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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Frank Ashburn (NPI 1538426051)

Field	Value
Entity Type	Individual
Organization	Frank Ashburn
Address	4910 Massachusetts Ave Nw Ste 21
City	Washington
State	DC
ZIP	20016
Taxonomy	Glaucoma Specialist (Ophthalmology) Physician
NPI Enumerated	April 20, 2012

Payer Source	Total Paid
Medicare	$418.4K
Medicaid	$0

Key Findings

This provider’s billing is effectively single‑payer: total Medicare revenue is $418.4K and there is no Medicaid billing on file, so operations and revenue exposure are concentrated in Medicare patients only. The NPI was enumerated on 2012-04-20 (~14 years ago), indicating an established practice tenure in the market.

Revenue concentration is high: the precomputed top 3 Medicare codes by revenue account for 66.8% of this provider’s total Medicare revenue, with 66984 contributing $171.6K (41.0%), 99214 contributing $54.1K (12.9%), and 99213 contributing $53.5K (12.8%). This concentration means a small set of services drives roughly two‑thirds of receipts, amplifying the financial impact of changes to those codes.

The clinical mix is surgery‑oriented with substantial office care: 66984 (cataract extraction with IOL) is the single largest revenue driver (359 claims, $478 avg paid/claim, $171.6K), while 99214 and 99213 together represent significant evaluation and management volume (564 and 704 claims respectively) that supports pre‑op, post‑op, and routine glaucoma follow‑up. High use of both surgical cataract codes and mid‑to‑high complexity E/M codes suggests an ophthalmology practice that combines operating room procedures with a busy outpatient clinic.

Diagnostic imaging is a distinct operational emphasis: 92250 appears as an outlier with 929 claims, $31 avg paid/claim, generating $28.8K and labeled an "extreme outlier" (ranks #309 of 25087, 99th percentile). That unusually high fundus photography throughput relative to peers points to heavy reliance on imaging workflows and could indicate a centralized imaging service or protocol that generates many billable imaging events per patient.

Competitive standing varies by service line. For the top surgical code 66984 the provider ranks #3592 of 15965 (77th percentile), characterized as typical and unremarkable national volume for cataract surgery, whereas 99213 ranks #14092 of 457151 (97th percentile) and 99204 ranks #5662 of 227068 (97th percentile), both described as notably above typical national volumes—together these patterns indicate a practice that is a modest surgical participant but a high‑volume clinic for office E/M.

Several other codes reinforce the service mix but remain small contributors: codes such as 92250 (6.9%), 99204 (5.6%), and 65820 (3.8%) fill out the portfolio, while many additional CPTs each contribute under ~3.1% of Medicare revenue. The long tail of lower‑value codes suggests revenue diversification beyond the top three, but no single secondary code approaches the top contributor’s scale.

The absence of Medicaid activity ("none below — this provider has no Medicaid billing on file") means competitive and contracting assessments should treat this entity as effectively Medicare‑focused; payer negotiations or network development aimed at Medicaid populations are unlikely to find existing utilization. From a population‑health or access perspective, this provider does not appear to engage materially with Medicaid beneficiaries based on the available billing data.

Operational risk is concentrated: with 66.8% of Medicare revenue tied to three codes, reimbursement policy changes or shifts in cataract surgery volume could disproportionately affect the practice. At the same time, extreme and notably above‑typical rankings for imaging and certain E/M codes underscore strengths in outpatient throughput that could be leveraged in payer discussions or capacity planning.

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
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…	360	$480	$171.6K
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…	560	$100	$54.1K
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…	700	$80	$53.5K
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,…	930	$30	$28.8K
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…	190	$130	$23.6K
65820	The provider incises the limbus to improve drainage of aqueous humor in the eye. This procedure is typically performed on children, usually to treat congenital glaucoma.	20	$750	$15.7K
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…	120	$110	$13K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	40	$310	$12.9K
66988	The provider inserts an artificial lens after endoscopic cyclophotocoagulation and removing an extracapsular cataract by aspiration or use of ultrasonic waves.	20	$580	$12.2K
92136	The provider uses a noninvasive method to measure the patient’s eye or eyes to get information that the provider then uses to calculate the appropriate power for an intraocular lens (IOL). Selecting…	210	$40	$8.8K

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. District of Columbia Distribution

Frank Ashburn — 4 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. state median

19 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
66984	2	30	70	$460	$45.8K
92014	25	50	100	$90	$26.2K
65820	2	10	20	$700	$15.5K
99214	70	1,400	90	$100	$15.3K
65855	6	10	50	$210	$14.4K
99215	388	660	50	$130	$12.3K
66988	1	10	20	$580	$12.2K
66821	6	20	30	$290	$9.6K
92250	3	40	130	$30	$9.3K
99213	30	1,200	50	$70	$8.5K

Showing 1–10 of 19

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Thomas Johnson	VA	Retina Specialist (Ophthalmology) Physician	$3.6M	$0
Travis Peck	MD	Ophthalmology Physician	$2.5M	$0
Joshua Levinson	MD	Retina Specialist (Ophthalmology) Physician	$2.4M	$0
William Phillips	MD	Retina Specialist (Ophthalmology) Physician	$2.4M	$0
Sneha Padidam	MD	Retina Specialist (Ophthalmology) Physician	$1.6M	$0
Brian Do	MD	Retina Specialist (Ophthalmology) Physician	$1.2M	$0
Mariam Mathai	MD	Retina Specialist (Ophthalmology) Physician	$1.1M	$4.2K
Musa Abdelaziz	TX	Retina Specialist (Ophthalmology) Physician	$693.1K	$0
Michael Summerfield	MD	Ophthalmology Physician	$648.3K	$0
Pedro Rivera-velazquez	MD	Legal Medicine	$570.5K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lucy Webb Hayes National Training School For Deaconesses & Missionarie	DC	General Acute Care Hospital	$0	$19.1M
Jeffrey Steinberg	DC	Foot & Ankle Surgery Podiatrist	$13.3M	$0
Friendship Place	DC	Case Management Agency	$0	$5.6M
Wisconsin Ave Psychiatric Center Inc	DC	Psychiatric Hospital	$0	$3.1M
Iona Senior Services	DC	Adult Health Nurse Practitioner	$0	$1.1M
Mary Ella Carter	DC	Plastic Surgery Physician	$942.2K	$0
Jaydot LLC	DC	Case Management Agency	$0	$820.6K
Edward Tanner	DC	Gynecologic Oncology Physician	$786.3K	$2.1K
Brandi Page	DC	Radiation Oncology Physician	$761K	$0
Joshua Yamamoto	DC	Cardiovascular Disease Physician	$688.3K	$0

Frank Ashburn — Billing Profile & Reimbursement Data

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Frank Ashburn — 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