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

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

Adam Carver (NPI 1588824221)

Field	Value
Entity Type	Individual
Organization	Adam Carver
Address	1229 E Seminole St Ste 420
City	Springfield
State	MO
ZIP	65804
Taxonomy	Ophthalmology Physician
NPI Enumerated	June 16, 2008

Payer Source	Total Paid
Medicare	$2.2M
Medicaid	$0

Key Findings

This provider’s billing is effectively single‑payer Medicare: total Medicare revenue is $2.2M and there is no Medicaid billing on file. The practice’s revenue is highly concentrated — the top 3 Medicare codes by revenue account for 82.3% of this provider's total Medicare revenue — indicating most clinical activity and revenue are driven by a very small set of services.

J0178 is the dominant revenue driver: J0178 (Injection, aflibercept, 1 mg) accounts for $1.5M revenue (68.5% of this provider's total Medicare revenue) with 2.1K claims. That concentration on a high-cost injectable reflects a practice model built around repeated intravitreal anti‑VEGF administration rather than broad primary ophthalmology visits.

The code mix beyond J0178 further supports a retina/procedural focus: 67028 (vitreous injection as an isolated/separate procedure) has $183.7K revenue (8.5%) with 2K claims, and 92014 (comprehensive established eye exam) has $114.5K revenue (5.3%) with 1.4K claims. High volumes for intravitreal injection codes alongside substantial imaging and comprehensive exam activity suggest the practice manages chronic retinal disease through recurring injection visits paired with periodic diagnostic evaluation.

Several services are extreme outliers or notably elevated versus national peers, underlining a specialized practice footprint. 92014 ranks #722 of 35415 providers nationally (98th percentile; extreme outlier, far above typical national volume), 92134 ranks #468 of 26868 (98th percentile; extreme outlier, far above typical national volume), and J9035 ranks #30 of 1852 (98th percentile; notably above typical national volume), indicating unusually high volumes of comprehensive established exams, OCT imaging, and bevacizumab injections relative to peers.

Competitive standing is mixed: J0178’s rank (#473 of 3204, 85th percentile) is high but described as "typical, unremarkable volume" for that code at the national level, so the provider is a meaningful but not dominant national user of aflibercept. At the same time, the extreme outlier status of 92014 and 92134 suggests the provider is a regional/national high-volume outlier for evaluation and retinal imaging services, which can signal market leadership in retina care within its service area.

Clinical implications from the code profile point to management of chronic retinal conditions: heavy use of intravitreal anti‑VEGF agents (J0178 and J9035), frequent retinal imaging (92134), and fluorescein angiography (92235) are consistent with ongoing treatment and monitoring of conditions such as neovascular age‑related macular degeneration and diabetic macular edema. The presence of retina surgery codes (e.g., 67036, 67108, 67113) at lower but nonzero levels indicates the practice also performs surgical retinal procedures rather than referring all surgical cases elsewhere.

Operational signal — visit and procedure balance: the practice reports 2.1K J0178 claims and 1.4K 92014 claims, meaning intravitreal injection encounters are at least as frequent as comprehensive established exams according to billed claims. This pattern is consistent with a workflow focused on high-frequency procedure visits (injection-only encounters and imaging) interspersed with periodic comprehensive evaluations.

Tenure is long enough to suggest an established local practice footprint: the NPI was enumerated 2008-06-16 (~18 years ago). Combined with the concentrated revenue mix and several high-percentile code rankings, the provider appears to be a long‑standing retinal specialist with a steady Medicare revenue base and little to no Medicaid participation.

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
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.	2,040	$90	$183.7K
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…	1,410	$80	$114.5K
J9035	Injection, bevacizumab, 10 mg	1,680	$60	$92.5K
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.	2,840	$30	$79.5K
67210	The provider destroys a lesion of the retina using a laser beam that heats up the tissue.	140	$430	$58.3K
J7312	Injection, dexamethasone, intravitreal implant, 0.1 mg	170	$160	$26.7K
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	$830	$23.4K
67108	The provider repairs a detached retina using heat produced by a laser beam or by freezing the tissues. He may attach a scleral buckle to simplify the passage of fluid through and behind the retina or…	20	$860	$18.9K
67113	The provider repairs a complicated detached retina. He removes vitreous humor, the gelatinous material that gives shape to the eye, and peels the retinal membrane. He reattaches the retina with…	20	$940	$18.7K

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. Missouri Distribution

Adam Carver — 6 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. state median

19 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	6	60	820	$690	$683.3K
67028	6	80	600	$90	$69.7K
J7312	6	10	170	$160	$33.8K
67042	7	30	20	$1,070	$26.8K
67113	4	10	20	$1,170	$25.8K
67036	9	20	20	$980	$25.5K
J9035	2	40	170	$60	$21.8K
67108	3	20	10	$1,060	$18K
92014	6	730	120	$80	$18K
67210	1	10	20	$400	$13.7K

Showing 1–10 of 19

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Hospital Springfield	MO	General Acute Care Hospital	$0	$64.5M
Mercy Clinic Springfield Communities	MO	Family Medicine Physician	$0	$51.5M
Mercy Hospital Joplin	MO	General Acute Care Hospital	$0	$46.7M
Mercy Hospital Springfield	MO	Land Ambulance	$0	$46.7M
Mercy Clinic Joplin LLC	MO	Family Medicine Physician	$0	$20.4M
Mercy Hospital Carthage	MO	Critical Access Hospital	$0	$18.8M
Mercy Clinic Springfield Communities	MO	Family Medicine Physician	$0	$15.1M
Mercy Hospital Springfield	MO	General Acute Care Hospital	$0	$6.6M
Mercy Hospital Springfield	MO	Air Ambulance	$0	$6.5M
Erica Ballard	MO	Ophthalmology Physician	$1.4M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Burrell, Inc.	MO	Community/Behavioral Health Agency	$0	$758.9M
Phoenix Home Care, LLC	MO	Nursing Care Agency	$0	$199.5M
Phoenix Home Care, LLC	MO	In Home Supportive Care Agency	$0	$149M
Integrity Home Care, LLC	MO	Home Health Agency	$0	$115.7M
Preferred Family Healthcare, Inc.	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$23M
Premier Home Health Care, Inc.	MO	Home Health Agency	$0	$12.1M
Burrell, Inc.	MO	Community/Behavioral Health Agency	$0	$9.1M
2gethertech, LLC	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$7.5M
Easter Seals Midwest	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$5.7M
Elite Pain Management, LLC	MO	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$0	$3.5M

Adam Carver — 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