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

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

Thelma Barnes (NPI 1316920291)

Thelma Barnes is a optometrist provider located in Scottsdale, Arizona. This profile covers 11 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Provider details (source: NPPES NPI Registry)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Thelma Barnes
Address	13400 E Shea Blvd
City	Scottsdale
State	AZ
ZIP	85259
Taxonomy	Optometrist
NPI Enumerated	November 23, 2005

Payer Source	Total Paid
Medicare	$111K
Medicaid	$0

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	820	$80	$67K
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…	280	$60	$17.5K
92083	The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for an extended…	240	$40	$10.2K
92133	The provider performs computerized diagnostic imaging of the optic nerve in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both…	240	$30	$6K
99203	The provider sees a new 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 provider…	30	$80	$2.7K
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.	90	$30	$2.6K
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.	30	$80	$2.6K
67820	The provider removes deviated or abnormal eyelashes, a condition known as trichiasis. He uses forceps to extract the unwanted lashes that cause eye irritation.	50	$20	$940
92002	The provider performs an intermediate level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program.	10	$70	$790
92060	The basic eye sensorimotor exam checks the alignment of the eyes and their ability to move together in eight fields of gaze ( up, down, right, left, up–left, up–right, down–left, down–right) and…	20	$40	$620

Showing 1–10 of 11

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
92014	49	650	140	$80	$21.5K
92012	48	260	80	$60	$10.9K
92134	268	540	90	$30	$10.1K
92004	294	510	40	$90	$6.4K
92136	169	170	190	$20	$6K
92060	31	40	30	$50	$5.7K
92083	68	500	70	$40	$4.9K
99203	2,107	4,100	40	$70	$4K
92133	75	490	70	$20	$2.9K
92002	41	50	20	$50	$1.7K

Thelma Barnes — Billing Profile & Reimbursement Data

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Thelma Barnes — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References