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

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

Moss Fenberg (NPI 1396852943)

Field	Value
Entity Type	Individual
Organization	Moss Fenberg
Address	1266 Escalante Dr Ste 301
City	Durango
State	CO
ZIP	81303
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	August 23, 2006

Payer Source	Total Paid
Medicare	$2.3M
Medicaid	$0

Key Findings

Specialty and service mix: The provider’s billing is concentrated in retina-focused medical ophthalmology, dominated by intravitreal drug administration and retinal imaging rather than broad primary eye care. This is reflected by large revenues from J2778, J0178, and J2777 alongside elevated volumes of retinal imaging (92134) and a mix of vitrectomy and other retina surgery codes (e.g., 67028, 67036).

Revenue concentration: Medicare accounts for $2.3M of lifetime revenue and the top three Medicare codes (J2778, J0178, J2777) together represent 65.1% of that Medicare revenue. Individually, J2778 contributes $614.9K (27.1%), J0178 contributes $607.9K (26.8%), and J2777 contributes $252.3K (11.1%), indicating heavy reliance on anti-VEGF and related intravitreal therapies.

Payer mix: This provider is effectively single-payer in observed claims: lifetime Medicare revenue is $2.3M while there is no Medicaid billing on file. The absence of Medicaid activity suggests limited engagement with Medicaid populations or billing under other group NPIs for that payer.

Competitive standing on drug administration: For ranibizumab (J2778) this provider ranks #86 of 1208 nationally (93th percentile), indicating above-typical national volume for that specific drug. By contrast, aflibercept (J0178) ranks #1379 of 3204 (57th percentile) and faricimab (J2777) ranks #1104 of 2039 (46th percentile), both described as typical or modest volumes, so the provider is a relatively strong user of ranibizumab but a more average user of other anti-VEGF agents.

Diagnostic intensity outlier: The OCT diagnostic code 92134 shows 2.1K claims for $63.8K in revenue (2.8% of Medicare revenue) and ranks #923 of 26868 providers (97th percentile), labeled as notably above typical national volume. This high imaging volume alongside large injection volumes is consistent with an active retina practice that performs frequent monitoring and treatment visits.

Revenue from ancillary drugs and procedures: Non-anti-VEGF items also contribute meaningfully to Medicare revenue, including J3490 at $140.4K (6.2%) and 67028 at $133K (5.9%), plus a range of surgical retina codes (e.g., 67036 at $26.9K and 67042 at $22.6K). These line items indicate a mixed medical-surgical retina practice where drug revenue predominates but procedural and unclassified drug billing are nontrivial.

Tenure and billing history: The provider’s NPI was enumerated on 2006-08-23 (~20 years ago), reflecting long-standing enrollment and an established billing history in Medicare. The longevity combined with concentrated anti-VEGF and high OCT volumes suggests an established retina referral base in the market.

Competitive footprint summary: Overall this provider is a specialized, Medicare-centric retina specialist with concentrated revenue from intravitreal therapies (65.1% from the top three codes) and unusually high OCT utilization (92134 at the 97th percentile). National ranks for the top drugs are mixed—strong for J2778 (93th percentile) but typical for J0178 and J2777—positioning the clinician as a significant local retina injector with selective national-level strength on ranibizumab usage rather than a broadly dominant national operator.

Medicare: Complete Services Breakdown

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

35 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2778	Injection, ranibizumab, 0.1 mg	3,490	$180	$614.9K
J0178	Injection, aflibercept, 1 mg	910	$670	$607.9K
J2777	Injection, faricimab‑svoa, 0.1 mg	8,700	$30	$252.3K
J3490	Unclassified drugs	80	$1,760	$140.4K
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.	1,330	$100	$133K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	840	$120	$100.8K
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.	2,130	$30	$63.8K
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…	540	$80	$44.5K
J7312	Injection, dexamethasone, intravitreal implant, 0.1 mg	200	$160	$31.9K
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…	450	$70	$30.3K

Showing 1–10 of 35

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 35 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Colorado Distribution

Moss Fenberg — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. state median

35 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	26	60	740	$690	$618.3K
J2777	21	40	8,910	$30	$456.1K
J2778	1	20	600	$180	$199.7K
66984	136	280	70	$570	$97.1K
J2781	5	10	470	$120	$79.4K
67028	15	80	670	$100	$73.3K
J7312	6	10	220	$160	$37.4K
67036	8	30	20	$1,100	$37.3K
67042	9	30	20	$1,140	$29.6K
67108	13	20	20	$1,260	$26.5K

Showing 1–10 of 35

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sara Haug	CO	Retina Specialist (Ophthalmology) Physician	$3.9M	$0
Grant Gebhard	CO	Ophthalmology Physician	$706.5K	$0
Scott Allen	NM	Ophthalmology Physician	$345.1K	$0
Brian Baxter	CO	Optometrist	$112.7K	$0
Cameron Clarke	CO	Glaucoma Specialist (Ophthalmology) Physician	$97.8K	$0
Kiley Berry	CO	Optometrist	$74.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Connections Inc.	CO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$21.5M
Southwest Colorado Mental Health Center, Inc	CO	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$13.5M
Justin Curtis	CO	Podiatrist	$7.7M	$0
Durango Fire Protection District	CO	Land Ambulance	$434.9K	$1.7M
Victoria Knauf	CO	Foot & Ankle Surgery Podiatrist	$1.7M	$0
Kayse Lake	CO	Podiatrist	$1.3M	$790
Mark Gaughan	CO	Dermatology Physician	$480.5K	$0
Carmen Julian	CO	Dermatology Physician	$420.6K	$0
Kristin Pogue	CO	Physician Assistant	$191K	$0
Janelle Stewart	CO	Physician Assistant	$138.5K	$0

Moss Fenberg — 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