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

Why is the Medicaid comparison limited to New Hampshire 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. New Hampshire (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.

Douglas Scott (NPI 1629064639)

Field	Value
Entity Type	Individual
Organization	Douglas Scott
Address	368 Hounsell Ave
City	Gilford
State	NH
ZIP	03249
Taxonomy	Ophthalmology Physician
NPI Enumerated	September 26, 2005

Payer Source	Total Paid
Medicare	$500.8K
Medicaid	$0

Key Findings

This provider’s revenue is effectively single-payer Medicare: Total Medicare revenue is $500.8K and there is no Medicaid billing on file. The absence of Medicaid activity means payer mix is highly concentrated and the practice’s commercial or Medicaid-facing volumes cannot be assessed from these records.

Revenue concentration is high: the precomputed top-3 Medicare codes account for 73.2% of total Medicare revenue, driven by J0178 (45.0%), 99214 (19.5%), and 66984 (8.7%). This indicates a small number of services produce the bulk of reported Medicare dollars for this clinician.

The code mix points to an ophthalmology practice organized around intravitreal anti-VEGF therapy, office evaluation visits, and cataract surgery: J0178 (aflibercept injection) and 67028 (vitreous injection) are prominent, alongside 66984 (routine cataract extraction with lens implant) and diagnostic imaging codes such as 92134. That combination suggests a workflow blending procedure-based injection clinics, outpatient surgical cases, and imaging-supported medical retina follow-up.

99214 is a pronounced statistical outlier for E/M volume: it ranks #8687 of 479517 providers nationally (98th percentile; extreme outlier), meaning this provider bills far more moderate-complexity established patient visits than typical peers. By contrast, J0178 ranks #2251 of 3204 (30th percentile; typical, unremarkable volume) and 66984 ranks #7871 of 15965 (50th percentile; typical, unremarkable volume), so the unusually high E/M volume is the standout competitive signal rather than dominant national leadership in injections or cataract surgery.

Imaging and diagnostic services are relatively strong versus peers: 92134 ranks #3245 of 26868 (88th percentile; typical, unremarkable volume) and 92250 ranks #1650 of 25087 (93th percentile; typical, unremarkable volume). These higher percentiles for retinal imaging and fundus photography imply the practice uses objective imaging extensively to manage retinal disease and document outcomes.

Claim-level payment patterns show injections and surgery are higher-value per encounter: J0178 average paid/claim is $692, 99214 average paid/claim is $88, and 66984 average paid/claim is $425. The juxtaposition of a high per-claim drug payment (J0178) with large volume of E/M visits (99214) helps explain how a relatively modest Medicare revenue base ($500.8K) is allocated across services.

Tenure is long-standing: the NPI was enumerated on 2005-09-26 (~21 years ago), indicating this clinician has an extended period of Medicare billing history and likely established referral and follow-up relationships in the local market. That longevity supports the consistent mix of procedure, injection, and imaging services seen in the claims.

Operational and reimbursement risk is concentrated: with 73.2% of Medicare revenue coming from three codes and no Medicaid revenue recorded, the practice’s Medicare income is sensitive to changes in anti-VEGF utilization, drug pricing/reimbursement, or E/M policy adjustments. Limited payer diversification and a narrow set of high-revenue services increase exposure to shifts in clinical practice patterns or reimbursement policy.

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	330	$690	$225.6K
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…	1,110	$90	$98K
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…	100	$430	$43.8K
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.	420	$90	$36.4K
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.	560	$30	$17.3K
J9035	Injection, bevacizumab, 10 mg	260	$50	$14K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	40	$250	$10K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	420	$20	$10K
92083	The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for an extended…	220	$40	$9K
66982	The provider inserts an intraocular lens prosthesis after extracapsular cataract extraction using complex techniques and devices. He may perform this by means of an iris expansion device, providing…	20	$590	$8.8K

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. New Hampshire Distribution

Douglas Scott — 1 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Hampshire

Full comparison — all codes billed, vs. state median

15 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	10	10	590	$680	$549.1K
66984	45	60	220	$310	$144.6K
67028	10	20	600	$90	$67K
66982	26	30	30	$660	$26.5K
66821	29	40	60	$250	$19.4K
99214	19	3,150	110	$80	$13.2K
J9035	4	10	150	$50	$10.6K
65855	20	30	40	$170	$8K
99213	1,102	2,900	70	$50	$6.9K
92136	24	50	200	$30	$6K

Showing 1–10 of 15

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Andrew Garfinkle	NH	Ophthalmology Physician	$143.8K	$0
Cynthia Lawrence	NH	Optometrist	$76.3K	$9.5K
Reid Feller	ME	Ophthalmology Physician	$78.8K	$0
Laconia Eye Associates PA	NH	Ophthalmology Physician	$0	$62K
Catherine Vishton	VT	Optometrist	$53.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Dentistry Of The Lakes Region, PLLC	NH	Dentist	$0	$16.7M
Horizons Counseling Center, Inc.	NH	Community/Behavioral Health Agency	$0	$263.5K
Bahder Behavioral Services LLC	NH	Psychiatry Physician	$0	$254.5K
David Parisi	NH	Clinical Social Worker	$11.2K	$175.4K
Cvs Manchester Nh, L.L.C.	NH	Pharmacy	$163.8K	$0
Stephen Catalano	NH	Clinical Child & Adolescent Psychologist	$0	$145.4K
Town Of Gilford	NH	Land Ambulance	$130.8K	$1.8K
Wal-mart Stores East LP	NH	Community/Retail Pharmacy	$100.4K	$0
Jacqueline Abikoff	NH	Addiction (Substance Use Disorder) Counselor	$0	$98K
Savida Health, PC	NH	Addiction Medicine (Internal Medicine) Physician	$0	$90K

Douglas Scott — Billing Profile & Reimbursement Data

Sign up for Douglas Scott — Billing Profile & Reimbursement Data policy alerts

Douglas Scott — Billing Profile & Reimbursement Data

Sign up for Douglas Scott — Billing Profile & Reimbursement Data policy alerts

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