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.

Albert Edwards (NPI 1215930763)

Field	Value
Entity Type	Individual
Organization	Albert Edwards
Address	1011 Valley River Way Ste 110
City	Eugene
State	OR
ZIP	97401
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	May 28, 2005

Payer Source	Total Paid
Medicare	$1.9M
Medicaid	$0

Key Findings

This provider bills exclusively to Medicare ($1.9M total Medicare revenue) with no Medicaid billing on file, making the practice effectively single-payer in the claim data and heavily dependent on Medicare volume for its revenue base. The absence of any Medicaid claims suggests minimal Medicaid exposure or nonparticipation in Medicaid networks rather than mixed payer operations.

Revenue is highly concentrated in intravitreal drug administration: J0178 accounts for $1.2M (60.9% of Medicare revenue), J2777 contributes $142.7K (7.5%), and J2781 contributes $126K (6.6%), and the precomputed top-three codes together represent 75.1% of the provider's Medicare revenue. This concentration indicates the practice’s financial backbone is dominated by high-cost retinal injectables rather than diverse outpatient services.

The code mix and volumes point to a procedure-driven retina specialty practice: substantial counts for injection-related codes (J0178 1.7K claims; 67028 1.2K claims, $113.2K revenue) and retinal imaging (92134 1.7K claims, $50.4K revenue) indicate routine, high-frequency intravitreal treatment and accompanying diagnostic imaging. These patterns are consistent with ongoing management of chronic retinal conditions requiring repeated injections and serial imaging.

Competitive standing on the nation-wide stage is mixed by drug: for J0178 the provider ranks #694 of 3204 (78th percentile) which is characterized as typical, unremarkable national volume — a solid but not dominant presence for aflibercept. For J2781 the provider ranks #111 of 490 (77th percentile, typical) while for J2777 the provider ranks #1541 of 2039 (24th percentile, typical), indicating comparatively lower adoption or volume with faricimab relative to peers.

Several non-drug service codes are reported at notably high national percentiles, signaling strong outpatient management activity: 99214 is in the 97th percentile (904 claims, $80.5K revenue) and 92134 is in the 95th percentile (1.7K claims, $50.4K revenue). High E/M and imaging percentiles together suggest frequent, moderately complex follow-up visits integrated with diagnostic testing and treatment.

The provider is an established clinician with a long tenure: NPI enumerated 2005-05-28 (~21 years ago), which supports interpretation of the observed procedure volumes as coming from a sustained retinal practice rather than a new entrant. Longevity combined with high injection counts implies an entrenched local referral footprint for retinal care.

There are both concentration risks and operational implications: J0178 alone represents $1.2M and 60.9% of Medicare revenue, creating sensitivity to utilization shifts or changes in reimbursement or clinical preference for that agent. Given that the top three codes make up 75.1% of Medicare revenue, any market or formulary movement away from these specific injectables would have outsized impact on revenue.

The data show niche prescribing patterns for certain biologics: J0179 (brolucizumab) appears but at modest scale (294 claims, $72.6K revenue, ranked #47 of 64, 27th percentile), placing the provider among a small group of clinicians using this drug but not at high volume. This mixed adoption profile—high reliance on aflibercept with limited faricimab and brolucizumab relative volumes—may reflect clinical preference, local formulary choices, or patient mix rather than broad market leadership in newer agents.

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
J0178	Injection, aflibercept, 1 mg	1,690	$680	$1.2M
J2777	Injection, faricimab‑svoa, 0.1 mg	4,920	$30	$142.7K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	1,050	$120	$126K
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.	1,180	$100	$113.2K
J3490	Unclassified drugs	200	$440	$86.7K
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…	900	$90	$80.5K
J0179	Injection, brolucizumab-dbll, 1 mg	290	$250	$72.6K
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.	1,740	$30	$50.4K
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…	400	$60	$24.6K
J9035	Injection, bevacizumab, 10 mg	430	$60	$23.8K

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. Oregon Distribution

Albert Edwards — 3 of 20 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

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	10	60	840	$680	$623.7K
J2777	31	30	10,050	$30	$527.6K
J2781	4	10	690	$120	$102.6K
J0179	1	10	290	$250	$72.6K
67028	18	70	580	$90	$72.3K
J3490	4	50	40	$640	$42.9K
J9035	4	10	250	$50	$14.9K
92235	27	30	60	$100	$11.1K
99214	52	6,070	80	$70	$10.3K
92134	17	390	80	$30	$8.1K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sterling Vision, PC	OR	Ophthalmology Physician	$0	$1.9M
Jason Friedrichs	FL	Ophthalmology Physician	$695K	$0
Julia Kuhn	OR	Ophthalmology Physician	$285.2K	$0
Matthew Neale	ID	Ophthalmology Physician	$282.1K	$0
Judith Sabah	OR	Ophthalmology Physician	$270K	$2.1K
Eric Niespodzany	OR	Ophthalmology Physician	$164.2K	$0
Mehrdad Malihi	OR	Retina Specialist (Ophthalmology) Physician	$164.1K	$0
Jason Newman	OR	Ophthalmology Physician	$129.5K	$0
Balamurali Ambati	OR	Ophthalmology Physician	$123.7K	$0
Nicholas Hedden	OR	Certified Registered Nurse Anesthetist	$44K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Peacehealth Medical Group	OR	Family Medicine Physician	$0	$45.3M
Options Counseling Services Of Oregon	OR	Mental Health Counselor	$0	$25.9M
Eugene Emergency Physicians PC	OR	Emergency Medicine Physician	$0	$16.9M
Center For Family Development, Inc.	OR	Mental Health Counselor	$0	$15.6M
Laurel Hill Center	OR	Eyewear Supplier	$0	$14M
Looking Glass Community Services	OR	Mental Health Counselor	$0	$13.5M
Peacehealth	OR	General Acute Care Hospital	$0	$13.3M
Addiction Counseling And Education Services Inc.	OR	Mental Health Counselor	$0	$12.8M
Oregon Eye Consultants LLC	OR	Ophthalmology Physician	$0	$9.6M
Ch Mh Services (or), LLC	OR	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$9.4M

Albert Edwards — 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