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

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

August Stein (NPI 1477719755)

Field	Value
Entity Type	Individual
Organization	August Stein
Address	160 Heritage Way
City	Kalispell
State	MT
ZIP	59901
Taxonomy	Ophthalmology Physician
NPI Enumerated	August 5, 2008

Payer Source	Total Paid
Medicare	$391.4K
Medicaid	$0

Key Findings

AUGUST STEIN is an Ophthalmology Physician in KALISPELL, MT with an NPI enumerated 2008-08-05 (~18 years ago). Lifetime Medicare revenue on file is $391.4K and there is no Medicaid billing on file, indicating the provider operates with effectively single-payer public exposure concentrated in Medicare.

Revenue concentration is high: the precomputed top 3 Medicare codes by revenue (J0178, 66984, 92014) account for 67.2% of this provider's total Medicare revenue. The single largest line item is J0178 with $148.4K (37.9% of Medicare revenue), followed by 66984 with $78.6K (20.1%) and 92014 with $36K (9.2%).

The code mix indicates a hybrid surgical and medical-retina practice model: large shares from J0178 (aflibercept injections) and 67028 (intravitreal injection) point to ongoing medical-retina treatment volume, while substantial revenue from 66984 and 66982 shows a meaningful cataract surgery practice. High counts for diagnostic imaging codes such as 92134 (460 claims) and E/M code 92014 (444 claims) support steady clinic throughput and post-procedure or follow-up care associated with both retina and cataract services.

Competitive standing by code is mixed: J0178 ranks #2551 of 3204 (20th percentile) and is described as typical, unremarkable volume for this code, indicating modest national participation in aflibercept injections; 66984 ranks #5410 of 15965 (66th percentile) and is described as typical, unremarkable volume for this code, reflecting an above-average cataract surgery volume relative to national peers; 92014 ranks #6265 of 35415 (82th percentile) and is described as typical, unremarkable volume for this code, suggesting a comparatively high level of established comprehensive eye exams.

Operational detail: the provider submitted 216 claims for J0178 at $687 avg paid/claim and 200 claims for 66984 at $393 avg paid/claim, showing that injection therapy and cataract procedures are both material drivers of cash flow — J0178’s per-claim payment is particularly high which magnifies its revenue contribution despite fewer than some high-volume peers. The practice also shows substantial utilization of retinal imaging (92134) with 460 claims at $29 avg paid/claim, a pattern consistent with active management of retinal disease.

Absence of Medicaid billing (none below) means there is no in-state Medicaid volume to evaluate; this lack of Medicaid exposure concentrates payer risk on Medicare and commercial payers and may affect contract negotiations or access considerations for Medicaid populations in the region. Given total Medicare revenue of $391.4K and no Medicaid revenue on file, the provider should be considered effectively single-payer (Medicare) in public program mix.

Financial concentration risk: with J0178 and 66984 among the top revenue drivers and the top 3 codes totaling 67.2% of Medicare revenue, the provider’s topline is sensitive to changes in reimbursement, utilization patterns, or formularies affecting aflibercept and to shifts in surgical volume for cataract procedures. Monitoring reimbursement trends for J0178 and surgical throughput for 66984 will be important to anticipate short- to medium-term revenue variability.

Medicare: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	220	$690	$148.4K
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	200	$390	$78.6K
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…	440	$80	$36K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	80	$220	$18.4K
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.	180	$90	$16.6K
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…	190	$90	$16.2K
66982	The provider inserts an intraocular lens prosthesis after extracapsular cataract extraction using complex techniques and devices. He may perform this by means of an iris expansion device, providing…	30	$550	$15.8K
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.	460	$30	$13.3K
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…	200	$60	$12.1K
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…	80	$100	$8K

Showing 1–10 of 19

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Montana Distribution

August Stein — 0 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. state median

19 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	16	20	460	$680	$663.4K
66984	26	120	50	$490	$78.1K
67028	17	20	390	$90	$73.7K
J7999	9	10	470	$70	$45.4K
66982	14	30	30	$600	$29.6K
92014	36	170	190	$80	$22.7K
66821	20	70	50	$220	$18.3K
99214	586	1,810	100	$70	$12.4K
92012	29	50	80	$60	$11.9K
92136	20	30	270	$30	$8.9K

Showing 1–10 of 19

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Glacier Eye Clinic PC	MT	Ophthalmology Physician	$0	$2.3M
Aaron Alme	MT	Ophthalmology Physician	$2.1M	$0
Tyler Ofstad	MT	Retina Specialist (Ophthalmology) Physician	$1.1M	$0
Mark Remington	MT	Ophthalmology Physician	$665.6K	$0
Roger Barth	MT	Ophthalmology Physician	$422.8K	$0
Mark Goerlitz-jessen	MT	Ophthalmology Physician	$259.5K	$0
Caleb Morris	NV	Ophthalmology Physician	$227.2K	$0
William Stoddard	MT	Ophthalmology Physician	$165.9K	$0
Nicholas Ranson	MO	Ophthalmology Physician	$144.3K	$0
Jonathan Olsen	MT	Optometrist	$125.8K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Flathead Industries	MT	Community/Behavioral Health Agency	$0	$40.7M
A Plus Health Care Inc	MT	In Home Supportive Care Agency	$0	$28.2M
Gabriel Dawson	MT	Pediatric Dentistry	$0	$10.7M
Kalispell Regional Medical Center Inc	MT	General Acute Care Hospital	$0	$8.8M
Benefis Community Care, Inc.	MT	Case Management Agency	$0	$6.8M
Kiddsteeth PLLC	MT	Pediatric Dentistry	$0	$6.7M
Kalispell Regional Medical Center, Inc	MT	Clinic/Center	$0	$6.2M
Kalispell Public Schools	MT	Local Education Agency (LEA)	$0	$6M
Kalispell Regional Medical Center Inc	MT	Psychiatry Physician	$0	$5.9M
Kalispell Regional Medical Center Inc	MT	Emergency Medicine Physician	$0	$5.4M

August Stein — Billing Profile & Reimbursement Data

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August Stein — 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