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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Jeffrey Sutton (NPI 1255526232)

Field	Value
Entity Type	Individual
Organization	Jeffrey Sutton
Address	717 Greenway Rd
City	Boone
State	NC
ZIP	28607
Taxonomy	Optometrist
NPI Enumerated	September 12, 2007

Payer Source	Total Paid
Medicare	$75.3K
Medicaid	$0

Medicare: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	400	$100	$40.2K
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…	290	$90	$26.7K
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…	70	$60	$4.1K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	120	$30	$3K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	20	$80	$1.3K
76514	The provider uses conventional contact B scan imaging to measure the thickness of the cornea in one or both eyes.	20	$10	$140

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. North Carolina Distribution

Jeffrey Sutton — 1 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99309	878	900	260	$70	$31.2K
92014	206	880	110	$80	$17.7K
92012	159	300	80	$60	$8.9K
92004	5	620	30	$90	$4.6K
92250	309	850	80	$20	$3.5K
76514	165	230	30	$10	$280

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lady Aycock	NC	Optometrist	$172.2K	$0
Julie Belanger	NC	Optometrist	$114.5K	$53.9K
Daniel Jones	NC	Optometrist	$114K	$0
Keitha Covalla	NC	Optometrist	$85.1K	$0
Bonnie Fanelli	NC	Optometrist	$82.5K	$2.3K
Jessica Oneil	NC	Optometrist	$79.5K	$0
Patrick Dooley	NC	Optometrist	$34.2K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Blue Ridge Pediatric & Adolescent Medicine, Inc	NC	Pediatrics Physician	$0	$13.2M
Watauga Opportunities, Inc	NC	Developmentally Disabled Services Day Training Agency	$0	$7.9M
Ovidiu Negrea	NC	Medical Oncology Physician	$1.8M	$0
Watauga Medics Inc	NC	Ambulance	$487K	$387K
James Logan	NC	Rheumatology Physician	$533.1K	$0
Ronald Stanley	NC	Dermatology Physician	$519.2K	$0
Brittain Tulbert	NC	Dermatology Physician	$405K	$0
Daniel Krontz	NC	Ophthalmology Physician	$320K	$0
Aaron Westphal	NC	MOHS-Micrographic Surgery Physician	$291.4K	$0
David Whittaker	NC	Dermatology Physician	$273K	$0

Jeffrey Sutton — Billing Profile & Reimbursement Data

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Jeffrey Sutton — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References