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.

Daniel Whipple (NPI 1164413431)

Field	Value
Entity Type	Individual
Organization	Daniel Whipple
Address	2601 Stout Heritage Pkwy Ste 100
City	Plainfield
State	IN
ZIP	46168
Taxonomy	Ophthalmology Physician
NPI Enumerated	November 4, 2005

Payer Source	Total Paid
Medicare	$1.9M
Medicaid	$0

Key Findings

This provider’s billing is effectively single‑payer Medicare: total Medicare revenue is $1.9M while there is no Medicaid billing on file, and the top three Medicare codes account for 90.8% of the provider’s Medicare revenue. That high concentration means the practice’s financial profile is heavily tied to a small set of procedure lines rather than a broad mix of payers or services.

Revenue is extraordinarily concentrated in anti‑VEGF therapy: J0178 accounts for $1.5M in revenue (81.9% of this provider's total Medicare revenue) alone, and the precomputed top‑3 share is 90.8%. For analysts, this signals that changes in Medicare coverage, reimbursement, or utilization of intravitreal biologics would have outsized impact on this provider’s topline.

The code mix indicates an injection‑centered ophthalmology practice with supplemental cataract work: J0178 (large anti‑VEGF volume), 67028 ($104.2K revenue, 5.6%) for intravitreal injection procedure entries, and 66984 ($61.9K revenue, 3.3%) for cataract with IOL insertion. The presence of 67028 and 66984 alongside dominant J0178 billing suggests the practice performs high-volume intravitreal injections and maintains some cataract surgical activity, but surgery represents a much smaller share of revenue than injections.

Competitive standing on key codes is mixed: for J0178 the provider ranks #425 of 3204 nationally (87th percentile; typical, unremarkable volume), indicating above‑median national volume but not an extreme outlier; 67028 ranks #1286 of 4255 (70th percentile; typical, unremarkable), and 66984 ranks #6153 of 15965 (61th percentile; typical, unremarkable). In short, the provider is a meaningful regional participant for injection therapies but not a dominant national outlier in cataract surgery.

Diagnostic and monitoring services are relatively prominent and consistent with frequent intravitreal management: 92134 shows 1.5K claims with $42K revenue (2.2% of Medicare revenue) and ranks #1523 of 26868 (94th percentile; notably above typical national volume). Additional imaging/biometry codes (92133, 92136) are present and support an integrated injection/monitoring workflow rather than an exclusively surgical practice.

Ambulatory evaluation-and-management activity shows a focus on established patients and higher‑complexity visits: 99214 has 549 claims with $46.7K revenue (2.5%) and ranks #41723 of 479517 (91th percentile; typical, unremarkable volume), while 99213 and other E/M codes appear at lower volumes. This pattern aligns with frequent follow‑up visits required for chronic retinal disease management in a primarily injection‑based practice.

The provider’s limited use of lower‑cost biologic bevacizumab relative to aflibercept is visible in the drug billing mix: J9035 (bevacizumab) accounts for 319 claims and $16.9K revenue (0.9%), far smaller than J0178’s $1.5M (81.9%). Payers and contracting teams should note the strong tilt toward aflibercept in the injectable portfolio when evaluating utilization management or formulary strategies.

Operational tenure is long: NPI enumerated 2005-11-04 (~21 years ago), indicating an established practice likely with steady referral patterns. That longevity, combined with concentrated anti‑VEGF billing, suggests entrenched clinical workflows oriented around frequent injections and associated imaging/follow‑up care.

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	2,230	$690	$1.5M
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.	1,090	$100	$104.2K
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…	160	$380	$61.9K
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…	550	$90	$46.7K
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.	1,500	$30	$42K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	120	$220	$25.4K
J9035	Injection, bevacizumab, 10 mg	320	$50	$16.9K
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…	210	$60	$12.5K
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…	140	$70	$9.2K
92083	The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for an extended…	150	$40	$6.2K

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

Daniel Whipple — 1 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	11	60	830	$690	$868.8K
66984	110	450	50	$480	$87.5K
67028	27	80	550	$80	$78.6K
66821	68	240	60	$200	$23.1K
J9035	11	30	200	$50	$19.2K
99214	863	10,540	110	$80	$15.5K
92014	296	740	100	$70	$12.9K
99213	2,105	10,820	80	$50	$7.6K
92136	84	160	190	$20	$7.1K
92134	29	660	60	$30	$6K

Showing 1–10 of 16

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Midwest Eye Consultants, P.C.	IN	Optometrist	$0	$3.6M
Midwest Eye Consultants, P.C.	IN	Ambulatory Surgical Clinic/Center	$840.8K	$749.4K
Midwest Eye Consultants, P.C.	IN	Ambulatory Surgical Clinic/Center	$907K	$515.6K
Thucanh Multerer	PA	Retina Specialist (Ophthalmology) Physician	$862.9K	$139.4K
Kuumba Long	IN	Ophthalmology Physician	$668.1K	$0
Midwest Eye Consultants, P.C.	IN	Ambulatory Surgical Clinic/Center	$317K	$85.2K
Michael Coleman	MI	Ophthalmology Physician	$399.7K	$0
Randal Hughes	IN	Ophthalmology Physician	$365.1K	$0
Stephen Kimmell	IN	Optometrist	$353K	$460
William Keeling	IN	Ophthalmology Physician	$263.5K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hamilton Center Inc.	IN	Methadone Clinic	$0	$4.8M
Town Of Plainfield	IN	Ambulance	$312.9K	$1.4M
Philip Borders	IN	Psychiatry Physician	$122.9K	$0
Daniel Hill	IN	Diagnostic Radiology Physician	$84.6K	$0
Tracy Lee	IN	Foot & Ankle Surgery Podiatrist	$82.9K	$0
Cindy De Neira	IN	Family Medicine Physician	$66.9K	$0
Jay Toole	IN	Occupational Therapist	$66.2K	$0
Kimberly Lockridge	IN	Foot & Ankle Surgery Podiatrist	$55K	$0
Rachel Muessel	IN	Optometrist	$53.9K	$0
Ryan Rodela	IN	Foot & Ankle Surgery Podiatrist	$48.2K	$0

Daniel Whipple — Billing Profile & Reimbursement Data

Sign up for Daniel Whipple — Billing Profile & Reimbursement Data policy alerts

Daniel Whipple — Billing Profile & Reimbursement Data

Sign up for Daniel Whipple — 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