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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

John Pitcher (NPI 1538312582)

Field	Value
Entity Type	Individual
Organization	John Pitcher
Address	5757 Harper Dr Ne
City	Albuquerque
State	NM
ZIP	87109
Taxonomy	Ophthalmology Physician
NPI Enumerated	November 3, 2008

Payer Source	Total Paid
Medicare	$5.1M
Medicaid	$0

Key Findings

This provider is effectively single‑payer: lifetime Medicare revenue is $5.1M while Medicaid shows none on file, indicating the practice’s billed activity and revenue are concentrated entirely in the Medicare population rather than a mixed Medicaid/Medicare payer base. That concentration will shape payer negotiations, network considerations, and population health outreach strategies given the lack of Medicaid volume.

Revenue is highly concentrated in a small set of drugs and injections: the precomputed top‑3 Medicare codes account for 80.1% of the provider’s Medicare revenue, with J0178 ($1.9M, 37.3%), J2777 ($1.7M, 33.1%), and J2778 ($502.6K, 9.8%) supplying the dominant share of payments. This level of concentration implies the practice’s financial performance is tightly tied to usage and reimbursement for a few high‑cost intravitreal therapies.

The code mix points to a retina‑focused ophthalmology operation centered on intravitreal biologic injections and retina diagnostics: high revenue from J0178, J2777, and J2778 (aflibercept, faricimab, ranibizumab) combined with notable volume in retinal imaging 92134 and injection procedure 67028 indicates a clinic built around frequent injection visits, retinal monitoring, and some procedure throughput. The presence of vitrectomy and retina repair codes (for example 67042, 67041, 67113) shows the practice also offers surgical retinal services, though at lower volumes.

For its top injectable biologics the provider is a national high‑volume participant: J0178 ranks #221 of 3204 providers (93th percentile; notably above typical national volume) and J2777 ranks #68 of 2039 providers (97th percentile; notably above typical national volume), signaling that this clinician is well above typical national volumes for aflibercept and faricimab administration. By contrast, J2778 ranks #136 of 1208 (89th percentile; typical, unremarkable volume), indicating ranibizumab use is elevated but less dominant compared with the other two agents.

The provider shows unusually high office visit E/M throughput for Medicare: 99214 accounts for 1.2K claims and $108.2K revenue (2.1% of Medicare revenue) and ranks #6662 of 479517 providers (99th percentile; extreme outlier). This extreme outlier status for a mid‑level established visit code suggests a large panel of established Medicare patients and frequent follow‑up encounters consistent with an injection‑centric practice that requires recurrent monitoring.

Several ancillary drug and unclassified biologic codes contribute meaningful secondary revenue: J3590 (159 claims, $345.2K, 6.7%) ranks #211 of 631 (67th percentile; typical, unremarkable volume) and J3490 (34 claims, $61.9K, 1.2%) ranks #2096 of 2838 (25th percentile; typical, unremarkable volume). These entries indicate use of additional high‑cost or unclassified products beyond the primary anti‑VEGF agents, which can add variability to per‑patient revenue and inventory/administration requirements.

Procedure mix shows high injection procedure throughput with selective surgical work: 67028 appears at 2.5K claims and $237.3K (4.6% of Medicare revenue) with a national rank of #180 of 4255 (96th percentile; notably above typical national volume), while vitrectomy codes such as 67042 and 67041 are present at much lower claim counts and revenue. This pattern is consistent with a practice that is primarily an outpatient injection and monitoring center but maintains capacity for more complex retinal surgeries on a smaller scale.

The provider has long tenure in Medicare billing — NPI enumerated 2008-11-03 (~18 years ago) — which, combined with concentrated anti‑VEGF revenue and repeated high‑volume codes, suggests an established retina practice with a sustained Medicare patient base; reliance on a narrow set of high‑cost drugs, however, creates revenue sensitivity to changes in utilization patterns or reimbursement for those specific codes.

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	2,780	$690	$1.9M
J2777	Injection, faricimab‑svoa, 0.1 mg	58,740	$30	$1.7M
J2778	Injection, ranibizumab, 0.1 mg	2,720	$190	$502.6K
J3590	Unclassified biologics	160	$2,170	$345.2K
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.	2,500	$100	$237.3K
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…	1,230	$90	$108.2K
J7312	Injection, dexamethasone, intravitreal implant, 0.1 mg	500	$150	$77.1K
J3490	Unclassified drugs	30	$1,820	$61.9K
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.	1,510	$30	$42.3K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	350	$120	$41.4K

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. New Mexico Distribution

John Pitcher — 7 of 23 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. state median

23 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	1	20	1,100	$690	$816.1K
J2777	1	20	17,340	$30	$653.4K
J2778	2	10	720	$180	$247.3K
J3590	1	10	30	$1,420	$97.9K
67028	1	30	390	$90	$71.6K
J2781	3	10	560	$120	$62K
J7312	1	10	310	$150	$50.2K
67041	3	10	20	$1,200	$44.5K
67042	4	10	30	$980	$31.3K
67036	5	10	20	$980	$31.2K

Showing 1–10 of 23

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eye Associates Of New Mexico Ltd	NM	Ophthalmology Physician	$0	$46.9M
Mark Chiu	NM	Ophthalmology Physician	$3.8M	$0
Christopher Roybal	NM	Ophthalmology Physician	$3.8M	$0
Richard Kinsey	TN	Anatomic Pathology & Clinical Pathology Physician	$3.3M	$147.3K
Ashok Reddy	NM	Ophthalmology Physician	$3.2M	$0
Mark Carmichael	CA	Hematology & Oncology Physician	$3.1M	$0
Howard Martin	TX	Dermatopathology (Pathology) Physician	$3M	$0
Kamalesh Ramaiya	NM	Ophthalmology Physician	$2.9M	$0
Daniel Kasuga	TX	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Richard Hwang	TX	Retina Specialist (Ophthalmology) Physician	$2.6M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Presbyterian Healthcare Services	NM	Internal Medicine Physician	$0	$240.8M
Heritage Home Healthcare Services, Inc.	NM	Home Health Agency	$0	$141.5M
Home Medical Equipment Specialists LLC	NM	Durable Medical Equipment & Medical Supplies	$0	$100M
The New Beginnings LLC	NM	Adult Day Care Clinic/Center	$0	$85.1M
We Care Agency, Inc.	NM	In Home Supportive Care Agency	$0	$60.1M
Lovelace Health System, LLC	NM	General Acute Care Hospital	$0	$57.7M
Adelante Development Center, Inc.	NM	Personal Care Attendant	$0	$57M
Southwest Labs LLC	NM	Clinical Medical Laboratory	$1.1M	$41.5M
Southwest Medical Associates, LLC	NM	General Practice Physician	$0	$41.4M
Tspc-nm, LLC	NM	Nursing Care Agency	$0	$28.9M

John Pitcher — 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