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

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

Dale Reynolds (NPI 1578531364)

Field	Value
Entity Type	Individual
Organization	Dale Reynolds
Address	2330 Troop Dr
City	Sartell
State	MN
ZIP	56377
Taxonomy	Ophthalmology Physician
NPI Enumerated	March 9, 2006

Payer Source	Total Paid
Medicare	$5.6M
Medicaid	$0

Key Findings

DALE REYNOLDS is an Ophthalmology Physician based in SARTELL, MN with an NPI enumerated on 2006-03-09 (~20 years ago), indicating two decades of Medicare enrollment and an established clinical presence in the regional market. This tenure supports the observed concentrated service patterns in retinal diagnostics and intravitreal therapy.

This provider has reported Total Medicare revenue of $5.6M and has no Medicaid billing on file, making the practice effectively single-payer in scale with Medicare as the dominant revenue source. The absence of Medicaid activity suggests either a Medicare-skewed patient panel or that Medicaid encounters are billed under a different entity.

Revenue concentration is extreme: the precomputed top 3 Medicare codes by revenue account for 87.9% of this provider's total Medicare revenue. Those top three are J2777 ($3.1M revenue, 55.4%), J0178 ($1.5M revenue, 26.3%), and 67028 ($352.1K revenue, 6.3%), indicating that a small set of drug injections and a single injection procedure drive the vast majority of billings.

The code mix points to a specialized retinal practice focused on in-office intravitreal pharmacotherapy and retinal imaging rather than broad general ophthalmology. High-volume drug codes J2777 and J0178 and procedure 67028, together with notable volumes in retinal imaging 92134 and angiography 92235, indicate primary operations are diagnosis and repeated intravitreal treatment of retinal disease.

On competitive standing, this provider is a national outlier for several core services: J2777 ranks #15 of 2039 providers nationally (99th percentile; extreme outlier) and 67028 ranks #55 of 4255 providers nationally (99th percentile; extreme outlier), while retinal imaging 92134 ranks #127 of 26868 providers nationally (100th percentile; extreme outlier). These ranks and percentiles indicate the provider is a dominant national-volume supplier for faricimab injections and high-throughput retinal diagnostic services.

Other drug and procedure volumes are more typical or modest in comparison: J0178 (aflibercept) ranks #471 of 3204 (85th percentile; typical, unremarkable volume), Q5124 ranks #41 of 122 (66th percentile; typical, unremarkable volume), and J2781 ranks #343 of 490 (28th percentile; typical, unremarkable volume). This suggests that apart from a few standout codes, the provider’s utilization of other agents and procedures falls within expected national ranges.

Operationally, the practice shows extremely high injection throughput for J2777 with 106.8K claims and a low reported average paid/claim of $29, producing $3.1M in revenue from that single code; this profile is consistent with large-volume, repetitive in-office administration of a high-cost biologic where average per-claim payments and total revenue are driven by claim count and billing modality. Similar high-volume patterns are present for 67028 (3.4K claims, $103 avg paid/claim, $352.1K revenue) and substantial imaging volume (92134: 4K claims, $31 avg paid/claim, $125.1K revenue), reinforcing a high-frequency procedure model.

The absence of Medicaid billing (none below) combined with concentrated Medicare revenue exposes the provider to payer-specific reimbursement risk: changes in Medicare drug reimbursement policy, utilization management, or shifts in clinical guidelines for intravitreal agents could disproportionately affect overall revenue. Monitoring utilization trends for J2777, J0178, and 67028 is therefore critical for payer and provider analysts evaluating financial sustainability and competitive leverage.

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
J2777	Injection, faricimab‑svoa, 0.1 mg	106,800	$30	$3.1M
J0178	Injection, aflibercept, 1 mg	2,140	$690	$1.5M
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.	3,420	$100	$352.1K
Q5124	Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg	790	$170	$136.7K
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.	4,040	$30	$125.1K
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…	1,140	$100	$108.5K
J9035	Injection, bevacizumab, 10 mg	1,740	$60	$95.6K
92235	The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken…	530	$110	$56.9K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	390	$120	$46.8K
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…	30	$860	$26.8K

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. Minnesota Distribution

Dale Reynolds — 9 of 18 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. state median

19 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	8	40	580	$690	$743.4K
J2777	1	20	6,120	$30	$411.1K
67028	1	80	420	$90	$64.8K
J2781	2	10	360	$120	$62.5K
Q5124	1	10	200	$170	$49.2K
67042	3	10	20	$1,300	$48K
67039	2	10	20	$1,250	$23.8K
J9035	1	40	220	$50	$16.9K
92014	3	830	100	$80	$11.9K
92012	151	200	60	$60	$8.8K

Showing 1–10 of 19

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vamsi Gullapalli	MN	Ophthalmology Physician	$380.4K	$17.4K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rem Central Lakes, Inc.	MN	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$122.1M
Sleep Therapy	MN	Durable Medical Equipment & Medical Supplies	$0	$11.6M
Northway Academy, Inc.	MN	Community/Behavioral Health Agency	$0	$10.5M
Centracare Clinic	MN	Primary Care Clinic/Center	$0	$6.1M
Foundations Autism Center LLC	MN	Adolescent and Children Mental Health Clinic/Center	$0	$4.7M
Regional Diagnostic Radiology	MN	Diagnostic Radiology Physician	$0	$4.4M
Charles Cunningham	MN	Diagnostic Radiology Physician	$256.8K	$0
Barry Labine	MN	Dermatology Physician	$201.4K	$0
Mats Liden	MN	Diagnostic Radiology Physician	$172.4K	$0
Joseph Nessler	MN	Orthopaedic Surgery Physician	$171.8K	$0

Dale Reynolds — Billing Profile & Reimbursement Data

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Dale Reynolds — 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