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

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

St Clair Shores Mi Ophthalmology Asc LLC (NPI 1326215468)

Field	Value
Entity Type	Organization
Organization	St Clair Shores Mi Ophthalmology Asc LLC
Address	21711 Greater Mack Ave
City	Saint Clair Shores
State	MI
ZIP	48080
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	May 8, 2008

Payer Source	Total Paid
Medicare	$759.7K
Medicaid	$0

Medicare: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	590	$800	$474.2K
J1097	phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml	1,520	$80	$116.7K
66982	The provider inserts an intraocular lens prosthesis after extracapsular cataract extraction using complex techniques and devices. He may perform this by means of an iris expansion device, providing…	90	$810	$71.7K
65820	The provider incises the limbus to improve drainage of aqueous humor in the eye. This procedure is typically performed on children, usually to treat congenital glaucoma.	30	$1,300	$40.3K
66183	The provider inserts a small device into the anterior chamber of the eye that helps to reduce the intraocular pressure of the eye in patients with glaucoma.	10	$2,140	$25.7K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	90	$210	$18.5K
J1096	Dexamethasone, lacrimal ophthalmic insert, 0.1 mg	80	$100	$7.8K
65855	In this procedure, the provider uses a laser to burn the trabecular meshwork, the tissue of mesh where the iris meets the sclera, to drain aqueous humor from the anterior chamber and treat glaucoma.	50	$100	$5K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Michigan Distribution

St Clair Shores Mi Ophthalmology Asc LLC — 2 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. state median

8 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J1097	3	10	1,310	$80	$172.2K
66984	25	480	70	$470	$69.5K
J1096	9	10	450	$100	$48K
66183	2	10	20	$2,150	$36.5K
65820	16	60	20	$880	$25.6K
66982	6	130	30	$630	$22.2K
66821	50	310	40	$230	$13.4K
65855	13	80	30	$160	$6.5K

Nearby Providers

Other providers in the same ZIP code as St Clair Shores Mi Ophthalmology Asc LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
James Klein	MI	Ophthalmology Physician	$622.1K	$0
Richard Perry	MI	Sports Medicine (Orthopaedic Surgery) Physician	$519.4K	$0
Thomas Davis	MI	Cardiovascular Disease Physician	$321.9K	$0
Nicholas Schoch	MI	Orthopaedic Surgery Physician	$306.2K	$0
Benedict Pellerito	MI	Orthopaedic Surgery Physician	$292.1K	$0
Andrew Ajluni	MI	Orthopaedic Surgery Physician	$250.7K	$0
Sailaja Datla	MI	Internal Medicine Physician	$249.4K	$0
Mark Alrais	MI	Family Medicine Physician	$244.6K	$0
Marc Gosselin	MI	Cardiovascular Disease Physician	$237.1K	$0
Georges Ghafari	MI	Cardiovascular Disease Physician	$232K	$0

St Clair Shores Mi Ophthalmology Asc LLC — Billing Profile & Reimbursement Data

Sign up for St Clair Shores Mi Ophthalmology Asc LLC — Billing Profile & Reimbursement Data policy alerts

St Clair Shores Mi Ophthalmology Asc LLC — Billing Profile & Reimbursement Data

Sign up for St Clair Shores Mi Ophthalmology Asc LLC — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References