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

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

James Bell (NPI 1376860668)

Field	Value
Entity Type	Individual
Organization	James Bell
Address	1025 Regent St
City	Madison
State	WI
ZIP	53715
Taxonomy	Ophthalmology Physician
NPI Enumerated	April 26, 2010

Payer Source	Total Paid
Medicare	$1.4M
Medicaid	$0

Key Findings

This provider is a retina-focused ophthalmology practitioner: the top revenue-driving codes are retinal intravitreal injections and retina imaging/surgery codes (J0178, J2777, 67028) and together the precomputed top 3 Medicare codes account for 86.9% of the provider’s lifetime Medicare revenue, indicating a practice concentrated on pharmacologic retinal therapy and related procedural care. The prominence of J0178 (aflibercept) and faricimab (J2777) alongside vitreous injection code 67028 suggests the office primarily delivers intravitreal biologic treatments for retinal disease rather than broad primary eye care.

Revenue concentration is very high in Medicare: 86.9% of total Medicare revenue comes from the top three codes, with J0178 alone representing $925.9K (65.0% of Medicare revenue). This concentration implies that changes in reimbursement, utilization, or drug supply for these injection products would materially affect the provider’s clinical volumes and revenue.

The provider’s Medicare activity shows mixed competitive standing across codes: for J0178 the provider ranks #950 of 3204 (70th percentile), a typical national volume that places them above the median but not among top regional leaders for aflibercept administration. For J2777 the provider ranks #1237 of 2039 (39th percentile), indicating below-median national volume for faricimab administration, while for 67028 the provider ranks #1235 of 4255 (71st percentile), a modestly above-median procedural volume for isolated intravitreal injections. These ranks suggest a solid local presence in retinal injections without national dominance.

There are notable utilization outliers in evaluation and diagnostic imaging codes compared with national peers: 99213 ranks in the 98th percentile (#9147 of 457151) and 92134 ranks in the 95th percentile (#1337 of 26868), both described as "notably above typical" national volume. This pattern indicates unusually high volumes of established office visits and retinal OCT imaging relative to peers, which is consistent with a busy injection practice that schedules frequent follow-up visits and imaging.

The provider reports no Medicaid billing on file, so payer mix is effectively single-payer (Medicare-only) in the available datasets; total Medicare revenue is $1.4M and Medicaid revenue is none, meaning any analysis of public-payer exposure should treat this entity as not participating in Medicaid based on the available records. This absence of Medicaid activity may reflect practice payer contracts, patient demographics, or data capture limits, and it concentrates public-payer risk exposure in Medicare reimbursement policies.

Clinical complexity is reflected in a small volume of higher-acuity retinal surgical codes: 67042 (ILM peel/vitrectomy) appears with 22 claims and $19K revenue and ranks #467 of 1087 (54th percentile), while 67108 and 67145 appear at lower volumes. The presence of these surgical codes alongside high-volume injection codes indicates ability to manage both office-based intravitreal therapy and some operative retinal procedures, suggesting the provider treats a spectrum of retinal disease from medical to surgical.

The provider has long-tenure in the NPI registry, enumerated on 2010-04-26 (~16 years ago), which indicates stability and experience in the market; combined with high percentiles on follow-up visit (99213) and imaging (92134) codes, this tenure supports a sustained, established retinal practice model and referral relationships over time.

Medicare: Complete Services Breakdown

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,340	$690	$925.9K
J2777	Injection, faricimab‑svoa, 0.1 mg	7,320	$30	$212.3K
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.	1,120	$90	$99.6K
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…	860	$60	$52.5K
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.	1,690	$30	$45.5K
J9035	Injection, bevacizumab, 10 mg	520	$50	$28K
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	$860	$19K
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…	150	$90	$14.2K
67108	The provider repairs a detached retina using heat produced by a laser beam or by freezing the tissues. He may attach a scleral buckle to simplify the passage of fluid through and behind the retina or…	10	$840	$10.9K
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…	60	$80	$4.9K

Showing 1–10 of 14

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Wisconsin Distribution

James Bell — 2 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. state median

14 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	9	60	440	$690	$488.1K
J2777	12	30	7,290	$30	$332K
67028	10	110	310	$80	$43.7K
67042	8	20	20	$870	$20.8K
67108	8	10	20	$960	$17.3K
J9035	14	70	110	$50	$14.5K
99214	2,643	9,800	80	$70	$9.2K
92134	9	600	60	$30	$4.7K
99213	26	9,380	60	$50	$4.7K
92235	18	30	50	$70	$4.5K

Showing 1–10 of 14

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Dean Health Systems, Inc	WI	Allergy & Immunology Physician	$0	$26.3M
University Of Utah Adult Services	UT	Emergency Medicine Physician	$0	$6.9M
Ronald Hobbs	AZ	Ophthalmology Physician	$4.1M	$0
University Of Utah Adult Services	UT	Diagnostic Radiology Physician	$0	$4M
University Of Utah Adult Services	UT	Internal Medicine Physician	$0	$3.5M
University Of Utah Adult Services	UT	Ophthalmology Physician	$0	$3.1M
University Of Utah Adult Services	UT	Anesthesiology Physician	$0	$3M
Dean Health Systems, Inc.	WI	Ambulatory Surgical Clinic/Center	$2M	$856.3K
Infinity Healthcare Physicians, S.c.	WI	Emergency Medicine Physician	$0	$2.5M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Meriter Hospital, Inc.	WI	General Acute Care Hospital	$0	$25.5M
Ssm Health Care Of Wisconsin, Inc.	WI	General Acute Care Hospital	$0	$14.7M
Ssm Health Care Of Wisconsin, Inc	WI	Clinical Medical Laboratory	$0	$6.4M
Madison Surgery Center, Inc.	WI	Ambulatory Surgical Clinic/Center	$3.6M	$549.2K
Ryan Bros Ambulance LLC	WI	Land Ambulance	$1.5M	$2.3M
Madison Emergency Physicians, Sc	WI	Emergency Medicine Physician	$0	$3.2M
Emergency Medicine Associates Of Madison, Sc	WI	Emergency Medicine Physician	$0	$2.1M
Amol Kulkarni	WI	Ophthalmology Physician	$2.1M	$0
Meriter Health Enterprises Inc.	WI	Clinical Medical Laboratory	$680.6K	$1M
Mitchell Wolf	WI	Ophthalmology Physician	$1.6M	$0

James Bell — 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