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.

Stephen Perkins (NPI 1427054436)

Field	Value
Entity Type	Individual
Organization	Stephen Perkins
Address	1342 Old Weisgarber Rd
City	Knoxville
State	TN
ZIP	37909
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	June 23, 2005

Payer Source	Total Paid
Medicare	$2.3M
Medicaid	$0

Key Findings

Practice is functionally a retina-focused ophthalmology operation centered on frequent intravitreal pharmacologic therapy and retina imaging: the top revenue codes are J0178, J2778, and J2777 (all intravitreal injections of aflibercept, ranibizumab, and faricimab respectively) and the procedure 67028 for isolated intravitreal injection appears in the top list, indicating a workflow built around repeated in-office injections and associated retina diagnostics. High-volume imaging and diagnostic codes (notably 92134) further support a service line concentrated on medical retina management rather than broad general ophthalmology care.

Revenue is highly concentrated in a small set of drug-administration codes: the precomputed top-3 Medicare codes by revenue account for 76.4% of this provider's total Medicare revenue, with J0178 contributing 41.2%, J2778 contributing 18.4%, and J2777 contributing 16.8% of Medicare revenue. Total reported Medicare revenue is $2.3M, so these three codes dominate the economic picture of the practice.

Payer mix is effectively single-payer Medicare: this provider reports $2.3M in Medicare revenue and has no Medicaid billing on file, so all measurable public-payor activity in the dataset is Medicare-only. That concentration implies limited exposure to Medicaid-managed care contracts and suggests Medicare reimbursement dynamics drive most public-payer revenue performance.

On national competitive standing for anti-VEGF and related injection codes, this provider is a solid but not dominant participant: J0178 ranks #905 of 3204 providers (72th percentile; typical, unremarkable volume), J2778 ranks #162 of 1208 providers (87th percentile; typical, unremarkable volume), and J2777 ranks #774 of 2039 providers (62th percentile; typical, unremarkable volume). These percentiles indicate consistent, above-average throughput for some drugs but overall a typical national footprint for these therapy lines rather than leadership.

Diagnostic imaging represents a relative area of exceptional volume: 92134 (retinal computerized diagnostic imaging) shows 3K claims and $81K revenue and ranks #404 of 26868 providers (98th percentile; extreme outlier, far above typical national volume). Coupled with a high-volume office-visit code 99213 that ranks in the 95th percentile (notably above typical national volume), the pattern points to heavy reliance on imaging-driven follow-up visits and monitoring as part of the practice model.

Procedural mix includes both routine injection procedures and some surgical retina work: 67028 appears with 2K claims and $166.7K revenue and ranks #396 of 4255 providers (91th percentile; typical, unremarkable volume), while 67042 (vitrectomy with internal limiting membrane work) appears at lower volume (25 claims, $21K revenue). This suggests most care is outpatient injection and monitoring, with occasional higher-acuity surgical interventions.

There are signals of occasional use of non-standard drug billing and bevacizumab: J3490 (unclassified drugs) shows 23 claims with $37.3K revenue and a high avg paid/claim, yet ranks relatively low nationally (#2509 of 2838, 10th percentile; typical, unremarkable volume), while J9035 (bevacizumab) shows 683 claims, $36.9K revenue and ranks #155 of 1852 providers (92th percentile; typical, unremarkable volume). These items indicate intermittent use of alternative or compounded agents alongside branded intravitreal therapies and may affect per-claim revenue patterns.

Provider tenure is long-established in the NPI registry, enumerated on 2005-06-23 (~21 years ago), which is consistent with an experienced retina specialist likely operating an established referral network. That longevity combined with concentrated Medicare revenue and very high retinal imaging volume suggests a mature outpatient retina practice focused on chronic, imaging-guided intravitreal therapy management.

Medicare: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,390	$690	$956.3K
J2778	Injection, ranibizumab, 0.1 mg	2,430	$180	$428K
J2777	Injection, faricimab‑svoa, 0.1 mg	13,440	$30	$389.8K
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.	2,010	$80	$166.7K
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.	3,000	$30	$81K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	540	$120	$64.8K
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…	490	$80	$40.3K
J3490	Unclassified drugs	20	$1,620	$37.3K
J9035	Injection, bevacizumab, 10 mg	680	$50	$36.9K
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…	530	$60	$30.6K

Showing 1–10 of 22

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Tennessee Distribution

Stephen Perkins — 3 of 22 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

22 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	27	80	790	$680	$769.8K
J2777	29	50	15,060	$30	$592.1K
J2778	14	40	1,340	$180	$370.2K
67028	13	80	1,130	$90	$98.5K
J2781	10	20	560	$120	$82.5K
J3490	55	60	70	$400	$41.9K
67042	18	40	20	$1,020	$34.5K
92014	128	810	120	$80	$19.2K
J9035	9	70	140	$50	$17.1K
99214	3,326	11,370	120	$80	$16.6K

Showing 1–10 of 22

Related Providers

Other providers that share a Tax Identification Number (TIN) with Stephen Perkins, 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
Robert Shuler	TN	Retina Specialist (Ophthalmology) Physician	$2.6M	$0
Tod Mcmillan	TN	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
Ailee Laham	TN	Retina Specialist (Ophthalmology) Physician	$2.5M	$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 Stephen Perkins, 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

Stephen Perkins — 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