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

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

William Thomas (NPI 1245246263)

Field	Value
Entity Type	Individual
Organization	William Thomas
Address	11606 Nicholas St
City	Omaha
State	NE
ZIP	68154
Taxonomy	Ophthalmology Physician
NPI Enumerated	July 31, 2006

Payer Source	Total Paid
Medicare	$2.7M
Medicaid	$0

Key Findings

This provider is effectively single‑payer in the available data: lifetime Medicare revenue is $2.7M while Medicaid shows none on file, indicating no Medicaid billing on record and concentrated reliance on Medicare for billed services. The top three Medicare codes account for 82.9% of Medicare revenue, so a small set of services drive most of the practice’s revenue.

Revenue is highly concentrated in intravitreal anti‑VEGF therapies: J0178 ($1M, 38.3% of Medicare revenue), J2777 ($988K, 37.2%), and J2778 ($197.5K, 7.4%) together represent the precomputed 82.9% concentration. This mix points to drug administration (high‑cost biologics) as the primary revenue engine rather than broad-based E/M or ancillary services.

Service‑line mix and code descriptions support a retina‑focused ophthalmology practice: high revenue from J0178, J2777, and J2778 (aflibercept, faricimab, ranibizumab) plus frequent use of intravitreal injection procedure 67028 (1.7K claims) and retina procedures like 67042 and 67108 indicate ongoing medical retina management and some surgical retina activity. High utilization of diagnostic imaging (92134 with 2K claims) aligns with routine retina monitoring and treatment follow‑up workflows.

Competitive standing on the leading drug codes is notable but not dominant nationally: J0178 ranks #812 of 3204 providers (75th percentile; typical/unremarkable), J2777 ranks #212 of 2039 providers (90th percentile; typical/unremarkable), and J2778 ranks #393 of 1208 providers (68th percentile; typical/unremarkable). In plain terms, the provider is a significant regional user of these agents but not a national outlier or market leader for anti‑VEGF therapy.

The practice shows two clear utilization outliers relative to national peers: 92134 (OCT imaging) ranks in the 96th percentile and is labeled notably above typical national volume, and 99212 (established patient E/M) ranks in the 99th percentile and is labeled an extreme outlier, far above typical national volume. These signals together suggest a high throughput of follow‑up office visits combined with frequent retinal imaging, consistent with intensive monitoring of retinal disease.

Non‑drug and ancillary revenue is present but modest: 67028 (intravitreal injection procedure) contributes $148.5K (5.6% of Medicare revenue) and unclassified drug/biologic codes J3490 ($64.4K, 2.4%) and J3590 ($24.3K, 0.9%) are small contributors and rank in lower percentiles. This pattern indicates procedure and ancillary billing supports the drug revenue but does not meaningfully diversify payor exposure.

Tenure is long and may support established referral patterns: the NPI was enumerated on 2006‑07‑31 (~20 years ago), indicating roughly two decades in the Medicare billing system. Long enumeration combined with concentrated anti‑VEGF activity suggests an established medical retina practice rather than a recent or transient billing footprint.

Implications for payer and network analysis: given the concentrated exposure to high‑cost intravitreal biologics and absence of Medicaid claims, reimbursement, utilization management, and drug‑specific contracting (especially around J0178 and J2777) will disproportionately affect total cost of care for this clinician. Analysts should treat this provider as Medicare‑centric with predictable retina treatment patterns and limited Medicaid risk or volume to consider in state programs.

Medicare: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,510	$670	$1M
J2777	Injection, faricimab‑svoa, 0.1 mg	35,280	$30	$988K
J2778	Injection, ranibizumab, 0.1 mg	1,120	$180	$197.5K
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.	1,710	$90	$148.5K
J3490	Unclassified drugs	40	$1,700	$64.4K
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.	2,040	$30	$57K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	330	$120	$39.6K
67042	In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina…	40	$820	$28.7K
J3590	Unclassified biologics	320	$80	$24.3K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	500	$40	$20.1K

Showing 1–10 of 21

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Nebraska Distribution

William Thomas — 3 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. state median

21 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2777	4	10	25,950	$30	$1.5M
J0178	6	20	880	$690	$722.7K
J2778	2	10	670	$180	$137.8K
67028	8	20	1,070	$80	$106.4K
J2781	3	10	340	$120	$47.8K
J3590	9	10	430	$70	$29.7K
67042	3	10	30	$1,100	$29.6K
67108	9	10	20	$1,040	$20.8K
92014	193	270	170	$70	$20K
99214	1,196	3,210	110	$70	$14.9K

Showing 1–10 of 21

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Omaha Eye & Laser Institute, Inc.	NE	Ophthalmology Physician	$0	$596.1K
Mark Young	NE	Ophthalmology Physician	$387.3K	$0
Sao Liu	NE	Ophthalmology Physician	$319.4K	$0
Sao Liu	NE	Ophthalmology Physician	$275K	$0
Mary Haschke	NE	Ophthalmology Physician	$204.3K	$0
John Halgren	NE	Ophthalmology Physician	$188.2K	$0
Jessica Liu	MO	Ophthalmology Physician	$152.2K	$0
Christopher Bergman	NE	Optometrist	$48.9K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kubat Pharmacy, LLC	NE	Durable Medical Equipment & Medical Supplies	$0	$4.1M
Omega Surgery Center LLC	NE	Ambulatory Surgical Clinic/Center	$1.7M	$359.6K
Aria Eye Care, LLC	NE	Optometrist	$0	$2M
Diagnostic Radiology PC	NE	Diagnostic Radiology Physician	$0	$1.6M
Senior Vision Services LLC	NE	Optometrist	$0	$1.5M
Maxability Therapy Services, P.C.	NE	Speech-Language Pathologist	$0	$1.3M
Cord Where Science Meets Connection LLC	NE	Mental Health Counselor	$0	$1.1M
Verve Collaborative Health LLC	NE	Psychiatric/Mental Health Nurse Practitioner	$0	$804.3K
Miracle Hills Surgery Center LLC	NE	Ambulatory Surgical Clinic/Center	$719K	$56.8K
Omega Surgery Center LLC	NE	Ambulatory Surgical Clinic/Center	$482.4K	$0

William Thomas — Billing Profile & Reimbursement Data

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William Thomas — 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