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.

Craig Lemley (NPI 1285685032)

Field	Value
Entity Type	Individual
Organization	Craig Lemley
Address	1333 E Barnett Rd
City	Medford
State	OR
ZIP	97504
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	May 15, 2006

Payer Source	Total Paid
Medicare	$1M
Medicaid	$0

Key Findings

This provider’s billing is effectively single‑payer: lifetime Medicare revenue is reported at $1M and there is no Medicaid billing on file, indicating the practice’s publicly visible revenue comes almost entirely from Medicare reimbursements. Analysts should treat Medicare as the dominant payer when modeling this provider’s patient mix or revenue sensitivity.

Revenue concentration is high: the precomputed top three Medicare codes (J0178, J2777, 67028) together account for 79.9% of this provider’s total Medicare revenue. Those three codes individually generate $546.5K (53.0%) from J0178, $205.3K (19.9%) from J2777, and $72.8K (7.1%) from 67028, showing that anti‑VEGF drug administration and intravitreal injection procedures are the primary revenue drivers.

The code mix is consistent with a retina‑focused practice that delivers high volumes of intravitreal injections and in‑office drug administration: J0178 (aflibercept) is the top revenue line and J2777 (faricimab) and 67028 (intravitreal injection procedure) round out the top revenue contributors. The presence of drug administration codes alongside the injection procedure code suggests a workflow centered on recurring in‑office injections for retinal disease rather than primarily surgical retina work.

Diagnostic imaging and routine follow‑up are notable supporting services: 92134 appears with 1.5K claims and $44.5K in revenue (4.3%) and is described as "notably above typical national volume," indicating the provider performs retinal OCT imaging at a higher‑than‑typical rate. High volume in 92134 combined with substantial 99213 activity (523 claims, $29.8K, 2.9%, also "notably above typical national volume") signals regular monitoring visits and image‑guided management of chronic retinal conditions.

Competitive standing on key drug codes is modest nationally: J0178 ranks #1495 of 3204 providers (53th percentile, "typical, unremarkable volume") and J2777 ranks #1271 of 2039 providers (38th percentile, "typical, unremarkable volume"). These ranks imply the provider is neither a national outlier nor a dominant injector of these specific agents, despite those drugs being the largest revenue contributors to the practice.

Ancillary therapy and compounding appear in the mix but are not dominant: J7999 (compounded drug) contributes $28.7K (2.8%) and ranks #218 of 1333 providers (84th percentile, characterized as "typical, unremarkable volume"). This suggests some use of compounded agents or office‑administered supplies, but these services are secondary to the anti‑VEGF treatment line.

Procedure volumes for intravitreal injection itself are in the typical range: 67028 has 809 claims and $72.8K revenue and ranks #1649 of 4255 providers (61th percentile, "typical, unremarkable volume"), reinforcing that injections are a routine, high‑frequency service but not an extreme outlier in national rankings. Together with the drug codes, this pattern indicates a stable, recurring procedural practice model.

The provider has a long tenure in the Medicare program, with an NPI enumerated on 2006-05-15 (~20 years ago). This sustained enrollment supports the interpretation of the observed billing mix as an established practice pattern rather than a short‑term or recent shift in services.

Medicare: Complete Services Breakdown

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	810	$680	$546.5K
J2777	Injection, faricimab‑svoa, 0.1 mg	7,080	$30	$205.3K
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.	810	$90	$72.8K
J2778	Injection, ranibizumab, 0.1 mg	300	$180	$53.1K
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.	1,480	$30	$44.5K
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…	520	$60	$29.8K
J7999	Compounded drug, not otherwise classified	410	$70	$28.7K
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…	240	$100	$22.9K
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…	140	$90	$13K
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…	50	$100	$5.4K

Showing 1–10 of 18

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Oregon Distribution

Craig Lemley — 1 of 18 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

18 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	33	60	840	$680	$623.7K
J2777	27	30	10,050	$30	$527.6K
J2778	14	20	400	$180	$87.8K
67028	32	70	580	$90	$72.3K
J7999	18	50	270	$70	$23.4K
92014	130	440	110	$80	$16K
92235	19	30	60	$100	$11.1K
99214	1,883	6,070	80	$70	$10.3K
92134	26	390	80	$30	$8.1K
99215	2,059	2,170	40	$100	$6.7K

Showing 1–10 of 18

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Steven Saraf	OR	Retina Specialist (Ophthalmology) Physician	$1M	$0
Medical Eye Center Inc	OR	Ophthalmology Physician	$0	$961.4K
Poorav Patel	OR	Ophthalmology Physician	$704.9K	$0
Helen Koenigsman	OR	Glaucoma Specialist (Ophthalmology) Physician	$289.4K	$0
Matthew Oliva	OR	Cornea and External Diseases Specialist Physician	$270.5K	$0
Christine Petersen	OR	Glaucoma Specialist (Ophthalmology) Physician	$217.8K	$0
John Welling	OR	Cornea and External Diseases Specialist Physician	$191.6K	$0
Heather French Friedrich	OR	Optometrist	$98.1K	$0
Charles Paradise	OR	Certified Registered Nurse Anesthetist	$64.9K	$0
Nhung Do	OR	Optometrist	$59.9K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Asante	OR	General Acute Care Hospital	$0	$29.7M
Addictions Recovery Center, Inc.	OR	Substance Abuse Rehabilitation Facility	$0	$29.2M
Asante Physician Partners	OR	Family Medicine Physician	$0	$27.2M
Mercy Flights Incorporated	OR	Ambulance	$3.6M	$19.4M
Providence Health & Services - Oregon	OR	General Acute Care Hospital	$0	$20.9M
Crc Health Oregon, LLC	OR	Methadone Clinic	$193K	$13M
James Kolby Robinson, Dmd	OR	Pediatric Dentistry	$0	$11.6M
Valley Immediate Care, LLC	OR	Urgent Care Clinic/Center	$0	$9.4M
Lincare Inc	OR	Durable Medical Equipment & Medical Supplies	$0	$7.1M
Southern Oregon Pediatrics, LLP	OR	Pediatric Hospice and Palliative Medicine Physician	$0	$6.5M

Craig Lemley — 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