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

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

Alan Downie (NPI 1689679979)

Field	Value
Entity Type	Individual
Organization	Alan Downie
Address	2950 Curve Crest Blvd W
City	Stillwater
State	MN
ZIP	55082
Taxonomy	Ophthalmology Physician
NPI Enumerated	June 15, 2005

Payer Source	Total Paid
Medicare	$1M
Medicaid	$0

Key Findings

This provider’s billed activity is effectively single‑payer: total Medicare revenue is $1M while there is no Medicaid billing on file, indicating the practice’s public-payor footprint is concentrated entirely in Medicare rather than a mix of Medicare and Medicaid. The provider’s NPI was enumerated 2005-06-15 (~21 years ago), consistent with an established solo or small-group clinical presence serving Medicare beneficiaries.

Revenue is highly concentrated in a small set of intravitreal injection codes: the precomputed top three Medicare codes account for 88.8% of the provider’s total Medicare revenue, driven overwhelmingly by J2777 which alone represents $746.5K (74.4% of Medicare revenue) from 25.7K claims. J2778 contributes $101.9K (10.2%) and 67028 contributes $42.9K (4.3%), so financial performance is dominated by anti‑VEGF and related injection services.

The code mix and dollar concentration point to a retina‑focused, injection‑centric ophthalmology practice: J2777 (faricimab) and J2778 (ranibizumab) are intravitreal biologic injections used to treat retinal disease, and 67028 is the procedure code for intravitreal injection. This pattern suggests the operation is organized around high-volume injection therapy for retinal conditions rather than a broad surgical cataract or comprehensive ophthalmology practice.

Competitive standing on the top revenue driver is modest nationally: J2777 ranks #369 of 2039 providers nationally (82th percentile) and is described as typical, unremarkable volume relative to peers, while J2778 ranks #666 of 1208 (45th percentile) and 67028 ranks #2199 of 4255 (48th percentile), both likewise characterized as typical, unremarkable volume. These ranks indicate the provider is not a national outlier or dominant center for these injections, but rather a routine-volume participant in the national provider pool for these services.

Diagnostic imaging and E/M activity show relatively stronger placement within national distributions: 92134 (retinal OCT) appears with 835 claims and $25.9K (2.6% of Medicare revenue) and ranks #2463 of 26868 providers (91th percentile), while 99214 (established patient E/M) accounts for $39.3K (3.9%) and ranks #56535 of 479517 providers (88th percentile). These higher percentiles for OCT and mid‑complexity office visits suggest a steady ambulatory and diagnostic workload that supports the injection practice.

Surgical cataract and other ophthalmic procedures are present but low relative contributors: 66984 (cataract with IOL) generates $21.3K (2.1%) and ranks #10691 of 15965 providers (33th percentile), and 66821 (YAG capsulotomy) contributes $3.1K (0.3%) but is at the bottom of the listed distribution (#9887 of 10087 providers, 1th percentile). This profile indicates limited surgical volume and a clinical focus weighted toward medical retinal care rather than high-volume cataract surgery.

The extreme concentration of Medicare dollars in a single biologic code creates business sensitivity to utilization or reimbursement changes: J2777 alone is $746.5K (74.4% of Medicare revenue) and the top three codes together are 88.8% of revenue, which underscores potential operational vulnerability if prescribing patterns, payer coverage, or drug pricing shift. For payer or network analysts, these figures flag that small changes in injection-related utilization would disproportionately affect the provider’s Medicare revenue base.

Medicare: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2777	Injection, faricimab‑svoa, 0.1 mg	25,740	$30	$746.5K
J2778	Injection, ranibizumab, 0.1 mg	570	$180	$101.9K
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.	510	$80	$42.9K
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…	460	$90	$39.3K
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.	840	$30	$25.9K
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…	50	$420	$21.3K
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…	120	$70	$7.7K
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…	70	$80	$5.9K
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…	40	$100	$4.5K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	10	$260	$3.1K

Showing 1–10 of 13

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Minnesota Distribution

Alan Downie — 2 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. state median

13 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2777	4	20	6,120	$30	$411.1K
J2778	9	20	500	$180	$121K
67028	30	80	420	$90	$64.8K
66984	258	300	190	$50	$56K
66821	172	170	50	$110	$13.8K
92014	512	830	100	$80	$11.9K
92012	65	200	60	$60	$8.8K
99214	169	10,100	70	$80	$8.1K
92134	28	580	40	$30	$4.8K
99213	6,888	9,120	50	$50	$4K

Showing 1–10 of 13

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baldwin Area Medical Center, Inc.	WI	Critical Access Hospital	$0	$3.1M
Yang Liu	MN	Hematology & Oncology Physician	$1.4M	$0
Baldwin Area Medical Center, Inc.	WI	Rural Health Clinic/Center	$0	$1.4M
Associated Eye Care Ambulatory Surgery Center LLC	MN	Ophthalmologic Surgery Clinic/Center	$834.9K	$0
Sathish Kumar Cullath Harikrishnan	IL	Hospitalist Physician	$153.6K	$200.1K
Gaylord Hoffert	NC	Nephrology Physician	$227K	$54.9K
John Murphy	WI	Family Medicine Physician	$202.9K	$320
David Park	MN	Ophthalmology Physician	$193.3K	$0
Bryce Lund	NE	Nephrology Physician	$189.3K	$0
Adam Goddard	MN	Ophthalmology Physician	$176.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Washington County Community Services	MN	Case Management Agency	$0	$38.3M
Bluestone Physician Services, P.A.	MN	Family Medicine Physician	$0	$26.9M
Reflections	MN	Addiction (Substance Use Disorder) Counselor	$0	$14.4M
Cedar Ridge Treatment Center LLC	MN	Substance Abuse Rehabilitation Facility	$0	$10.4M
Supervalu Pharmacies Inc	MN	Community/Retail Pharmacy	$3.5M	$0
April Abrahamson	MN	Internal Medicine Physician	$307.2K	$0
Charles O'hare	MN	Family Medicine Physician	$164K	$0
Jesse Vislisel	MN	Ophthalmology Physician	$160.2K	$0
Robert Knowlan	MN	Orthopaedic Surgery Physician	$158K	$0
Joseph Macdonald	MN	Family Medicine Physician	$141.2K	$0

Alan Downie — 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