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

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

Gary Miller (NPI 1588866818)

Field	Value
Entity Type	Individual
Organization	Gary Miller
Address	1255 Pineview Dr
City	Morgantown
State	WV
ZIP	26505
Taxonomy	Ophthalmology Physician
NPI Enumerated	May 31, 2007

Payer Source	Total Paid
Medicare	$6.3M
Medicaid	$0

Key Findings

This provider’s Medicare business is highly concentrated: Total Medicare revenue is $6.3M and the precomputed top 3 Medicare codes by revenue account for 91.8% of this provider's total Medicare revenue, indicating most Medicare dollars flow from a very small set of high‑volume procedures. The practice is effectively single‑payer from a claims perspective because there is no Medicaid billing on file.

The dominant revenue driver is J0178 (aflibercept): 7.6K claims, $690 avg paid/claim, $5.2M revenue (82.8% of Medicare revenue). This code ranks #4 of 3204 providers nationally (100th percentile; extreme outlier), positioning the provider as an unusually large national volume outlier for aflibercept administration and implying an operational focus on high-frequency intravitreal anti‑VEGF delivery.

Other high-revenue procedure lines support a retina/injection-focused practice model: 67028 (3.6K claims, $95 avg, $343.4K, 5.5% of Medicare revenue) ranks #45 of 4255 (99th percentile; extreme outlier) and 92134 (4.6K claims, $29 avg, $132.4K, 2.1% of Medicare revenue) ranks #77 of 26868 (100th percentile; extreme outlier). Together with the aflibercept volume, these codes point to a service mix built around repeat intravitreal injections plus diagnostic retinal imaging rather than primary reliance on E/M office visits.

Evaluation-and-management codes are present but represent a small share of revenue: 92014 (1.6K claims, $88 avg, $144.5K, 2.3% of Medicare revenue) ranks #464 of 35415 (99th percentile; extreme outlier) and 99213 (725 claims, $61 avg, $44.2K, 0.7% of Medicare revenue) ranks #13224 of 457151 (97th percentile; notably above typical national volume). This pattern indicates the practice sees a high number of follow-up or procedure-focused visits relative to the revenue generated by traditional office E/M services.

The provider uses multiple anti‑VEGF agents but with markedly imbalanced revenue contributions: J2777 (faricimab) shows 7.8K claims and $226.2K revenue (3.6% of Medicare revenue) and ranks #1194 of 2039 (41th percentile; typical, unremarkable volume), while J2778 (ranibizumab) and J9035 (bevacizumab) have smaller revenue shares and typical-to-notable rank positions. This mix suggests clinical availability of several injectable therapies, but commercial and reimbursement dynamics heavily favor aflibercept in this practice’s billing.

Competitive standing is national-scale for multiple retinal procedures: the provider is an extreme outlier nationally for J0178, 67028, 92134 and 92014, indicating market share or throughput that is far above typical peers for these services. At the same time, several other codes (for example J2777 and J2778) fall into typical percentiles, showing that dominance is concentrated in a few specific services rather than across the full ophthalmology CPT set.

Operational and payer-risk implication: with $6.3M of Medicare revenue and no Medicaid activity reported, the provider’s financial exposure is heavily tied to Medicare reimbursement levels and to drug reimbursement/availability for high‑volume injectable agents. Any changes to coverage, reimbursement, or utilization patterns for aflibercept (J0178) would disproportionately affect this provider given that J0178 alone represents $5.2M and 82.8% of its Medicare revenue.

Tenure and continuity: the provider’s NPI was enumerated 2007-05-31 (~19 years ago), which indicates a long-established billing history in Medicare that aligns with the large cumulative volumes reported for intravitreal injections and retinal imaging. The long tenure reinforces that the observed high volumes and code concentration are persistent rather than short‑term anomalies.

Medicare: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	7,560	$690	$5.2M
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.	3,620	$100	$343.4K
J2777	Injection, faricimab‑svoa, 0.1 mg	7,800	$30	$226.2K
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…	1,640	$90	$144.5K
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.	4,570	$30	$132.4K
J2778	Injection, ranibizumab, 0.1 mg	720	$180	$129.6K
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…	730	$60	$44.2K
J9035	Injection, bevacizumab, 10 mg	620	$60	$34.8K
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…	110	$100	$10.6K
67036	The provider removes vitreous fluid from the eye to access the posterior segment of the eye and introduce surgical instruments through incisions in the pars plana.	10	$540	$5.9K

Showing 1–10 of 15

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. West Virginia Distribution

Gary Miller — 7 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. state median

15 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	1	10	2,090	$690	$1.7M
J2777	4	10	8,490	$30	$456.6K
67028	1	10	770	$80	$94.4K
J2778	1	10	370	$180	$74.3K
92014	1	180	120	$70	$16.3K
99214	1,272	2,740	100	$70	$11.8K
67036	4	10	10	$740	$10.4K
J9035	1	10	90	$50	$9.3K
99213	66	2,860	80	$50	$7.5K
92134	1	160	60	$30	$5.4K

Showing 1–10 of 15

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Regional Eye Associates, Inc	WV	Ambulatory Surgical Clinic/Center	$1.5M	$67.7K
Stephen Powell	WV	Ophthalmology Physician	$525.5K	$0
Heath Lemley	WV	Ophthalmology Physician	$512.8K	$0
Mark Mayle	WV	Ophthalmology Physician	$372.9K	$0
Brian Wood	WV	Ophthalmology Physician	$324.6K	$0
Edgar Gamponia	WV	Ophthalmology Physician	$256.6K	$0
Allison Bardes	WV	Ophthalmology Physician	$172.5K	$0
Lauren Digiovine	WV	Ophthalmology Physician	$164.2K	$0
Jennifer Talkington	WV	Certified Registered Nurse Anesthetist	$68.9K	$0
Stacy Commodore	WV	Certified Registered Nurse Anesthetist	$65.9K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Interim Healthcare Of Pittsburgh, Inc.	WV	Nursing Care Agency	$0	$23.1M
Monongalia County General Hospital Company	WV	General Acute Care Hospital	$0	$16.3M
Monongalia Emergency Medical Services Inc	WV	Ambulance	$1.4M	$11.3M
Gr&w, Inc	WV	Clinical Neuropsychologist	$0	$12.2M
Cardinal Pediatrics PLLC	WV	Pediatrics Physician	$0	$11.1M
Pace Training And Evaluation Center, Inc	WV	Developmentally Disabled Services Day Training Agency	$0	$9.2M
Therapy Services, LLC	WV	Speech-Language Pathologist	$0	$8.5M
Monongalia County General Hospital Company	WV	Specialist	$0	$6.8M
West Virginia Emergency Physicians, LLP	WV	Emergency Medicine Physician	$0	$4.7M
Renaissance Care Inc	WV	In Home Supportive Care Agency	$0	$3.1M

Gary Miller — 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