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

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

Claudia Hooten (NPI 1629360458)

Field	Value
Entity Type	Individual
Organization	Claudia Hooten
Address	1700 Curie Dr Ste 3800
City	El Paso
State	TX
ZIP	79902
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	May 12, 2011

Payer Source	Total Paid
Medicare	$2.6M
Medicaid	$0

Key Findings

This provider’s Medicare activity is overwhelmingly focused on intravitreal anti-VEGF therapy: J0178 (aflibercept) alone accounts for $1.4M in revenue and 52.9% of the provider’s Medicare revenue, and the precomputed top-3 codes together account for 71.9% of total Medicare revenue. That concentration indicates the practice operates primarily as a retina/injection-focused clinic rather than a broad, procedure-heavy surgical practice.

Clinical mix and service lines are retina-centric with high imaging and injection volumes. High-revenue diagnostic and treatment codes such as 92134 (OCT imaging, $92K, 3.5% of Medicare revenue) and 67028 (intravitreal injection as a procedure, $146.7K, 5.6%) support an outpatient retina practice that pairs frequent retinal imaging with large volumes of intravitreal injections.

The provider shows a strong tendency to use multiple anti-VEGF agents and biosimilars: J0178 (aflibercept) is the single largest revenue driver ($1.4M), supplemented by J2778 (ranibizumab, $230.3K) and Q5128 (ranibizumab-eqrn biosimilar, $80.4K). This mix suggests operational flexibility across branded biologics and biosimilars, likely responding to clinical indications or payer/formulary dynamics rather than exclusive reliance on a single molecule.

Revenue and payer mix are effectively single-payer Medicare: lifetime Medicare revenue is $2.6M while there is no Medicaid billing on file. The absence of Medicaid activity indicates the provider’s Medicare exposure dominates revenue and any payer-negotiation or utilization review will primarily hinge on Medicare patterns.

Competitive standing is mixed by code: for office-based comprehensive established exams (92014, $269.2K) the provider ranks #95 of 35415 (100th percentile) and is described as an extreme outlier, indicating unusually high established-patient clinic volume nationally. Conversely, for the highest-revenue drug J0178 the provider ranks #525 of 3204 (84th percentile) and is characterized as typical/unremarkable volume for that specific injection, so the practice is not a dominant national injector of aflibercept despite the high dollar concentration.

A set of codes are statistical outliers that point to concentrated operational strengths: 92014 (100th percentile, extreme outlier), 92134 (98th percentile, extreme outlier), 92202 (98th percentile, extreme outlier), and 99204 (99th percentile, extreme outlier) all rank well above typical national volumes. These outlier ranks together suggest a large, steady ambulatory clinic volume with substantial diagnostic imaging and both new and established patient visits feeding the injection service line.

Surgical retina procedures and other operative codes appear but represent only a small share of Medicare revenue (for example, 67036 is $15.1K, 0.6% and 67108 is $12K, 0.5%). This pattern implies the provider’s practice model emphasizes office-based diagnosis and injection therapy over higher-revenue surgical interventions.

Provider tenure is established: the NPI was enumerated on 2011-05-12 (~15 years ago), indicating a long-standing presence in the market that is consistent with the high volumes of established-patient visits and imaging. Longevity combined with concentrated Medicare revenues suggests the practice has maintained a stable referral base focused on retina care.

Medicare: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,030	$690	$1.4M
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…	2,690	$100	$269.2K
J2778	Injection, ranibizumab, 0.1 mg	1,250	$190	$230.3K
J2777	Injection, faricimab‑svoa, 0.1 mg	7,740	$30	$224.5K
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.	1,410	$100	$146.7K
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.	2,710	$30	$92K
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	370	$220	$80.4K
J3490	Unclassified drugs	20	$2,210	$35.4K
99204	The provider sees a new 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 provider…	240	$130	$30K
92202	The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece…	1,940	$10	$25.2K

Showing 1–10 of 22

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Texas Distribution

Claudia Hooten — 4 of 22 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. state median

22 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	1	210	610	$690	$694.9K
J2777	4	140	7,470	$30	$479.2K
J2778	1	80	630	$180	$345.3K
Q5128	1	50	770	$220	$263.7K
67028	1	290	510	$90	$73K
J3490	4	350	60	$480	$54.4K
J7312	1	40	200	$150	$40.8K
67036	2	70	20	$1,000	$29.1K
67108	2	60	20	$1,170	$28.1K
67041	1	30	20	$1,110	$25.5K

Showing 1–10 of 22

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wake Forest University Health Sciences	NC	Multi-Specialty Clinic/Center	$0	$188.2M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
The Retina Group Of Washington, PLLC	MD	Ophthalmology Physician	$0	$19.5M
Wake Forest University Health Sciences	NC	Multi-Specialty Clinic/Center	$0	$11.9M
Afc Urgent Care And Family Care Of Wnc, PLLC	NC	Urgent Care Clinic/Center	$0	$9.4M
Virginia Oncology Associates	VA	Hematology & Oncology Physician	$0	$6.2M
Rohit Lakhanpal	MD	Retina Specialist (Ophthalmology) Physician	$6.1M	$0
Gordon Byrnes	VA	Retina Specialist (Ophthalmology) Physician	$4.9M	$0
Daniel Berinstein	MD	Retina Specialist (Ophthalmology) Physician	$4.3M	$0
Alexander Melamud	VA	Retina Specialist (Ophthalmology) Physician	$4.2M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grace Personal Assistance Services LLC	TX	In Home Supportive Care Agency	$0	$45.7M
El Paso Healthcare System Ltd	TX	General Acute Care Hospital	$0	$38.5M
Abundant Living Home Health	TX	Personal Care Attendant	$0	$30.9M
Valor Personal Assistance Service, Inc.	TX	Personal Care Attendant	$0	$25.8M
Amor Personal Assistance Service, Inc.	TX	In Home Supportive Care Agency	$0	$23.8M
Always Caring Health Care Services Inc	TX	Home Health Agency	$0	$18.9M
Roberto Canales M.d. P.A.	TX	Pediatrics Physician	$0	$18.3M
La Familia Del Paso, Inc	TX	Community/Behavioral Health Agency	$0	$16.4M
Nuevo Hogar Home Care Providers LLC	TX	In Home Supportive Care Agency	$0	$15.7M
Tenet Hospitals Limited	TX	General Acute Care Hospital	$0	$15.7M

Claudia Hooten — Billing Profile & Reimbursement Data

Sign up for Claudia Hooten — Billing Profile & Reimbursement Data policy alerts

Claudia Hooten — Billing Profile & Reimbursement Data

Sign up for Claudia Hooten — 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