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

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

William Clark (NPI 1528057890)

Field	Value
Entity Type	Individual
Organization	William Clark
Address	124 Sunset Court
City	West Columbia
State	SC
ZIP	29169
Taxonomy	Ophthalmology Physician
NPI Enumerated	October 19, 2005

Payer Source	Total Paid
Medicare	$3.3M
Medicaid	$0

Key Findings

This provider’s public billing footprint is effectively single‑payer: lifetime Medicare revenue is $3.3M and there is no Medicaid billing on file, so the practice’s reimbursement exposure and patient mix are overwhelmingly Medicare-driven rather than balanced across payers. Analysts should treat Medicaid as absent when modeling payer mix or population access for this NPI.

Revenue is highly concentrated in a few drug/injection codes: the precomputed top 3 codes account for 74.8% of Medicare revenue, with J0178 contributing $1.6M (49.5%), J3490 contributing $448.7K (13.7%), and Q5128 contributing $385K (11.7%). This concentration indicates the practice’s financial performance is tightly linked to a small set of high-value intravitreal drug administrations.

Clinical/service-line pattern points to a retina-focused, procedure-driven practice: the top billings are intravitreal injection drugs (J0178, Q5128, J2778, J2777) alongside procedure codes that capture injections into the vitreous (67028). The predominance of high-revenue drug codes and injection procedure codes suggests the operation centers on medical retina care (anti‑VEGF and related therapies) rather than primary ophthalmic evaluation alone.

Despite the procedure focus, evaluation & management and standard eye exam codes contribute only a small share of revenue: for example, 99214 shows 230 claims with $17.7K revenue (0.5%) and 92012 shows 309 claims with $17.6K revenue (0.5%). This split indicates the practice generates outsized revenue from therapeutics and procedures rather than routine office visits.

Competitive standing for the largest drug codes is modestly strong but not dominant nationally: J0178 ranks #375 of 3204 providers (88th percentile; typical, unremarkable volume for this code), J3490 ranks #285 of 2838 providers (90th percentile; typical, unremarkable volume), and Q5128 ranks #74 of 373 providers (80th percentile; typical, unremarkable volume). In sum, the provider is above typical national volume for several key drugs but is not among a small set of national leaders.

There is a standout statistical signal in diagnostic imaging: 92134 shows 2.3K claims, $64K revenue (1.9%) and ranks #800 of 26868 providers nationally (97th percentile; extreme outlier). This suggests unusually high retinal imaging activity relative to peers and may reflect workflow or service-line emphasis on imaging-intensive retinal care.

Claim-count vs reimbursement patterns show a mix of very high claim volumes with low average paid amounts for some codes: J2777 reports 4.9K claims with $28 avg paid/claim and $136.1K revenue (4.1%) while 67028 reports 1.7K claims with $93 avg paid/claim and $161.5K revenue (4.9%). These patterns are consistent with high-throughput injection clinics where the item/unit counts are large but per-unit reimbursement can be modest for certain billing codes.

Provider tenure is long-established: the NPI was enumerated 2005-10-19 (~21 years ago), indicating a sustained presence in the market; combined with $3.3M in lifetime Medicare revenue and the concentrated drug/injection mix, this points to a stable, procedure-centered ophthalmology practice serving mainly the Medicare population.

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	2,360	$690	$1.6M
J3490	Unclassified drugs	230	$1,950	$448.7K
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	1,770	$220	$385K
J2778	Injection, ranibizumab, 0.1 mg	1,890	$180	$348.1K
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.	1,740	$90	$161.5K
J2777	Injection, faricimab‑svoa, 0.1 mg	4,860	$30	$136.1K
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.	2,290	$30	$64K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	390	$120	$46.8K
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…	230	$80	$17.7K
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…	310	$60	$17.6K

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. South Carolina Distribution

William Clark — 1 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. state median

15 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	14	50	970	$690	$1.1M
J2777	33	40	15,960	$30	$594.7K
J2778	11	30	1,440	$180	$337.4K
Q5128	4	10	1,150	$220	$273.3K
J2781	14	20	720	$120	$128K
67028	15	50	1,140	$90	$110.3K
J3490	4	50	70	$510	$57.7K
92014	323	540	160	$80	$24.3K
99426	18	20	200	$40	$23.3K
99214	3,101	7,860	160	$80	$23.2K

Showing 1–10 of 15

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Palmetto Retina Center LLC	SC	Ophthalmology Physician	$0	$10.6M
Shil Patel	VA	Ophthalmology Physician	$6.1M	$0
James Pate	NC	Ophthalmology Physician	$5.2M	$0
Nitin Gupta	NC	Ophthalmology Physician	$4.7M	$0
John Payne	SC	Ophthalmology Physician	$4M	$0
John Wells	SC	Ophthalmology Physician	$3.9M	$0
Joshua Robinson	MI	Ophthalmology Physician	$3.7M	$0
John Thordsen	NC	Retina Specialist (Ophthalmology) Physician	$3.5M	$0
Rebecca Manning	NC	Retina Specialist (Ophthalmology) Physician	$3.4M	$0
Matthew Cole	TN	Ophthalmology Physician	$3.3M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Palmetto Infusion Services LLC	SC	Infusion Therapy Clinic/Center	$0	$93.6M
Lexington Health Inc	SC	General Acute Care Hospital	$0	$27.4M
Lexington County Health Services District Inc	SC	General Acute Care Hospital	$0	$19.2M
United Cerebral Palsy Of South Carolina, Inc	SC	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$15.7M
Lexington Health Inc	SC	Emergency Medicine Physician	$0	$4.2M
Karen Park Family Dentistry, P.A.	SC	Dentist	$0	$4.2M
Lexington County Health Serv	SC	General Acute Care Hospital	$0	$4M
Steven Madden	SC	Hematology & Oncology Physician	$4M	$0
Lexington Treatment Specialists LLC	SC	Methadone Clinic	$76.7K	$3.6M
Lexington Health Inc	SC	Obstetrics & Gynecology Physician	$0	$3.5M

William Clark — Billing Profile & Reimbursement Data

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William Clark — 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