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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

Gail Bernard (NPI 1508817784)

Field	Value
Entity Type	Individual
Organization	Gail Bernard
Address	3024 Tower Rd
City	Rapid City
State	SD
ZIP	57701
Taxonomy	Ophthalmology Physician
NPI Enumerated	May 13, 2006

Payer Source	Total Paid
Medicare	$487.7K
Medicaid	$0

Key Findings

This provider’s Medicare business accounts for $487.7K in lifetime revenue while Medicaid shows none (no Medicaid billing on file), indicating an effectively single-payer footprint concentrated in Medicare rather than a mixed Medicaid/Medicare practice. The lack of any Medicaid billing on file makes the provider’s exposure and performance analysis primarily a Medicare-only exercise.

Revenue is highly concentrated in a small set of ophthalmology codes: the top 3 Medicare codes (J0178, 66984, 92014) together account for 63.8% of total Medicare revenue, with J0178 alone contributing 40.2% of Medicare revenue. This concentration signals that changes in utilization or reimbursement for anti-VEGF injections (J0178) would materially affect overall Medicare revenue.

The CPT/HCPCS mix shows a hybrid surgical and medical-retina practice: high-revenue surgical/cataract codes such as 66984 (cataract extraction with lens insertion) and other procedure codes (66982, 66821) appear alongside intravitreal injection codes (J0178, 67028) and diagnostic/imaging and exam codes (92014, 92012, 92134). This pattern is consistent with an ophthalmologist who performs cataract surgery and provides office-based retinal injection therapy and imaging services.

Competitive standing varies by service line. For intravitreal injections J0178 ranks #2357 of 3204 (26th percentile; typical, unremarkable volume for this code), which positions the provider as a modest national participant in anti-VEGF injection volume. By contrast, diagnostic imaging and office exam codes show relatively stronger placement — for example, 92134 ranks #3105 of 26868 (88th percentile; typical, unremarkable volume for this code) and 92012 ranks #1276 of 17177 (93th percentile; typical, unremarkable volume for this code) — suggesting above-median throughput for imaging and intermediate/established eye exams.

Cataract surgery volumes are moderate: 66984 generates $70.7K (14.5% of Medicare revenue) and the provider ranks #5849 of 15965 (63th percentile; typical, unremarkable volume for this code). This indicates the provider performs cataract surgery at a level slightly above the national median but is not a high-volume national surgical outlier.

Coding and visit-mix signal reliance on ophthalmology-specific exam codes rather than general medical E/M codes. General E/M codes such as 99213 and 99214 account for small shares of revenue ($10.1K and $900 respectively) and 99214 ranks #471424 of 479517 (1th percentile; typical, unremarkable volume for this code), while ophthalmology exam codes 92014 and 92012 together drive a larger share of visit-based revenue, implying clinical documentation and billing behavior concentrated on specialty ophthalmology exam services.

The provider’s NPI was enumerated 2006-05-13 (~20 years ago), indicating long-standing Medicare enrollment and likely established referral relationships and patient base in Rapid City, SD. This tenure supports the observed steady blend of surgical, injection, and diagnostic services rather than a newly opened practice profile.

Operationally, the large share of Medicare revenue tied to J0178 (40.2%) implies revenue sensitivity to changes in anti-VEGF supply, payer coverage, or utilization patterns for intravitreal therapy; similarly, any payer policy changes affecting cataract-related codes (66984) would meaningfully affect overall revenue given the 14.5% contribution from that code. Analysts should treat this provider as exposed to specialty ophthalmology reimbursement dynamics given the concentrated revenue mix.

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
J0178	Injection, aflibercept, 1 mg	280	$690	$196.2K
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…	180	$400	$70.7K
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…	530	$80	$44.6K
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…	620	$60	$38.1K
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.	300	$90	$26.4K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	80	$260	$19.9K
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.	590	$30	$17.7K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	150	$90	$13.7K
J7999	Compounded drug, not otherwise classified	140	$70	$10.1K
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…	170	$60	$10.1K

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. South Dakota Distribution

Gail Bernard — 3 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. state median

21 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	12	10	690	$690	$788.7K
67028	12	10	740	$90	$108.5K
66984	23	130	40	$410	$67.7K
J7999	10	10	260	$70	$39.1K
66821	21	30	100	$230	$35.6K
66982	22	20	40	$580	$25K
92014	13	200	170	$80	$17.1K
99214	1,626	1,660	90	$70	$11.4K
92136	17	30	210	$30	$9.2K
65855	6	10	40	$150	$8.6K

Showing 1–10 of 21

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nathan Steinle	CA	Retina Specialist (Ophthalmology) Physician	$9.5M	$0
Prema Abraham	SD	Retina Specialist (Ophthalmology) Physician	$7.1M	$0
Rapid City Medical Center, LLP	SD	Multi-Specialty Clinic/Center	$0	$4.5M
Kyle Thompson	ID	Retina Specialist (Ophthalmology) Physician	$4.5M	$0
Douglas Holmes	WY	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Mitchell Goff	UT	Retina Specialist (Ophthalmology) Physician	$3.8M	$0
Brendan Girschek	AZ	Ophthalmology Physician	$3.2M	$0
John Bormes	SD	Ophthalmology Physician	$2.6M	$0
John Purviance	WY	Radiation Oncology Physician	$2.5M	$0
Elie Fahed	WY	Medical Oncology Physician	$1.9M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Behavior Management Systems, Inc.	SD	Community/Behavioral Health Agency	$0	$19.8M
Monument Health Rapid City Hospital, Inc	SD	Multi-Specialty Clinic/Center	$0	$18.7M
Monument Health Rapid City Hospital, Inc.	SD	General Acute Care Hospital	$0	$11.5M
Community Health Center Of The Black Hills Inc	SD	Federally Qualified Health Center (FQHC)	$0	$10.2M
Jrk Services, Inc	SD	Home Health Agency	$0	$10.1M
Black Hills Pediatrics, LLP	SD	Pediatrics Physician	$0	$9.7M
Rapid City Emergency Services PA	SD	Emergency Medicine Physician	$0	$8.2M
Wellspring Inc.	SD	Psychiatry Physician	$0	$7.4M
Radiology Associates Prof, LLC	SD	Diagnostic Radiology Physician	$0	$5.3M
Monument Health Rapid City Hospital, Inc.	SD	Multi-Specialty Clinic/Center	$0	$5.2M

Gail Bernard — 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