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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

Elizabeth Atchison (NPI 1669738183)

Field	Value
Entity Type	Individual
Organization	Elizabeth Atchison
Address	6601 S Minnesota Ave
City	Sioux Falls
State	SD
ZIP	57108
Taxonomy	Ophthalmology Physician
NPI Enumerated	April 10, 2012

Payer Source	Total Paid
Medicare	$1.7M
Medicaid	$0

Key Findings

This provider is effectively single‑payer in the observed datasets: total Medicare revenue is $1.7M and there is no Medicaid billing on file. The absence of any Medicaid activity means analyses of payer mix, access for Medicaid populations, or state‑level Medicaid competitiveness are not supported by the available data. NPI enumeration dates to 2012-04-10 (~14 years ago), indicating an established practice history.

Revenue is highly concentrated in a small set of ophthalmology drug and injection codes: the precomputed top‑3 codes account for 73.2% of this provider’s Medicare revenue. Specifically, J2777 generated $586.4K (34.4%), J0178 generated $480.2K (28.2%), and 67028 generated $180.5K (10.6%) of Medicare revenue, signaling that intravitreal drug therapy and injection procedures are the principal revenue drivers.

The code mix points to a retina‑focused ophthalmology operation that performs high volumes of intravitreal injections and associated diagnostics. High‑revenue drug codes J2777 and J0178 are both anti‑VEGF/retinal injectable biologics, and the procedure 67028 (2K claims, $180.5K revenue) is an isolated intravitreal injection, together indicating routine, ongoing retinal therapeutic visits rather than a general ophthalmology practice.

Several utilization metrics mark the practice as atypical on specific inputs: J7999 (compounded drug) is an extreme outlier, ranked #13 of 1333 providers (99th percentile) with 1.7K claims and $120.1K revenue, and 92134 (retinal diagnostic imaging) is also an extreme outlier, ranked #610 of 26868 providers (98th percentile) with 2.6K claims and $72.7K revenue. These standout ranks suggest unusually high use of compounded drug billing and retinal imaging relative to national peers and warrant attention when benchmarking service mix and supply chains.

Competitive standing is mixed by code: the provider’s J2777 activity (20.2K claims, $586.4K revenue) ranks at the 75th percentile (rank #518 of 2039) and is described as typical/unremarkable, while J0178 (694 claims, $480.2K revenue) sits near the median at the 49th percentile (rank #1636 of 3204). In contrast, the provider’s 67028 procedural volume is comparatively high (rank #398 of 4255, 91th percentile) indicating stronger relative activity on the injection procedure itself than some peers, even as drug‑code participation varies.

Procedure and drug mix together imply an ambulatory, procedure‑oriented business model that likely depends on recurring injection visits and billed biologics for retinal disease management. The combination of substantial per‑claim reimbursement on J0178 ($692 avg paid/claim) and high claim counts for J2777 (20.2K claims) and 92134 (2.6K claims) suggests operational emphasis on throughput and device/drug delivery workflows rather than primarily office‑based E/M visits.

The absence of Medicaid activity plus the Medicare revenue scale ($1.7M) frames this provider as a Medicare‑dependent specialist with a moderate overall Medicare revenue footprint concentrated in a few high‑value services. Given the established NPI (~14 years) and the concentrated revenue mix, payers and network planners should consider this provider a stable, retina‑focused Medicare provider but not a broad multiservice Medicaid participant in the state; opportunities or risks tied to payer diversification are limited by the lack of Medicaid billing data.

Medicare: Complete Services Breakdown

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2777	Injection, faricimab‑svoa, 0.1 mg	20,220	$30	$586.4K
J0178	Injection, aflibercept, 1 mg	690	$690	$480.2K
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.	2,010	$90	$180.5K
J7999	Compounded drug, not otherwise classified	1,690	$70	$120.1K
J3590	Unclassified biologics	50	$2,080	$108.1K
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.	2,600	$30	$72.7K
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…	710	$90	$60.4K
67108	The provider repairs a detached retina using heat produced by a laser beam or by freezing the tissues. He may attach a scleral buckle to simplify the passage of fluid through and behind the retina or…	30	$900	$28.7K
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.	200	$100	$20.6K
67042	In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina…	20	$860	$17.1K

Showing 1–10 of 18

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Dakota Distribution

Elizabeth Atchison — 4 of 18 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. state median

18 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	7	10	690	$690	$788.7K
J2777	6	10	21,120	$30	$782K
67028	4	10	740	$90	$108.5K
J3590	3	10	60	$1,450	$81.2K
J7999	1	10	260	$70	$39.1K
67042	6	10	30	$1,140	$38.6K
67108	2	10	20	$1,180	$34.1K
67036	4	10	40	$1,090	$32.6K
92014	6	200	170	$80	$17.1K
99214	1,369	1,660	90	$70	$11.4K

Showing 1–10 of 18

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nathan Steinle	CA	Retina Specialist (Ophthalmology) Physician	$9.5M	$0
Prema Abraham	SD	Retina Specialist (Ophthalmology) Physician	$7.1M	$0
Kyle Thompson	ID	Retina Specialist (Ophthalmology) Physician	$4.5M	$0
Douglas Holmes	WY	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Mitchell Goff	UT	Retina Specialist (Ophthalmology) Physician	$3.8M	$0
Brendan Girschek	AZ	Ophthalmology Physician	$3.2M	$0
Chad Laurich	SD	Vascular Surgery Physician	$3.2M	$0
NPI 1588636484	—	—	$3.2M	$0
Ryan Geraets	SD	Ophthalmology Physician	$3M	$0
John Bormes	SD	Ophthalmology Physician	$2.6M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Avera Mckennan	SD	Psychiatry Physician	$0	$9.1M
Vance Thompson Vision Surgery Center Prof LLC	SD	Ambulatory Surgical Clinic/Center	$4.5M	$22.7K
Siouxland Oral Surgery	SD	Oral and Maxillofacial Surgery (Dentist)	$0	$3.9M
Avera Home Medical Equipment, LLC	SD	Durable Medical Equipment & Medical Supplies	$0	$3.4M
Anderson-smith Speech Therapy, LLC	SD	Speech-Language Pathologist	$0	$1.9M
Ophthalmology Ltd Eye Surgery Center L L C	SD	Ambulatory Surgical Clinic/Center	$1.8M	$16.2K
Dakota Vision Center, LLC	SD	Optometrist	$0	$1.2M
Usc Ambulatory Surgical Center Prof LLC	SD	Ambulatory Surgical Clinic/Center	$1.1M	$44.2K
Avera Mckennan	SD	Physical Therapist	$0	$1M
Encompass Mental Health, LLC	SD	Mental Health Counselor	$0	$908.7K

Elizabeth Atchison — 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