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

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

Samuel Taylor (NPI 1568491017)

Field	Value
Entity Type	Individual
Organization	Samuel Taylor
Address	500 Hargrove Rd E
City	Tuscaloosa
State	AL
ZIP	35401
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	June 30, 2006

Payer Source	Total Paid
Medicare	$1.3M
Medicaid	$0

Key Findings

This provider is effectively a Medicare-focused retina practice: lifetime Medicare revenue is $1.3M while there is no Medicaid billing on file, so the provider operates as a single‑payer (Medicare) biller in available data and has no recorded Medicaid activity to compare against. The lack of Medicaid claims suggests limited participation in state Medicaid networks or no Medicaid-covered patient volume during the reporting window.

Revenue is highly concentrated in a very small set of injection and retinal procedure codes — the precomputed top three Medicare codes account for 89.2% of this provider's Medicare revenue. Those top three contributors are J0178 (67.0% of Medicare revenue), J2777 (13.0%), and 67028 (9.2%), indicating most revenue comes from anti‑VEGF injections and isolated intravitreal procedures.

The code mix and top codes point to a procedure‑centric retina practice: J0178 (aflibercept) shows 1.2K claims at $692 avg paid/claim for $859.5K revenue, J2777 (faricimab) shows 5.8K claims at $29 avg paid/claim for $167K revenue, and 67028 shows 1.5K claims at $79 avg paid/claim for $117.7K revenue. Together these indicate frequent intravitreal injection activity and isolated vitreous injections as the primary service lines rather than a general ophthalmology panel of procedures.

Competitive standing on the principal anti‑VEGF code is middling rather than dominant: J0178 ranks #1052 of 3204 nationally (67th percentile) and is described as typical/unremarkable volume, while J2777 ranks #1428 of 2039 nationally (30th percentile) and is likewise described as typical/unremarkable volume. The isolated injection code 67028 ranks #812 of 4255 (81th percentile; typical/unremarkable volume), indicating somewhat higher relative use of the separate intravitreal injection procedure but still within typical national ranges.

There are notable above‑typical volumes in diagnostic imaging and established-patient visits that support ongoing management of chronic retinal disease: 92134 (retinal imaging) ranks #1238 of 26868 nationally (95th percentile; notably above typical national volume) and 99213 (established office visit) ranks #14612 of 457151 nationally (97th percentile; notably above typical national volume). High utilization of 92134 and 99213 suggests the practice not only performs injections but also sustains frequent imaging follow-up and routine E/M encounters for chronic retina patients.

Despite some high percentiles on imaging and E/M, certain alternative anti‑VEGF use is present but not dominant: J9035 (bevacizumab) appears with 738 claims, $53 avg paid/claim, $39.1K revenue and ranks #138 of 1852 (93th percentile) and is labeled typical/unremarkable; this indicates bevacizumab is used but contributes a modest share of revenue relative to aflibercept. The presence of multiple injectable agents in the mix suggests clinical flexibility in treatment options even though one agent dominates revenue.

The provider shows long tenure in Medicare billing: NPI enumerated 2006-06-30 (~20 years ago), indicating established presence in the Medicare market and sustained billing history over approximately two decades. That tenure aligns with the practice pattern of frequent chronic-disease management reflected in imaging and follow-up visit volumes.

From a business perspective, the practice has a narrow revenue base concentrated on anti‑VEGF injections (J0178/J2777) and one procedure code (67028), which implies sensitivity to changes in utilization patterns, reimbursement, or drug choice: with 89.2% of Medicare revenue coming from the top three codes, shifts in prescribing, pricing, or payer coverage for these specific services would materially affect revenue. At the same time, elevated imaging (92134) and E/M (99213) volumes provide recurring visit-driven revenue that supports ongoing management of retinal disease and may stabilize cash flow relative to procedure-only models.

Medicare: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,240	$690	$859.5K
J2777	Injection, faricimab‑svoa, 0.1 mg	5,760	$30	$167K
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.	1,490	$80	$117.7K
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.	1,790	$30	$50K
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…	690	$60	$41.5K
J9035	Injection, bevacizumab, 10 mg	740	$50	$39.1K
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…	50	$100	$4.7K
99203	The provider sees a new 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 provider…	40	$80	$3.3K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Alabama Distribution

Samuel Taylor — 1 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. state median

8 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	13	40	920	$690	$706.2K
J2777	17	20	7,140	$30	$267.9K
67028	8	40	990	$90	$82.5K
J9035	9	40	410	$50	$24.5K
99214	5,423	7,330	120	$80	$16.8K
99213	159	6,470	80	$50	$7.9K
92134	23	410	50	$30	$6.4K
99203	796	2,210	30	$70	$3.1K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vikram Saini	AL	Retina Specialist (Ophthalmology) Physician	$3.1M	$0
Andrew Mcfarland	VA	Retina Specialist (Ophthalmology) Physician	$3.1M	$0
Daniel Bennett	NC	Retina Specialist (Ophthalmology) Physician	$3M	$0
Daniel Kasuga	TX	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Edgar Ready	AL	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
Wasim Samara	TX	Ophthalmology Physician	$2.3M	$0
Kevin Wells	TX	Ophthalmology Physician	$2.1M	$0
Charles Clark	TX	Ophthalmology Physician	$2.1M	$0
Eric Zavaleta	TX	Ophthalmology Physician	$1.9M	$0
Mathew Sapp	AL	Retina Specialist (Ophthalmology) Physician	$1.6M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Dch Healthcare Authority	AL	General Acute Care Hospital	$0	$16M
Capstone Health Services Foundation PC	AL	Family Medicine Physician	$0	$12.5M
Whatley Health Services Inc	AL	Federally Qualified Health Center (FQHC)	$0	$8.8M
Northstar Ems, Inc.	AL	Land Ambulance	$2.1M	$5.6M
Greater Alabama Health Network	AL	Case Management Agency	$0	$5.1M
Relias Emergency Medicine Specialists Of Regional, LLC	AL	Emergency Medicine Physician	$0	$4.4M
Tuscaloosa Neonatal PC	AL	Neonatal-Perinatal Medicine Physician	$0	$2.9M
Dva Healthcare Of Tuscaloosa LLC	AL	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.1M
Neonatal Medical Care P.C.	AL	Neonatal-Perinatal Medicine Physician	$0	$1.7M
Greater Alabama Health Network	AL	Exclusive Provider Organization	$0	$1.4M

Samuel Taylor — 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