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

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

Brandon Busbee (NPI 1609952654)

Field	Value
Entity Type	Individual
Organization	Brandon Busbee
Address	345 23rd Ave N
City	Nashville
State	TN
ZIP	37203
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	October 31, 2006

Payer Source	Total Paid
Medicare	$4.3M
Medicaid	$0

Key Findings

BRANDON BUSBEE is operating as a retina specialist with a procedure-heavy, intravitreal-injection–centric practice: the top revenue-driving codes are J0178 ($1.1M, 25.2% of Medicare revenue), Q5128 ($1M, 23.9%), and J2777 ($769.1K, 18.1%), all of which correspond to intravitreal biologic therapies. These three codes together account for 67.3% of the provider’s Medicare revenue, reflecting a clinical focus on anti-VEGF and related retinal pharmacotherapies rather than predominantly office-based E/M work or surgical retina procedures.

The provider’s revenue is highly concentrated: the precomputed top-3 codes represent 67.3% of total Medicare revenue while lifetime Medicare revenue totals $4.3M. That concentration creates operational reliance on a small number of high-volume drug-administration codes and makes overall revenue sensitive to price, utilization, or formulary shifts affecting those agents.

Q5128 stands out competitively at the national level: the provider billed 4.8K claims for Q5128 and generated $1M in revenue, and the code ranks #14 of 373 providers nationally (97th percentile; notably above typical national volume). This rank and volume position the provider as an early or heavy adopter of the ranibizumab-eqrn biosimilar relative to peers, suggesting a differentiated drug mix versus many retina specialists.

Clinical throughput is also reflected in very high-volume evaluation and imaging codes: 92014 (2.3K claims, $188.4K) ranks #155 of 35415 providers (100th percentile; extreme outlier, far above typical national volume) and 92134 (2.8K claims, $79.2K) ranks #475 of 26868 providers (98th percentile; extreme outlier, far above typical national volume). These extreme outlier designations indicate unusually high visit and retinal imaging throughput consistent with a high-volume retina clinic managing many chronic intravitreal-treatment patients.

Procedure-level injection throughput is further supported by 67028 activity (2.5K claims, $219.7K), which ranks #172 of 4255 providers (96th percentile; notably above typical national volume), while J0178 and J2777 are described as typical, unremarkable volumes nationally. The mix of a notably high procedure count for vitreous injections alongside both high-cost agents (J0178) and lower–paid-per-claim agents (J2777 at $29 avg paid/claim) indicates a diversified agent mix within a high-volume injection workflow.

Unclassified drug codes are a non-trivial part of the mix: J3490 generated $240.8K (137 claims, $1758 avg paid/claim) and accounts for 5.7% of Medicare revenue while being characterized as typical, unremarkable volume. The high average paid per claim for J3490 suggests occasional use of high-cost, non-specified pharmaceuticals or billing for compound/office-administered products that contribute meaningfully to revenue outside the named J-codes.

This provider is effectively single-payer at the claims level: there is no Medicaid billing on file, so the practice’s public-payer exposure is concentrated in Medicare. That lack of Medicaid activity narrows payer diversification and implies that state Medicaid reimbursement and contracts are not a current source of patient volume or revenue for the practice.

The NPI was enumerated on 2006-10-31 (~20 years ago), indicating a long-established practice presence. Combined with sustained high-volume billing on key retinal injections and imaging codes, the tenure supports the view of a mature, procedure-oriented retina practice with an entrenched referral and treatment footprint in its market.

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	1,580	$680	$1.1M
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	4,770	$210	$1M
J2777	Injection, faricimab‑svoa, 0.1 mg	26,520	$30	$769.1K
Q5124	Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg	1,640	$180	$296.5K
J3490	Unclassified drugs	140	$1,760	$240.8K
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.	2,530	$90	$219.7K
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…	2,300	$80	$188.4K
J2778	Injection, ranibizumab, 0.1 mg	790	$160	$129.2K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	1,070	$120	$127.8K
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.	2,830	$30	$79.2K

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. Tennessee Distribution

Brandon Busbee — 8 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. state median

19 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	20	80	790	$680	$769.8K
J2777	13	50	15,060	$30	$592.1K
Q5128	1	20	1,190	$210	$394K
J2778	28	40	1,340	$180	$370.2K
Q5124	1	10	690	$180	$137.8K
67028	5	80	1,130	$90	$98.5K
J2781	3	20	560	$120	$82.5K
J3490	13	60	70	$400	$41.9K
67042	27	40	20	$1,020	$34.5K
67108	18	30	20	$970	$29.2K

Showing 1–10 of 19

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tennessee Retina PC	TN	Retina Specialist (Ophthalmology) Physician	$0	$6M
Roy Wallace	TN	Retina Specialist (Ophthalmology) Physician	$5.4M	$0
David Reichstein	TN	Retina Specialist (Ophthalmology) Physician	$4.9M	$141.7K
Carl Awh	TN	Retina Specialist (Ophthalmology) Physician	$4.7M	$0
Eric Schneider	TN	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Franco Recchia	TN	Retina Specialist (Ophthalmology) Physician	$3.6M	$2.6K
Akshay Thomas	TN	Retina Specialist (Ophthalmology) Physician	$3.2M	$52K
Everton Arrindell	TN	Retina Specialist (Ophthalmology) Physician	$3M	$0
Jay Glover	TN	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Peter Sonkin	TN	Retina Specialist (Ophthalmology) Physician	$2.2M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hca Health Services Of Tennessee, Inc.	TN	General Acute Care Hospital	$0	$45.9M
Pediatrix Medical Group Of Tennessee, P.C.	TN	Neonatal-Perinatal Medicine Physician	$0	$32.3M
Saint Thomas Medical Partners	TN	Internal Medicine Physician	$0	$21.9M
Radiology Alliance PC	TN	Diagnostic Radiology Physician	$0	$13.2M
Emergency Medicine Services Of Tn, PC	TN	Emergency Medicine Physician	$0	$12.9M
Tennessee Maternal-fetal Medicine LLC	TN	Specialist	$0	$12.5M
The Next Door, Inc.	TN	Substance Abuse Rehabilitation Facility	$0	$8.6M
Tennessee Oncology PLLC	TN	Hematology & Oncology Physician	$0	$8.5M
Vcphcs Ix, LLC	TN	Substance Use Disorder Rehabilitation Clinic/Center	$257.7K	$6.6M
Pediatric Associates Of Davidson County, P.C.	TN	Pediatrics Physician	$0	$5.8M

Brandon Busbee — 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