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

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

Elisha Tilton (NPI 1518189869)

Field	Value
Entity Type	Individual
Organization	Elisha Tilton
Address	1400 Dry Creek Dr
City	Longmont
State	CO
ZIP	80503
Taxonomy	Ophthalmology Physician
NPI Enumerated	May 3, 2007

Payer Source	Total Paid
Medicare	$1.9M
Medicaid	$0

Key Findings

This provider is effectively a Medicare-focused practice: lifetime Medicare revenue is $1.9M and there is no Medicaid billing on file (none). The absence of Medicaid activity makes the provider effectively single‑payer from a public-program perspective and concentrates reimbursement exposure on Medicare policy and beneficiary mix.

Revenue is highly concentrated in a small set of services: the precomputed top three Medicare codes account for 85.7% of Medicare revenue, led by J0178 at 47.8% and J2777 at 32.1%, with 67028 contributing 5.8%. That distribution indicates that a large majority of the provider’s Medicare dollars are generated by intravitreal drug administration and a related isolated injection procedure.

The code mix and descriptions point to a retina-oriented ophthalmology practice centered on in-office anti‑VEGF and related biologic injections (J0178, J2777) supported by diagnostic retinal imaging (92134, 92250) and frequent office E/M visits (99214, 99213). High-volume retinal imaging and E/M codes alongside the dominant drug codes are consistent with a treatment model of frequent follow-up and monitoring for chronic retinal disease.

Despite the heavy revenue weighting toward injectable drugs, the provider’s national standing on those drug codes is not that of an outlier: J0178 (47.8% of Medicare revenue) ranks #957 of 3204 providers (70th percentile) and is characterized as "typical, unremarkable volume," while J2777 (32.1% of Medicare revenue) ranks #469 of 2039 providers (77th percentile) and is also described as "typical, unremarkable volume." Those ranks indicate modest-to-above-average usage nationally rather than dominant market share for anti‑VEGF administration.

Clinical workload is augmented by above‑typical volumes of evaluation/management and retinal imaging: 99214 appears with 929 claims and $86.4K revenue and is labeled "notably above typical national volume" (97th percentile), and 92134 has 1.7K claims and $51.8K revenue and is labeled "notably above typical national volume" (95th percentile). This pattern suggests a substantial follow-up and monitoring workflow that complements the high-volume injection practice and drives non‑drug revenue.

The provider performs a limited set of surgical/advanced retinal procedures in addition to injections: 67042 (vitrectomy with internal limiting membrane peel) appears with 19 claims and $17.4K revenue (0.9% of Medicare revenue) and is characterized as a typical, unremarkable volume for that code. Additional low-frequency procedure codes (67145, 66821) appear at small revenue shares, indicating some surgical capability but item-level volumes that are far smaller than injection and imaging services.

The NPI tenure shows longstanding enrollment: the provider was enumerated on 2007-05-03 (~19 years ago), indicating an established presence in the market and likely continuity of clinical relationships that support repeated injection and monitoring encounters. This length of enrollment aligns with the sustained, procedure-driven revenue profile seen in the Medicare data.

From a business and payer‑mix perspective, the combination of being Medicare‑only (none for Medicaid) and deriving nearly half of Medicare revenue from J0178 and another third from J2777 creates concentrated financial exposure to changes in anti‑VEGF utilization, drug pricing, and Medicare reimbursement policy. For analysts, that concentration identifies both an operational strength (high procedural throughput and monitoring cadence) and a leverage point where shifts in drug use or payer rules would meaningfully affect overall revenue.

Medicare: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,330	$690	$912.3K
J2777	Injection, faricimab‑svoa, 0.1 mg	21,900	$30	$613.2K
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.	1,120	$100	$111.5K
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…	930	$90	$86.4K
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.	1,670	$30	$51.8K
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…	390	$90	$36.2K
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…	410	$70	$29.3K
J7999	Compounded drug, not otherwise classified	280	$70	$18.4K
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	$920	$17.4K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	380	$30	$10.9K

Showing 1–10 of 15

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Colorado Distribution

Elisha Tilton — 4 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. state median

15 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	14	60	740	$690	$618.3K
J2777	9	40	8,910	$30	$456.1K
67028	23	80	670	$100	$73.3K
67042	17	30	20	$1,140	$29.6K
J7999	17	50	230	$70	$21.5K
66821	163	180	40	$240	$15.5K
92014	96	670	100	$80	$15.2K
92235	29	50	50	$110	$12.2K
99214	49	8,160	80	$80	$11.3K
92134	20	440	60	$30	$7.8K

Showing 1–10 of 15

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Justin Kanoff	CO	Retina Specialist (Ophthalmology) Physician	$1.7M	$0
Carl Noble	CO	Retina Specialist (Ophthalmology) Physician	$1.7M	$0
Matthew Manry	CO	Retina Specialist (Ophthalmology) Physician	$1.6M	$0
Micah Rothstein	CO	Glaucoma Specialist (Ophthalmology) Physician	$283.4K	$0
Anjali Sheth	CO	Glaucoma Specialist (Ophthalmology) Physician	$234K	$0
Mansi Parikh	CO	Glaucoma Specialist (Ophthalmology) Physician	$167.1K	$0
Joel Meyers	CO	Ophthalmic Plastic and Reconstructive Surgery Physician	$154.7K	$0
Aimee Verner	CO	Cornea and External Diseases Specialist Physician	$138.2K	$0
Taylor Bowman	WY	Optometrist	$91.3K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kirk Mitchell	CO	Geriatric Medicine (Internal Medicine) Physician	$27.1M	$1M
Advanced Vision Surgery Center LLC	CO	Ambulatory Surgical Clinic/Center	$1.8M	$0
Front Range Orthopedic Surgery Center LLC	CO	Ambulatory Surgical Clinic/Center	$190.1K	$0
William Cooney	CO	Sports Medicine (Orthopaedic Surgery) Physician	$184.2K	$0
Timothy Pater	CO	Orthopaedic Hand Surgery Physician	$183.1K	$0
Nirav Shah	CO	Sports Medicine (Orthopaedic Surgery) Physician	$153.4K	$0
George Chaus	CO	Orthopaedic Trauma Physician	$139.3K	$0
Tamara Bockman	CO	Psychiatric/Mental Health Registered Nurse	$111.3K	$0
Elliot Good	CO	Psychiatric/Mental Health Nurse Practitioner	$107.8K	$0
Matthew Gerlach	CO	Orthopaedic Surgery of the Spine Physician	$97.3K	$0

Elisha Tilton — 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