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

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

Shawn Richards (NPI 1598929796)

Field	Value
Entity Type	Individual
Organization	Shawn Richards
Address	2500 W A St
City	Moscow
State	ID
ZIP	83843
Taxonomy	Ophthalmology Physician
NPI Enumerated	July 16, 2008

Payer Source	Total Paid
Medicare	$1.4M
Medicaid	$0

Key Findings

This provider bills almost exclusively to Medicare, reporting $1.4M in total Medicare revenue and no Medicaid billing on file, making their payer mix effectively single-payer (Medicare) in the available data. The NPI was enumerated on 2008-07-16 (~18 years ago), indicating a long-tenured Medicare billing history in the market.

Revenue concentration is high: the precomputed top three Medicare codes by revenue account for 73.0% of this provider's total Medicare revenue. Those top three are J0178 ($691.4K, 49.3%), J2777 ($250.6K, 17.9%), and 92014 ($80.2K, 5.7%), indicating significant dependence on a small set of services.

The service mix points to a medical-retina and injection-focused ophthalmology practice: J0178 (aflibercept) and J2777 (faricimab) together represent the largest share of revenue and volume, and 67028 (intravitreal injection procedure) has 916 claims and $76K revenue. This combination of high anti-VEGF drug billing and frequent intravitreal injection procedure codes is consistent with routine in-office retinal injection services rather than purely refractive or optometry-focused care.

Clinical visit and exam volumes are unusually high relative to national peers: 92014 (comprehensive established patient exam) has 1K claims and $80.2K revenue and ranks #1565 of 35415 providers (96th percentile), and 92012 (intermediate established patient exam) has 1.1K claims and $62.5K revenue and ranks in the 98th percentile. These codes are described as notably above typical national volume, suggesting a substantial ongoing established-patient panel and frequent follow-up visits.

Diagnostic and imaging services are also elevated: 92134 (retinal imaging) shows 1.5K claims, $38.7K revenue and ranks #1532 of 26868 providers (94th percentile), and 92083 (visual field testing) shows 350 claims, $13.7K revenue and also ranks in the 94th percentile. The available labels indicate both codes are notably above typical national volume, supporting the interpretation that the practice maintains robust in-office diagnostic capacity to manage retinal disease.

Competitive standing for drug/injection billing is mixed: J0178 ranks #1284 of 3204 providers (60th percentile) and J2777 ranks #1112 of 2039 providers (45th percentile), both characterized as typical, unremarkable volumes nationally for those codes, which implies the provider is a modest participant in anti-VEGF administration on the national stage. In contrast, the provider is relatively strong in office-based exam and imaging volumes versus peers, where multiple codes fall in the high percentiles described as notably above typical national volume.

Surgical cataract activity appears present but limited: 66984 (standard cataract with IOL) records 173 claims and $66.8K revenue and is characterized as typical, unremarkable volume (63th percentile), while 66982 (complex cataract) has 16 claims and $9K revenue and ranks in the 12th percentile. Together these entries indicate the provider performs some cataract surgery but is not a high-volume cataract surgical center based on the supplied national ranks.

The overall pattern—heavy revenue concentration in anti-VEGF drug codes (J0178 and J2777), substantial injection procedure counts (67028), and unusually high exam and imaging volumes—suggests a practice organized around frequent follow-up for chronic retinal conditions. The combination of high-frequency established-patient visits and elevated diagnostic imaging supports a care model oriented to ongoing management of retinal disease rather than episodic surgical throughput.

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	1,000	$690	$691.4K
J2777	Injection, faricimab‑svoa, 0.1 mg	8,640	$30	$250.6K
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…	1,030	$80	$80.2K
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.	920	$80	$76K
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…	170	$390	$66.8K
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	1,100	$60	$62.5K
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.	1,490	$30	$38.7K
J2778	Injection, ranibizumab, 0.1 mg	210	$180	$37.9K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	280	$90	$24K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	90	$230	$19.5K

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. Idaho Distribution

Shawn Richards — 7 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. state median

19 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	7	20	670	$690	$541.7K
J2777	7	10	8,640	$30	$454.7K
J2778	6	10	1,190	$180	$352.5K
66984	35	150	40	$520	$76K
67028	8	30	470	$90	$66.6K
66982	14	20	30	$690	$28.3K
66821	15	60	60	$200	$18.3K
92014	4	230	120	$70	$15.5K
92012	1	70	100	$60	$10.2K
J9035	1	10	100	$50	$6.4K

Showing 1–10 of 19

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
David Leach	ID	Ophthalmology Physician	$616.6K	$0
Clearview Surgery Center, LLC	ID	Ambulatory Surgical Clinic/Center	$418K	$0
Katherine Gleason	ID	Optometrist	$47.4K	$0
Julia Cheng	ID	Audiologist	$9.9K	$0
David Wood	ID	Audiologist-Hearing Aid Fitter	$4.8K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Health Association Of Spokane	ID	Federally Qualified Health Center (FQHC)	$0	$7.4M
Disability Action Center - Nw, Inc.	ID	In Home Supportive Care Agency	$0	$3.8M
Gritman Medical Center Inc	ID	Critical Access Hospital	$0	$3.7M
Community Health Association Of Spokane	ID	Federally Qualified Health Center (FQHC)	$0	$2.7M
Crt Children Services LLC	ID	Behavior Analyst	$0	$2.5M
County Of Latah School District 281	ID	Local Education Agency (LEA)	$0	$2M
Gritman Medical Center, Inc.	ID	Family Medicine Physician	$0	$1.4M
Lotus Early Learning	ID	Developmental Disabilities Clinic/Center	$0	$1.2M
Alyssa Hoehn	ID	Ophthalmology Physician	$1M	$0
Circles Of Caring Adult Day Health Foundation, Inc.	ID	Adult Day Care Clinic/Center	$0	$744.2K

Shawn Richards — Billing Profile & Reimbursement Data

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Shawn Richards — 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