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

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

Peter Nixon (NPI 1467438531)

Field	Value
Entity Type	Individual
Organization	Peter Nixon
Address	801 W 38th St
City	Austin
State	TX
ZIP	78705
Taxonomy	Ophthalmology Physician
NPI Enumerated	December 20, 2005

Payer Source	Total Paid
Medicare	$5.1M
Medicaid	$0

Key Findings

This provider is effectively single‑payer: Total Medicare revenue is $5.1M while Total Medicaid revenue is none (no Medicaid billing on file), so the practice’s entire reported public‑payer volume in these data is Medicare‑driven. Analysts should treat Medicare reimbursement dynamics as the primary revenue lever for this provider.

Revenue is highly concentrated in anti‑VEGF and intravitreal injection activity: the precomputed top‑3 Medicare codes account for 82.8% of this provider's Medicare revenue, led by J0178 ($2.9M, 56.8%), Q5128 ($1.1M, 20.7%), and 67028 ($269.3K, 5.3%). This concentration indicates operational dependence on a narrow set of office‑based injection services and associated drug administration.

The practice shows national‑scale volume for key injectable therapies: J0178 ranks #53 of 3204 providers nationally (98th percentile; notably above typical national volume for this code) and Q5128 ranks #11 of 373 providers nationally (97th percentile; notably above typical national volume for this code). These ranks position the provider as a high‑volume national participant for aflibercept and the ranibizumab biosimilar, suggesting substantial throughput relative to peers.

Diagnostic retinal imaging is a second major service line by utilization: 92134 has 3.7K claims and $107.2K revenue (2.1%) and ranks #183 of 26868 providers nationally (99th percentile; extreme outlier), while 92235 has 878 claims and $93.9K revenue (1.8%) and ranks #30 of 2192 providers nationally (99th percentile; extreme outlier). The combination of very high imaging volumes with the injection codes indicates an office structure optimized for frequent monitoring and same‑day or serial treatment of retinal disease.

Drug billing beyond the top two anti‑VEGF products shows additional revenue lines but at smaller scale: J3490 accounts for $183.5K (3.6%) across 99 claims and is described as typical/unremarkable volume (rank #797 of 2838; 72th percentile), and J2781 contributes $156.6K (3.1%) with 1.3K claims (rank #71 of 490; 86th percentile). These secondary drug codes provide measurable but non‑dominant revenue and are consistent with a retina practice that uses multiple intravitreal therapies.

Surgical vitreoretinal procedures are a minor portion of billed services: 67042 appears with 23 claims and $20.4K revenue (0.4%), and 67036 with 14 claims and $9.7K revenue (0.2%), both reflecting much lower volume relative to injections and imaging. This profile supports an ambulatory, injection‑centered practice model rather than a surgery‑heavy retina center.

Operationally, the provider’s high throughput on a few codes creates sensitivity to drug mix and reimbursement shifts: with $5.1M in Medicare revenue concentrated in a small set of injection and imaging codes, policy or market changes affecting J0178, Q5128, or intravitreal injection reimbursement could materially affect revenue. Analysts should flag this concentration when modeling revenue risk or negotiating payer contracts.

The provider is established in the marketplace: NPI enumerated (registered) 2005-12-20 (~21 years ago), indicating long tenure that plausibly supports the high national rankings observed for key injection and imaging codes. Tenure combined with concentrated high volumes suggests a mature, specialized outpatient retinal practice with sustained referral and treatment workflows.

Medicare: Complete Services Breakdown

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

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	4,210	$690	$2.9M
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	4,900	$220	$1.1M
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.	2,780	$100	$269.3K
J3490	Unclassified drugs	100	$1,850	$183.5K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	1,310	$120	$156.6K
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.	3,700	$30	$107.2K
92235	The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken…	880	$110	$93.9K
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…	870	$90	$75.9K
J2778	Injection, ranibizumab, 0.1 mg	390	$190	$72.4K
J2777	Injection, faricimab‑svoa, 0.1 mg	1,140	$30	$33.1K

Showing 1–10 of 23

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 23 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Texas Distribution

Peter Nixon — 7 of 23 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. state median

23 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	5	210	610	$690	$694.9K
J2777	139	140	7,470	$30	$479.2K
J2778	59	80	630	$180	$345.3K
Q5128	1	50	770	$220	$263.7K
J2781	9	50	720	$120	$131.9K
67028	10	290	510	$90	$73K
J3490	75	350	60	$480	$54.4K
67042	40	90	20	$1,150	$41.3K
67036	45	70	20	$1,000	$29.1K
92235	6	160	60	$100	$21.3K

Showing 1–10 of 23

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jose Martinez	TX	Ophthalmology Physician	$3.8M	$0
Robert Wong	TX	Ophthalmology Physician	$3.1M	$0
James Dooner	TX	Ophthalmology Physician	$2.9M	$0
Shelley Ghafoori	TX	Ophthalmology Physician	$2.8M	$0
Philip Storey	TX	Ophthalmology Physician	$2.8M	$0
Ryan Young	TX	Ophthalmology Physician	$2.7M	$0
Mark Levitan	TX	Ophthalmology Physician	$2.5M	$0
Edward Wood	TX	Ophthalmology Physician	$2.4M	$0
Aaron Roller	TX	Ophthalmology Physician	$1.8M	$0
Laura Snyder	NC	Ophthalmology Physician	$1.7M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Travis County Emergency Physicians PA	TX	Emergency Medicine Physician	$0	$47.3M
Longhorn Emergency Medical Associates PA	TX	Emergency Medicine Physician	$0	$16.1M
Richard Garza	TX	Radiation Oncology Physician	$2.5M	$0
Chirag Jhaveri	TX	Ophthalmology Physician	$1.5M	$0
Bailey Square Ambulatory Surgical Center, Ltd	TX	Ambulatory Surgical Clinic/Center	$1.2M	$297.4K
Jaclyn Gutierrez	TX	Family Nurse Practitioner	$1.5M	$0
Mathew Putzi	TX	Anatomic Pathology & Clinical Pathology Physician	$1.4M	$0
Niraj Pahlajani	TX	Radiation Oncology Physician	$1.4M	$0
Brian Sayers	TX	Rheumatology Physician	$1.4M	$0
Clio Harper	TX	Ophthalmology Physician	$1.2M	$0

Peter Nixon — Billing Profile & Reimbursement Data

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Peter Nixon — 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