1K
Warren Chang	IN	Ophthalmology Physician	$1.5M	$0
Andrew Huck	IN	Ophthalmology Physician	$940.5K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Centerstone Of Indiana, Inc.	IN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$318.8M
Southern Indiana Pediatrics, LLC	IN	Pediatrics Physician	$0	$10.7M
Limestone Health, LLC	IN	Methadone Clinic	$116.1K	$9M
Prime Healthcare Services - Monroe LLC	IN	General Acute Care Hospital	$0	$5.7M
Hands At Home, LLC	IN	Home Health Agency	$0	$4.1M
Bloomington Pediatric Dentistry L.L.C.	IN	Pediatric Dentistry	$0	$3.1M
Southern Indiana Surgery Center, LLC	IN	Ambulatory Surgical Clinic/Center	$1.4M	$516.1K
Bloomington Advanced Surgery Center, LLC	IN	Ambulatory Surgical Clinic/Center	$1.1M	$0
Bloomington Asc, LLC	IN	Ambulatory Surgical Clinic/Center	$706.5K	$0
Bloomington Endoscopy Center, LLC	IN	Ambulatory Surgical Clinic/Center	$663.6K	$0

Joseph Mackey — 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