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

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

Loren Jack (NPI 1306171970)

Field	Value
Entity Type	Individual
Organization	Loren Jack
Address	427 S Bernard St
City	Spokane
State	WA
ZIP	99204
Taxonomy	Ophthalmology Physician
NPI Enumerated	October 14, 2009

Payer Source	Total Paid
Medicare	$3.4M
Medicaid	$0

Key Findings

Practice economics are heavily driven by intravitreal biologic injections: J0178 (aflibercept) accounts for $1.5M in Medicare revenue (44.0% of the provider’s Medicare take) and J2777 (faricimab) contributes $1.2M (35.4%). These three injection codes together are the primary business line, and the precomputed top-3 codes account for 86.5% of this provider’s total Medicare revenue, indicating a revenue model built around repeat, high-cost ocular drug therapy rather than visit-based services alone.

Revenue concentration is extreme: the provider’s total Medicare revenue is $3.4M and the top three codes alone make up 86.5% of that amount. That concentration means the practice’s financial performance is closely tied to utilization and reimbursement for a small set of injectable drugs and associated procedures, increasing sensitivity to drug adoption, pricing, or coverage changes.

Clinical profile and service mix are consistent with a retina-focused ophthalmology practice: high counts of J0178, J2777, and J2778 (ranibizumab) reflect frequent intravitreal injections, while procedure codes such as 67028 and imaging code 92134 indicate office-based injection procedures and retinal diagnostic imaging. The combination of therapeutic injections plus retinal imaging suggests integrated injection clinics where imaging supports treatment decisions and follow-up.

Competitive standing on injections is above typical but not top-tier nationally: J0178 ranks #464 of 3204 providers (86th percentile; described as "typical, unremarkable volume"), J2777 ranks #159 of 2039 providers (92th percentile; "typical, unremarkable volume"), and J2778 ranks #342 of 1208 providers (72th percentile; "typical, unremarkable volume"). These positions show the provider is a solid, higher-volume participant for these biologic drugs but not a dominant national outlier.

The practice shows an exceptional footprint for retinal imaging: 92134 (computerized diagnostic imaging of the retina) is listed at 2.7K claims and $74.8K revenue and ranks #562 of 26868 providers (98th percentile; labeled an "extreme outlier, far above typical national volume"). This unusually high relative imaging volume underscores the retina-focused workload and may reflect a high throughput of monitoring visits that accompany injection-based treatment protocols.

Payer mix is effectively single-payer in the available data: Medicare revenue totals $3.4M while there is no Medicaid billing on file. This absence of Medicaid activity means the provider’s public-payer exposure in the dataset is concentrated entirely in Medicare, so analyses of low-income patient access or Medicaid reimbursement impact cannot be assessed from these records.

Ancillary coding and smaller revenue streams are present but limited: J3490 (unclassified drugs) produced $55.5K and J7999 (compounded drug) produced $12K, each representing small shares of Medicare revenue compared with the top injection codes. These smaller drug and compound entries are supplemental to the main injection-driven revenue and appear to be modest in scale relative to the practice’s core biologic administration activity.

Tenure and stability: the provider’s NPI was enumerated on 2009-10-14 (~17 years ago), indicating a long-standing presence in the market. Combined with the concentrated injection and imaging volumes, the longevity supports the interpretation of an established retina-oriented practice rather than a newly formed or transient biller.

Medicare: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,150	$690	$1.5M
J2777	Injection, faricimab‑svoa, 0.1 mg	40,980	$30	$1.2M
J2778	Injection, ranibizumab, 0.1 mg	1,290	$180	$235.3K
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.	1,880	$90	$176.5K
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.	2,670	$30	$74.8K
J3490	Unclassified drugs	30	$1,740	$55.5K
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…	500	$80	$40.6K
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…	390	$70	$26K
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…	150	$120	$17.8K
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…	20	$900	$16.2K

Showing 1–10 of 19

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Washington Distribution

Loren Jack — 2 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. state median

19 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2777	8	50	12,780	$30	$599.7K
J0178	11	90	470	$680	$597.2K
J2778	3	30	510	$180	$117.1K
67028	10	110	550	$90	$72.9K
J3490	47	70	70	$50	$51.2K
67042	24	40	30	$1,190	$39.2K
67108	16	20	20	$1,180	$29.6K
92014	88	790	110	$80	$16.8K
J7999	32	70	150	$70	$15.9K
99214	7,144	10,860	100	$80	$13.6K

Showing 1–10 of 19

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Spokane Eye Clinic Ps	WA	Multi-Specialty Clinic/Center	$0	$8M
Spokane Eye Clinic Ps	WA	Ambulatory Surgical Clinic/Center	$3M	$716.1K
Robert Wirthlin	WA	Ophthalmology Physician	$3.7M	$0
Andrew Cheek	WA	Ophthalmology Physician	$3.5M	$0
Dallin Andersen	WA	Ophthalmology Physician	$3.4M	$0
Ryan Whitted	GA	Ophthalmology Physician	$2.5M	$0
Robert Welch	UT	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
Shelly Lee	WA	Ophthalmology Physician	$1.9M	$0
Jessica Weinstein	OR	Retina Specialist (Ophthalmology) Physician	$691.2K	$49.8K
Steven Day	WA	Ophthalmology Physician	$379.5K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence Health & Services - Wa	WA	General Acute Care Hospital	$0	$78.7M
Providence Health & Services Washington	WA	Pulmonary Disease Physician	$0	$78.6M
Multicare Health System	WA	General Acute Care Hospital	$0	$55.1M
New Horizon Care Center, Inc.	WA	Substance Abuse Rehabilitation Facility	$0	$20.2M
Spokane Addiction Recovery Centers	WA	Substance Abuse Rehabilitation Facility	$0	$19M
Spokane Emergency Care Physicians PLLC	WA	Emergency Medicine Physician	$0	$13.9M
Spokane Emergency Physicians, Ps	WA	Emergency Medicine Physician	$0	$13.1M
Providence Health & Services Washington	WA	Clinical Medical Laboratory	$1.6M	$9.3M
Laboratory Corporation Of America	WA	Clinical Medical Laboratory	$1.6M	$6.1M
Integra Imaging, Ps	WA	Diagnostic Radiology Physician	$0	$7.5M

Loren Jack — Billing Profile & Reimbursement Data

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Loren Jack — 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