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.

Robert Welch (NPI 1376981894)

Field	Value
Entity Type	Individual
Organization	Robert Welch
Address	1055 N 300 W Ste 500
City	Provo
State	UT
ZIP	84604
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	June 6, 2013

Payer Source	Total Paid
Medicare	$2.5M
Medicaid	$0

Key Findings

This provider is effectively single‑payer: Total Medicare revenue is $2.5M and there is no Medicaid billing on file, so Medicare accounts for the observable public-payer activity and financial scale. Analysts should treat this profile as Medicare-driven when evaluating payer mix or access for low‑income populations.

Revenue is highly concentrated in three intravitreal drug codes: J0178 ($1.2M, 50.2%), J2777 ($696K, 28.1%), and J2778 ($151.8K, 6.1%), and the precomputed top-3 share is 84.4% of the provider's Medicare revenue. This level of concentration indicates the business is heavily dependent on a small set of injection drugs for the majority of its billed Medicare dollars.

The code mix and descriptions point to a retina-focused, procedure-driven practice with repeated intravitreal therapy and diagnostic imaging as core services. High-volume drug codes (J0178, J2777, J2778) plus procedure 67028 (1.6K claims, $146.5K, 5.9%) and extensive imaging (92134) are consistent with management of macular disease and ongoing injectable therapy visits.

Competitive standing for the primary drug codes is above-average but not nationally dominant: J0178 ranks #621 of 3204 providers nationally (81th percentile; typical, unremarkable volume for this code) and J2777 ranks #415 of 2039 providers nationally (80th percentile; typical, unremarkable volume for this code). By contrast, J2778 is more modestly represented at rank #493 of 1208 providers nationally (59th percentile; typical, unremarkable volume for this code), signaling stronger use of specific agents over others.

Diagnostic imaging is a distinguishing feature: 92134 has 2.5K claims, $68.6K revenue (2.8%) and is described as an "extreme outlier, far above typical national volume," ranking #689 of 26868 providers nationally (97th percentile). This markedly elevated retina imaging volume suggests the practice performs substantially more OCT diagnostic work per Medicare beneficiary than most peers, supporting high-frequency treatment decisions.

Office E/M activity shows meaningful ongoing patient management that supports the injection volume: 99213 has 497 claims and $32.3K revenue (1.3%), ranking #27380 of 457151 providers nationally (94th percentile), while 99214 has 264 claims and $24.6K revenue (1.0%), ranking #115855 of 479517 providers nationally (76th percentile). These ranks indicate a steady stream of established-patient visits consistent with follow-up and chronic disease management in a retina practice.

Operational exposure is concentrated in injectable biologics and one high-volume imaging procedure, which creates sensitivity to drug mix, utilization patterns, and reimbursement changes for those specific codes. Notably, J2777 appears as a high-claim, lower‑avg‑paid item (24K claims, $29 avg paid/claim, $696K revenue) versus J0178 (1.8K claims, $685 avg paid/claim, $1.2M revenue), so shifts in agent selection or unit pricing could materially affect revenue mix.

The provider has an established tenure in Medicare billing, with the NPI enumerated on 2013-06-06 (~13 years ago), which supports interpretation of these utilization patterns as steady practice behavior rather than transitory activity. Longevity plus the specific code mix suggests a stable retina specialist operation focused on intravitreal therapeutics and high-frequency retinal imaging.

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
J0178	Injection, aflibercept, 1 mg	1,820	$690	$1.2M
J2777	Injection, faricimab‑svoa, 0.1 mg	24,000	$30	$696K
J2778	Injection, ranibizumab, 0.1 mg	850	$180	$151.8K
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.	1,590	$90	$146.5K
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.	2,450	$30	$68.6K
J7312	Injection, dexamethasone, intravitreal implant, 0.1 mg	240	$160	$37.8K
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…	500	$70	$32.3K
J7999	Compounded drug, not otherwise classified	360	$70	$25.2K
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	$24.6K
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	$920	$13.8K

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. Utah Distribution

Robert Welch — 3 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. state median

21 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	18	40	620	$690	$683.2K
J2777	19	20	13,140	$30	$523.9K
J2778	7	10	870	$180	$224.3K
67028	20	60	440	$90	$61.7K
J7312	10	10	340	$160	$52.7K
67042	29	20	20	$1,100	$26.3K
67036	24	20	20	$1,010	$24.2K
J7999	8	20	120	$70	$16.9K
92014	501	330	140	$70	$16.6K
99214	1,951	4,080	80	$80	$11.6K

Showing 1–10 of 21

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Regents Of The University Of California	CA	General Acute Care Hospital	$0	$177.5M
Loma Linda University Medical Center-murrieta	CA	General Acute Care Hospital	$0	$70.8M
Spokane Eye Clinic Ps	WA	Multi-Specialty Clinic/Center	$0	$8M
Ryan Isom	UT	Retina Specialist (Ophthalmology) Physician	$3.7M	$0
Spokane Eye Clinic Ps	WA	Ambulatory Surgical Clinic/Center	$3M	$716.1K
Robert Wirthlin	WA	Ophthalmology Physician	$3.7M	$0
Andrew Cheek	WA	Ophthalmology Physician	$3.5M	$0
Dallin Andersen	WA	Ophthalmology Physician	$3.4M	$0
Jack Stringham	UT	Retina Specialist (Ophthalmology) Physician	$3.4M	$0
Loren Jack	WA	Ophthalmology Physician	$3.4M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$44.3M
Revere Health PC	UT	Multi-Specialty Clinic/Center	$0	$24M
Utah Valley Pediatrics L.L.C.	UT	Pediatrics Physician	$0	$11.9M
Riverwoods Surgery Center, LLC	UT	Ambulatory Surgical Clinic/Center	$737.9K	$5M
Utah Valley Emergency Physicians Inc	UT	Emergency Medicine Physician	$0	$4.7M
Ihc Health Services Inc	UT	Durable Medical Equipment & Medical Supplies	$0	$3.3M
Richard Corey	UT	Retina Specialist (Ophthalmology) Physician	$3M	$50.1K
Provo City Board Of Education	UT	Local Education Agency (LEA)	$0	$3M
Jonathan Gunther	UT	Retina Specialist (Ophthalmology) Physician	$2.3M	$3K
Ihc Health Services Inc	UT	Diagnostic Radiology Physician	$0	$2M

Robert Welch — Billing Profile & Reimbursement Data

Sign up for Robert Welch — Billing Profile & Reimbursement Data policy alerts

Robert Welch — Billing Profile & Reimbursement Data

Sign up for Robert Welch — Billing Profile & Reimbursement Data policy alerts

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