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

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

Patricia Cosgrove (NPI 1124017942)

Field	Value
Entity Type	Individual
Organization	Patricia Cosgrove
Address	3820 N. 27th Ave
City	Bozeman
State	MT
ZIP	59718
Taxonomy	Ophthalmology Physician
NPI Enumerated	October 14, 2005

Payer Source	Total Paid
Medicare	$292.2K
Medicaid	$0

Key Findings

This provider’s Medicare practice is driven primarily by cataract and routine ophthalmic care: the single largest revenue source is 66984 (cataract extraction with IOL) at $85.5K, supplemented by high-volume evaluation codes 92014 and 92012, indicating a mixed surgical and outpatient diagnostic practice focused on cataract surgery and follow-up eye exams. The top three Medicare codes by revenue account for 63.6% of total Medicare revenue, confirming a concentrated revenue mix where a few cataract and evaluation services dominate billings.

Total Medicare revenue on file is $292.2K and there is no Medicaid billing on file, so the provider operates effectively as a Medicare-only billing entity in the available data; payer mix is therefore highly skewed toward Medicare with no recorded Medicaid activity to offset or diversify revenue.

Competitive standing for the top codes is generally modest to above-average: 92014 ranks in the 94th percentile nationally and is described as "notably above typical national volume," signaling unusually high outpatient exam volume for an established-patient comprehensive eye exam. In contrast, 66984 ranks in the 67th percentile (described as typical, unremarkable volume) and 92012 is in the 88th percentile (typical, unremarkable volume), so the provider is particularly prominent for comprehensive established-patient exams while surgical cataract volume is closer to typical for peers.

Service-line implications from the code mix point to a full-scope ophthalmology practice that combines procedural surgery (66984, 66821) with diagnostic imaging and functional testing (92134, 92133, 92136, 92083) and office-based management (99214, 99204). The presence of 15823 (ptosis/upper eyelid skin surgery) and punctal procedures (68761, 68801) indicates some minor oculoplastic and lacrimal procedural capacity in addition to cataract care.

Tenure in the Medicare program is long: the NPI was enumerated on 2005-10-14 (approximately 21 years ago), indicating established presence in the Medicare market and likely sustained referral and patient volumes over time. That longevity combined with concentration in a few high-revenue codes suggests a stable, specialty-focused practice rather than a recent entrant or generalist.

Several codes are statistical outliers or notable by descriptor: 92014 is explicitly labeled "notably above typical national volume," which aligns with the 94th-percentile rank and highlights a referral or patient panel skew toward comprehensive established exams. Most other high-revenue codes are described as "typical, unremarkable volume," so aside from 92014 there are no extreme national outlier volumes in the top code set.

Given the lack of Medicaid claims, the provider’s competitive positioning should be evaluated primarily against Medicare peers; for Medicare cataract surgery (66984) the provider sits in the middle range nationally (67th percentile), so it is not a high-volume surgical outlier but does maintain meaningful surgical activity that complements a higher-than-typical office exam throughput.

Medicare: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	210	$420	$85.5K
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…	870	$80	$71.4K
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…	460	$60	$28.7K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	100	$270	$26.6K
15823	In this procedure, the provider surgically trims excessive skin that weighs down the upper eyelid, typically to improve the cosmetic appearance of the face and due to the interference of the tissue…	30	$660	$21.1K
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…	130	$90	$11.8K
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.	280	$30	$8.1K
68761	The provider places a plug to close off the lacrimal punctum and block excessive drainage of tears. He performs this procedure to treat dry eye syndrome.	40	$150	$6.7K
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.	70	$80	$6.2K
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…	60	$110	$6K

Showing 1–10 of 20

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Montana Distribution

Patricia Cosgrove — 0 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. state median

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
66984	23	120	50	$490	$78.1K
15823	6	10	30	$510	$23.6K
92014	11	170	190	$80	$22.7K
66821	16	70	50	$220	$18.3K
99214	779	1,810	100	$70	$12.4K
92012	6	50	80	$60	$11.9K
92136	10	30	270	$30	$8.9K
92134	31	160	100	$30	$7.8K
99204	198	780	30	$100	$4.8K
92004	28	150	40	$80	$4.4K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Angela Watkins	MT	Ophthalmology Physician	$449.5K	$0
Kristy Moeller	MT	Ophthalmology Physician	$426.7K	$0
Joseph Sheehan	MT	Ophthalmology Physician	$342.1K	$0
Lisa Herrygers	MT	Ophthalmology Physician	$260.7K	$0
Colin Mcinnis	MT	Glaucoma Specialist (Ophthalmology) Physician	$228.2K	$0
Shannon Currier	MT	Optometrist	$72.8K	$0
Callie Harberts	MT	Optometrist	$68.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wojj Pediatric Dentistry	MT	Dental Clinic/Center	$0	$3.3M
Smiles Across Montana	MT	Dental Hygienist	$0	$1.9M
West Bozeman Surgery Center, LLC	MT	Ambulatory Surgical Clinic/Center	$1.9M	$55K
Psychiatry Associates PC	MT	Psychiatry Physician	$0	$1.4M
Marc Comaratta	MT	Retina Specialist (Ophthalmology) Physician	$1.2M	$124.7K
Foundation Therapy Services Inc	MT	Speech-Language Pathologist	$0	$1.1M
Lincare Inc.	MT	Durable Medical Equipment & Medical Supplies	$0	$1M
Montana Psychiatry, PLLC	MT	Psychiatry Physician	$0	$1M
Kenneth Olson	MT	Addiction Psychiatry Physician	$29.3K	$809.9K
Aaron Bruce	MT	Dermatology Physician	$682.7K	$0

Patricia Cosgrove — Billing Profile & Reimbursement Data

Sign up for Patricia Cosgrove — Billing Profile & Reimbursement Data policy alerts

Patricia Cosgrove — Billing Profile & Reimbursement Data

Sign up for Patricia Cosgrove — Billing Profile & Reimbursement Data policy alerts

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