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.

Elizabeth Verner-cole (NPI 1205153905)

Field	Value
Entity Type	Individual
Organization	Elizabeth Verner-cole
Address	12817 Se 93rd Ave
City	Clackamas
State	OR
ZIP	97015
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	April 21, 2010

Payer Source	Total Paid
Medicare	$1.7M
Medicaid	$0

Key Findings

Practice is heavily procedure-driven and focused on retinal injections: the three highest-revenue Medicare codes are J0178, J2777, and 67028, which together account for 88.1% of this provider's Medicare revenue; the largest single contribution is J0178 at $941.2K (55.6% of Medicare revenue), indicating intravitreal anti-VEGF therapy is the primary service line.

Revenue concentration is pronounced: with total Medicare revenue of $1.7M and the top three codes contributing 88.1% of that amount, this provider’s Medicare economics are highly dependent on a small set of injection and injection-related procedure codes rather than broad office-service mix.

Payer mix is effectively single-payer Medicare: there is no Medicaid billing on file, so Medicare ($1.7M total) represents the material public-payor footprint and there is no recorded Medicaid activity to diversify public payer exposure.

Competitive standing for the principal drug codes is mid-tier nationally: J0178 ranks #913 of 3204 (71th percentile; typical, unremarkable volume) and J2777 ranks #710 of 2039 (65th percentile; typical, unremarkable volume), so the provider is a modest, regionally active user of these injectables rather than a national outlier or dominant center.

Office evaluation and retinal imaging volumes are notable outliers relative to peers: 99213 generated $50.6K and ranks #11751 of 457151 (97th percentile; notably above typical national volume) and 92134 generated $50.2K and ranks #1496 of 26868 (94th percentile; notably above typical national volume), signaling higher-than-typical office follow-up and retinal imaging activity for an established-retina practice.

Other supporting codes show a conventional retina practice mix: 67028 (intravitreal injection procedure) produced $111.6K (6.6% of Medicare revenue) and ranks #1223 of 4255 (71th percentile; typical, unremarkable volume), while J7312 and J7999 add smaller but expected shares ($44.5K and $28.9K respectively) consistent with intravitreal implant use and compounded drugs.

Tenure is established: the NPI was enumerated 2010-04-21 (~16 years ago), indicating long-standing practice presence in the market that likely supports sustained referral and injection volume rather than a new entrant profile.

Operational implication for payers and network planners: because injections (J0178, J2777) dominate revenue and there is no Medicaid activity on file, contracting or utilization management interventions should focus on intravitreal drug utilization and follow-up visit/imaging patterns (given high percentiles on 99213 and 92134) rather than broad primary-care or Medicaid-related service lines.

Medicare: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,380	$680	$941.2K
J2777	Injection, faricimab‑svoa, 0.1 mg	15,120	$30	$438.5K
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.	1,130	$100	$111.6K
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…	770	$70	$50.6K
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.	1,520	$30	$50.2K
J7312	Injection, dexamethasone, intravitreal implant, 0.1 mg	300	$150	$44.5K
J7999	Compounded drug, not otherwise classified	400	$70	$28.9K
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…	220	$90	$20.7K
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…	30	$110	$2.7K
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…	20	$110	$1.7K

Showing 1–10 of 13

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Oregon Distribution

Elizabeth Verner-cole — 1 of 13 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

13 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	15	60	840	$680	$623.7K
J2777	11	30	10,050	$30	$527.6K
67028	20	70	580	$90	$72.3K
J7312	4	10	300	$150	$47.7K
J7999	19	50	270	$70	$23.4K
92014	142	440	110	$80	$16K
92235	30	30	60	$100	$11.1K
92134	24	390	80	$30	$8.1K
99213	53	5,480	60	$50	$5.7K
99204	1,492	2,750	30	$110	$4.4K

Showing 1–10 of 13

Related Providers

Other providers that share a Tax Identification Number (TIN) with Elizabeth Verner-cole, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eye Health Northwest, PC	OR	Ophthalmology Physician	$0	$15.7M
Stephen Davis	AR	Retina Specialist (Ophthalmology) Physician	$2.5M	$4.7K
Christopher Aderman	OR	Retina Specialist (Ophthalmology) Physician	$2.2M	$0
Jonathan Yoken	OR	Retina Specialist (Ophthalmology) Physician	$1.5M	$0
Brian Chan-kai	OR	Retina Specialist (Ophthalmology) Physician	$1.3M	$0
Joseph Simonett	OR	Ophthalmology Physician	$532.6K	$0
Christopher Kirkpatrick	WI	Ophthalmology Physician	$288.6K	$0
David Sanders	OR	Ophthalmology Physician	$229.6K	$0
Jonathan Kemp	OR	Ophthalmology Physician	$221.9K	$0
Shane Kim	OR	Ophthalmology Physician	$191.1K	$0

Nearby Providers

Other providers in the same ZIP code as Elizabeth Verner-cole, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kaiser Foundation Hospitals	OR	General Acute Care Hospital	$0	$18M
Northwest Medical, LLC.	OR	Oxygen Equipment & Supplies (DME)	$0	$9.8M
First Transit, Inc.	OR	Transportation Broker	$0	$6.7M
Rupa K. Shah, Md, PC	OR	Pediatrics Physician	$0	$5.5M
Sleep Technologies Ltd	OR	Durable Medical Equipment & Medical Supplies	$0	$3.9M
Clackamas County	OR	Federally Qualified Health Center (FQHC)	$0	$3.3M
Active Recovery Tms PLLC	OR	Psychiatry Physician	$0	$2.4M
Kaiser Foundation Hospitals	OR	Ambulatory Surgical Clinic/Center	$6.9K	$1.9M
Crossing Bridges Counseling Center	OR	Mental Health Counselor	$0	$1.9M
Kaiser Foundation Hospitals	OR	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.8M

Elizabeth Verner-cole — 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