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

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

Robert Shuler (NPI 1376644476)

Field	Value
Entity Type	Individual
Organization	Robert Shuler
Address	1342 Old Weisgarber Rd
City	Knoxville
State	TN
ZIP	37909
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	September 25, 2006

Payer Source	Total Paid
Medicare	$2.6M
Medicaid	$0

Key Findings

ROBERt SHULER’s Medicare billing profile is dominated by intravitreal anti‑VEGF therapy and related retina care: J2778 (6.1K claims, $178 avg paid/claim, $1.1M revenue, 41.5% of Medicare revenue), J0178 (1.5K claims, $685 avg paid/claim, $1.1M revenue, 40.1% of Medicare revenue), and 67028 (2K claims, $86 avg paid/claim, $171.1K revenue, 6.5% of Medicare revenue) together illustrate a practice focused on high-volume injection management of retinal disease. The top three Medicare codes account for 88.1% of this provider's total Medicare revenue, underscoring that recurring injection visits are the operational core of the practice.

The provider shows high revenue concentration in a very small set of services: the precomputed top‑3 codes account for 88.1% of Medicare revenue, with J2778 and J0178 each reported as roughly $1.1M in revenue individually. That concentration implies material exposure to shifts in drug utilization, pricing, or reimbursement for these specific intravitreal agents, making those codes the primary drivers of financial performance.

On national competitiveness, this provider is a clear outlier for ranibizumab and retinal imaging volumes: J2778 ranks #28 of 1208 providers nationally (98th percentile; notably above typical national volume) and 92134 ranks #333 of 26868 providers nationally (99th percentile; extreme outlier). By contrast, J0178 ranks #789 of 3204 (75th percentile; typical) and 67028 ranks #407 of 4255 (90th percentile; typical), indicating dominant national standing for certain retinal services while other high‑revenue codes are delivered at more typical volumes.

Diagnostic imaging is a prominent supporting service for the injection practice: 92134 appears with 3.2K claims, $27 avg paid/claim, $85.8K revenue and is labeled an "extreme outlier," which points to unusually high OCT imaging throughput relative to national peers. High OCT volume is consistent with active monitoring and treatment of macular disease and likely reflects a workflow that pairs frequent imaging with intravitreal therapy.

The payer mix is effectively single‑payer Medicare: lifetime Medicare revenue is reported as $2.6M and there is no Medicaid billing on file. Absence of Medicaid activity means this provider’s public‑payer exposure and revenue profile are concentrated in Medicare beneficiaries, which has implications for network contracting and access to dually eligible or Medicaid‑dependent populations.

Practice tenure suggests stability: the NPI was enumerated 2006-09-25 (~20 years ago), indicating a long‑established presence in the market. That duration supports interpretation of the current high volumes as sustained clinical throughput rather than a short‑term spike.

Surgical retina procedures are present but represent a small share of activity and revenue; for example, 67042 shows 24 claims, $845 avg paid/claim, $20.3K revenue (0.8% of Medicare revenue) and 67108 shows 12 claims, $842 avg paid/claim, $10.1K revenue (0.4% of Medicare revenue). These modest surgical volumes suggest the practice largely operates as an injection‑ and imaging‑centric retina clinic with occasional operative cases.

There is limited diversification across intravitreal agents beyond the two revenue leaders: J2781 (525 claims, $120 avg paid/claim, $63K revenue, 2.4% of Medicare revenue) and J9035 (269 claims, $53 avg paid/claim, $14.3K revenue, 0.5% of Medicare revenue) appear at much smaller scales. The presence of these additional agents indicates some therapeutic variety, but revenue and claim counts show they are secondary to the practice’s primary reliance on J2778 and J0178.

Medicare: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2778	Injection, ranibizumab, 0.1 mg	6,150	$180	$1.1M
J0178	Injection, aflibercept, 1 mg	1,540	$690	$1.1M
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.	1,990	$90	$171.1K
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.	3,180	$30	$85.8K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	530	$120	$63K
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…	620	$80	$48K
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…	260	$90	$23.8K
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…	380	$60	$23.4K
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	$850	$20.3K
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…	140	$110	$15.6K

Showing 1–10 of 15

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Tennessee Distribution

Robert Shuler — 2 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. state median

15 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	23	80	790	$680	$769.8K
J2778	2	40	1,340	$180	$370.2K
67028	14	80	1,130	$90	$98.5K
J2781	11	20	560	$120	$82.5K
67042	20	40	20	$1,020	$34.5K
67108	24	30	20	$970	$29.2K
92014	92	810	120	$80	$19.2K
J9035	24	70	140	$50	$17.1K
99214	3,150	11,370	120	$80	$16.6K
92134	7	600	60	$30	$8.2K

Showing 1–10 of 15

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
James Miller	TN	Retina Specialist (Ophthalmology) Physician	$3.9M	$0
Devon Ghodasra	TN	Retina Specialist (Ophthalmology) Physician	$3.6M	$0
Nicholas Anderson	TN	Retina Specialist (Ophthalmology) Physician	$3M	$0
Rohan Shah	TN	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Scott Barb	TN	Ophthalmology Physician	$2.8M	$0
Tod Mcmillan	TN	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
Ailee Laham	TN	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
Stephen Perkins	TN	Retina Specialist (Ophthalmology) Physician	$2.3M	$0
Francis Decroos	TN	Retina Specialist (Ophthalmology) Physician	$2.3M	$0
Cristoforo Larzo	TN	Retina Specialist (Ophthalmology) Physician	$2.2M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Omni Community Health, Inc.	TN	Community/Behavioral Health Agency	$0	$77.7M
Summit Medical Group, PLLC	TN	Internal Medicine Physician	$0	$44.5M
Allergy Associates, P.A.	TN	Specialist	$0	$26.5M
Knoxville Pediatric Dentistry, PLLC	TN	General Practice Dentistry	$0	$11.2M
The Florence Crittenton Agency Inc	TN	Community/Behavioral Health Agency	$0	$10.7M
Bsp Enterprises, LLC	TN	In Home Supportive Care Agency	$0	$8M
Associated Pain Specialists, PC	TN	Pain Medicine Physician	$0	$6.8M
Jeremiah Bivins	TN	Allergy & Immunology Physician	$419.4K	$4.6M
Westbrook Medical Center, PLLC	TN	Family Medicine Physician	$0	$4M
Pcet Surgery Center LLC	TN	Ambulatory Surgical Clinic/Center	$1.7M	$60K

Robert Shuler — 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