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

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

Scott Warden (NPI 1407910748)

Field	Value
Entity Type	Individual
Organization	Scott Warden
Address	3226 Nassau St
City	Everett
State	WA
ZIP	98201
Taxonomy	Ophthalmology Physician
NPI Enumerated	December 21, 2006

Payer Source	Total Paid
Medicare	$2.3M
Medicaid	$0

Key Findings

This provider bills almost exclusively to Medicare with Total Medicare revenue of $2.3M and no Medicaid billing on file, meaning the practice is effectively single‑payer in the available datasets and any payer-level analyses should treat Medicaid volume as absent. The lack of Medicaid activity should be noted when benchmarking in-state access or safety‑net participation.

Revenue is highly concentrated in a small number of injection and office‑visit codes: the precomputed top three Medicare codes account for 79.7% of this provider's total Medicare revenue, with J2777 representing 62.6% of Medicare revenue, J0178 representing 11.8%, and 92012 representing 5.4%. This concentration indicates that a few high-volume therapies and follow-up visits dominate the practice's revenue base.

The code mix and volumes indicate a retina‑focused ophthalmology operation centered on intravitreal pharmacotherapy and retinal imaging: J2777 (faricimab) has 50.1K claims ($29 avg paid/claim) and 92134 (retinal OCT imaging) has 2.5K claims, while procedural codes such as 67028 (injections into the vitreous) appear at scale with 1.2K claims. Together these patterns point to a high-throughput, treatment‑and-monitoring model typical of medical retina clinics managing wet AMD/diabetic macular edema populations.

For competitive standing, the practice is a national high‑volume outlier on several services: J2777 ranks #105 of 2039 providers (95th percentile; notably above typical national volume), 92012 ranks #139 of 17177 providers (99th percentile; extreme outlier), and 92134 ranks #656 of 26868 providers (98th percentile; extreme outlier). These ranks indicate the provider is well above typical national volumes for both injection and follow‑up/imaging services, and would register as a major service contributor in those code buckets.

Not all biologic injection lines are equally prominent: J0178 (aflibercept) shows 406 claims and $672 avg paid/claim but ranks #2117 of 3204 (34th percentile; typical, unremarkable volume), and J2778 (ranibizumab) ranks in the 30th percentile as well. This contrast shows the provider’s dominance is concentrated in faricimab (J2777) rather than across all anti‑VEGF agents, suggesting a specific treatment mix or formulary/preference driving the high J2777 volume.

The practice also performs surgical and procedural retina work at modest, typical volumes: vitrectomy/retinal repair codes such as 67042 and 67108 appear (18 claims each, ~$1007 and $1051 avg paid/claim respectively) and rank in mid‑percentiles, indicating some operative retina capability but not a dominant surgical retina practice relative to national peers. These entries support a blended medical+surgical retina profile rather than a purely surgical subspecialty.

Operationally, the heavy follow‑up workload implied by 1.6K claims for 92012 and 2.5K claims for 92134 suggests high clinic throughput for established patients and frequent imaging visits, which has implications for staffing, imaging capacity, and infusion/injection room throughput. The low per‑claim average for J2777 ($29 avg paid/claim) combined with its extreme claim count indicates revenue driven by volume rather than per‑unit drug reimbursement.

The provider has long tenure in the registry with an NPI enumerated date of 2006-12-21 (~20 years ago), supporting stability of billing patterns over time; however, given the practice's heavy dependence on Medicare and on a small set of high‑volume injection codes (top three = 79.7% of Medicare revenue), the business is materially exposed to changes in Medicare drug or injection reimbursement policy and to shifts in standard of care for retinal therapeutics.

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
J2777	Injection, faricimab‑svoa, 0.1 mg	50,100	$30	$1.5M
J0178	Injection, aflibercept, 1 mg	410	$670	$272.8K
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…	1,630	$80	$125.8K
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.	1,180	$100	$117K
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.	2,520	$30	$85.5K
J2778	Injection, ranibizumab, 0.1 mg	410	$180	$72.7K
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…	750	$90	$68.9K
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…	20	$1,050	$18.9K
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	$1,010	$18.1K
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…	130	$130	$17.2K

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. Washington Distribution

Scott Warden — 4 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. state median

21 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2777	4	50	12,780	$30	$599.7K
J0178	53	90	470	$680	$597.2K
J2778	18	30	510	$180	$117.1K
67028	31	110	550	$90	$72.9K
67042	24	40	30	$1,190	$39.2K
67108	9	20	20	$1,180	$29.6K
92014	37	790	110	$80	$16.8K
99214	6,646	10,860	100	$80	$13.6K
92012	1	220	70	$70	$12.9K
J9035	21	40	70	$50	$10.9K

Showing 1–10 of 21

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eric Subong	WA	Ophthalmology Physician	$4.2M	$0
Laura Teasley	CA	Ophthalmology Physician	$2.4M	$0
David Drucker	WA	Retina Specialist (Ophthalmology) Physician	$1.8M	$0
George Ko	WA	Retina Specialist (Ophthalmology) Physician	$1.7M	$0
George Peters	MA	Ophthalmology Physician	$1.6M	$0
Ariel Tyring	WA	Ophthalmology Physician	$1.5M	$0
Sharel Ongchin	WA	Ophthalmology Physician	$1.3M	$0
Jacqueline Wong	WA	Ophthalmology Physician	$402.7K	$0
Linda Day	MI	Retina Specialist (Ophthalmology) Physician	$395.6K	$0
Jay Haynie	WA	Optometrist	$394.5K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Health Center Of Snohomish County	WA	Dentist	$0	$112.1M
Providence Health & Services-wa	WA	General Acute Care Hospital	$0	$62.4M
Sunrise Services, Inc.	WA	Community/Behavioral Health Agency	$0	$21.4M
Optum Care Washington PLLC	WA	Multi-Specialty Clinic/Center	$0	$19.5M
North Sound Emergency Medicine PC	WA	Emergency Medicine Physician	$0	$8.7M
Catholic Community Services Western Washington	WA	Substance Use Disorder Rehabilitation Clinic/Center	$0	$7.9M
Providence Health & Services- Washington	WA	General Practice Physician	$0	$7.6M
Assured Independence, LLC	WA	Emergency Response System Companies	$0	$7M
Pioneer Human Services	WA	Substance Abuse Rehabilitation Facility	$0	$6.2M
Evergreen Recovery Centers	WA	Substance Use Disorder Rehabilitation Clinic/Center	$0	$5.9M

Scott Warden — 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