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

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

Joseph Sheehan (NPI 1336381748)

Field	Value
Entity Type	Individual
Organization	Joseph Sheehan
Address	3820 N 27th Ave Ste 100
City	Bozeman
State	MT
ZIP	59718
Taxonomy	Ophthalmology Physician
NPI Enumerated	March 31, 2009

Payer Source	Total Paid
Medicare	$342.1K
Medicaid	$0

Key Findings

This provider’s Medicare billing is concentrated: top 3 Medicare codes by revenue account for 59.1% of the provider’s total Medicare revenue, and lifetime Medicare revenue is $342.1K. That concentration indicates a relatively narrow set of services drive most revenue rather than a broad, even distribution across many small codes.

The dominant revenue drivers point to a blended surgical and medical ophthalmology practice. Code 66984 (cataract extraction with IOL insertion) generates $76.4K (22.3% of Medicare revenue) with $404 avg paid/claim, while J0178 (aflibercept injection) produces $71.8K (21.0%) with $690 avg paid/claim, and 92014 (comprehensive established eye exam) contributes $54K (15.8%). Together these codes imply a practice focused on cataract surgery, intravitreal injections for retinal disease, and high-volume established-patient ophthalmic care.

Payer mix is effectively single-payer Medicare: the record shows Total Medicaid revenue is none (no Medicaid billing on file), so operational and revenue risk is concentrated on Medicare reimbursement and referral patterns rather than split across public programs. Analysts should treat Medicaid-driven access or pricing strategies as not applicable to this provider based on the available billing.

Competitive standing varies by service line. For surgical cataract work, 66984 ranks #5639 of 15965 nationally (65th percentile; typical, unremarkable volume), indicating a modestly above-median national presence for that code. By contrast J0178 ranks #2980 of 3204 (7th percentile; typical, unremarkable volume), signaling relatively low national volume among aflibercept injectors despite its large share of this provider’s revenue, while 92014 ranks #3519 of 35415 (90th percentile; typical, unremarkable volume), showing notably higher exam volume versus most peers.

The practice shows steady use of diagnostic and perioperative ophthalmic services consistent with surgical and retina care. High claim counts and utilization for 92134 (399 claims, $11.6K revenue) and 92136 (373 claims, $6.3K revenue) alongside substantial counts for biometry 92136 and visual field 92083 suggest routine imaging and pre/post-op workflows that support cataract and retinal injection services.

There are occasional higher-complexity procedures on file that are rare but contribute meaningfully when they occur. Code 65756 (full-thickness corneal transplant) accounts for $12.9K (3.8% of Medicare revenue) with $921 avg paid/claim and ranks #476 of 567 (10th percentile; typical, unremarkable volume), indicating infrequent corneal surgery activity that is higher-paid per case.

Payment profile differences between codes underscore how fewer high-paid procedures can equal many lower-paid encounters. J0178 pays $690 avg paid/claim and accounts for $71.8K (21.0%), while 92014 has a much higher claim count (675) at $80 avg paid/claim producing $54K (15.8%); this pattern shows reimbursement-per-encounter drives revenue concentration as much as raw visit volume.

The provider’s tenure and scale should frame competitive assessments: NPI enumerated 2009-03-31 (~17 years ago) and lifetime Medicare revenue of $342.1K suggests modest Medicare billing across that tenure, consistent with a small independent or low-volume specialist practice rather than a high-volume ambulatory surgery center or large multispecialty group.

Medicare: Complete Services Breakdown

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

21 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…	190	$400	$76.4K
J0178	Injection, aflibercept, 1 mg	100	$690	$71.8K
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…	680	$80	$54K
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…	340	$90	$29.5K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	60	$290	$18.4K
65756	During this procedure, the provider performs a complete corneal transplant to replace a damaged corneal endothelium.	10	$920	$12.9K
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.	400	$30	$11.6K
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.	120	$100	$11.2K
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.	130	$90	$11K
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…	110	$70	$7.6K

Showing 1–10 of 21

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Montana Distribution

Joseph Sheehan — 0 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. state median

21 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	17	20	460	$680	$663.4K
66984	27	120	50	$490	$78.1K
67028	19	20	390	$90	$73.7K
92014	17	170	190	$80	$22.7K
65756	6	10	20	$1,180	$22.3K
66821	27	70	50	$220	$18.3K
99214	260	1,810	100	$70	$12.4K
92012	23	50	80	$60	$11.9K
J9035	6	10	100	$50	$10.3K
92136	9	30	270	$30	$8.9K

Showing 1–10 of 21

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rahul Khurana	CA	Ophthalmology Physician	$2.3M	$1.8M
Kent Adler	CA	Hematology & Oncology Physician	$1.3M	$0
Bradley Ekstrand	CA	Hematology & Oncology Physician	$1.3M	$0
Ostap Melnyk	CA	Hematology & Oncology Physician	$584.6K	$0
Gladys Rodriguez Araiza	IL	Hematology & Oncology Physician	$479.1K	$700
Angela Watkins	MT	Ophthalmology Physician	$449.5K	$0
Kristy Moeller	MT	Ophthalmology Physician	$426.7K	$0
Allyson Tevrizian	CA	Allergy & Immunology Physician	$340.3K	$0
Natalie Marshall	CA	Medical Oncology Physician	$305.4K	$0
David Macgregor	CA	Dermatology Physician	$302.4K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wojj Pediatric Dentistry	MT	Dental Clinic/Center	$0	$3.3M
Smiles Across Montana	MT	Dental Hygienist	$0	$1.9M
West Bozeman Surgery Center, LLC	MT	Ambulatory Surgical Clinic/Center	$1.9M	$55K
Psychiatry Associates PC	MT	Psychiatry Physician	$0	$1.4M
Marc Comaratta	MT	Retina Specialist (Ophthalmology) Physician	$1.2M	$124.7K
Foundation Therapy Services Inc	MT	Speech-Language Pathologist	$0	$1.1M
Lincare Inc.	MT	Durable Medical Equipment & Medical Supplies	$0	$1M
Montana Psychiatry, PLLC	MT	Psychiatry Physician	$0	$1M
Kenneth Olson	MT	Addiction Psychiatry Physician	$29.3K	$809.9K
Aaron Bruce	MT	Dermatology Physician	$682.7K	$0

Joseph Sheehan — 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