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

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

Retina Associates Of Southern Utah (NPI 1326307083)

Field	Value
Entity Type	Organization
Organization	Retina Associates Of Southern Utah
Address	585 E Riverside Drive
City	St George
State	UT
ZIP	84790
Taxonomy	Ophthalmology Physician
NPI Enumerated	May 15, 2012

Payer Source	Total Paid
Medicaid	$646.4K
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	1,750	$320	$558.9K
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.	3,130	$20	$56.3K
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…	340	$60	$18.8K
J9035	Injection, bevacizumab, 10 mg	440	$20	$9.7K
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	$2.7K

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Utah providers billing the same CPT/HCPCS codes.

Claims Volume vs. Utah Distribution

Retina Associates Of Southern Utah — 1 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. Utah median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	4	10	1,350	$100	$124K
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…	40	160	120	$100	$55.5K
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.	104	140	100	$90	$42.5K
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.	5	20	430	$30	$36K
J9035	Injection, bevacizumab, 10 mg	1	10	150	$20	$4.2K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Retina Associates Of Southern Utah, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ron Lord	UT	Ophthalmology Physician	$3.2M	$0
Joshua Carlson	UT	Retina Specialist (Ophthalmology) Physician	$2.6M	$0
Kevin Kirk	UT	Ophthalmology Physician	$557.5K	$0

Nearby Providers

Other providers in the same ZIP code as Retina Associates Of Southern Utah, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$65.8M
Southwest Utah Community Health Center	UT	Federally Qualified Health Center (FQHC)	$0	$7.3M
Zion Eye Institute, Inc	UT	Ambulatory Surgical Clinic/Center	$6.1M	$19.7K
Summit Behavior Services	UT	Counselor	$0	$5.4M
Ihc Health Services Inc	UT	Multi-Specialty Clinic/Center	$0	$4.4M
St George Surgical Center LP	UT	Ambulatory Surgical Clinic/Center	$2.5M	$0
Coral Desert Surgery Center LLC	UT	Ambulatory Surgical Clinic/Center	$2.5M	$17.8K
Ihc Health Services Inc	UT	Clinical Medical Laboratory	$2.4M	$42.7K
Jerry D Twiggs Md PC	UT	Pediatric Adolescent Medicine Physician	$0	$2.2M
Ihc Health Services Inc	UT	Pediatrics Physician	$0	$2.1M

Retina Associates Of Southern Utah — Billing Profile & Reimbursement Data

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Retina Associates Of Southern Utah — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References