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

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

Brian Phelps (NPI 1689866576)

Field	Value
Entity Type	Individual
Organization	Brian Phelps
Address	1851 S Kelly Ave Ste A
City	Edmond
State	OK
ZIP	73013
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	August 14, 2007

Payer Source	Total Paid
Medicare	$4.1M
Medicaid	$0

Key Findings

BRIAN PHELPS is a retina specialist in EDMOND, OK with an NPI enumerated 2007-08-14 (~19 years ago). His lifetime Medicare revenue on file is $4.1M and there is no Medicaid billing on file, indicating an effectively single‑payer Medicare practice footprint in the datasets available.

Revenue is highly concentrated in a small set of injection and retina procedure codes: the precomputed top three Medicare codes account for 84.7% of this provider's total Medicare revenue. Specifically, J0178 accounts for $2.5M (61.4% of Medicare revenue), J2777 for $743K (18.0%), and 67028 for $213.8K (5.2%), underscoring that a very large share of income derives from intravitreal medication administration and related retina procedures.

The code mix is characteristic of a medical‑and‑surgical retina practice that delivers frequent intravitreal therapies and high-volume outpatient retina care. High revenue and claim counts for intravitreal drug codes (J0178, J2777, J9035, J7312) alongside substantial billing for retinal imaging and comprehensive exams (92134 at $99K and 92014 at $165.4K) indicate routine anti‑VEGF and advanced retinal diagnostic workflows, while the presence of vitrectomy and laser codes (67042 $53.8K, 67036 $14.7K, 67145 $13K) denotes operative capability.

On competitive standing, this provider is a national high-volume user of aflibercept: J0178 ranks #93 of 3204 providers nationally (97th percentile; notably above typical national volume for this code). J2777 ranks #372 of 2039 providers nationally (82th percentile; typical, unremarkable volume for this code), while 67028 ranks #206 of 4255 providers nationally (95th percentile; notably above typical national volume for this code), signaling dominance for certain injection services but more typical volumes for other biologic injectables.

Several non‑drug codes are statistical outliers in national comparisons, implying above‑average throughput for diagnostic and higher‑acuity visits. Examples include 92014 (2.1K claims, $165.4K revenue) and 92134 (3.7K claims, $99K revenue), both listed as 99th percentile extreme outliers, and 99204 (305 claims, $32.9K revenue) and 67145 (72 claims, $13K revenue) which are also flagged as extreme outliers or very high percentiles; this combination suggests the practice handles a large volume of comprehensive exams, retinal imaging, and complex retinal procedures relative to peers.

The payer mix is effectively single‑payer Medicare for the period reflected: the provider has $4.1M in total Medicare revenue and “none below” for Medicaid, so there is no Medicaid revenue to analyze. This concentration means benchmarking and contract negotiations should be grounded in Medicare utilization dynamics rather than Medicaid exposure.

Business implications of the concentration in J0178 and related injection codes include operational dependence on frequent anti‑VEGF administration and related drug supply, billing, and visit throughput. With J0178 representing $2.5M (61.4% of Medicare revenue) and the top three codes accounting for 84.7% of Medicare revenue, changes in reimbursement, drug mix, or clinical protocols for these therapies would materially affect practice revenue, and resource planning should reflect that sensitivity.

Taken together, the code profile—high percentiles for injection, imaging, and comprehensive exam codes plus a mix of surgical retina procedures—indicates a practice that functions as a high‑volume retinal treatment center managing both chronic intravitreal therapy and episodic surgical care. That operational breadth, combined with long tenure (NPI enumerated ~19 years), supports a view of an established regional retina provider with pockets of national‑level volume for specific injection services.

Medicare: Complete Services Breakdown

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

27 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	3,680	$690	$2.5M
J2777	Injection, faricimab‑svoa, 0.1 mg	25,620	$30	$743K
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.	2,430	$90	$213.8K
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…	2,070	$80	$165.4K
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.	3,670	$30	$99K
J7312	Injection, dexamethasone, intravitreal implant, 0.1 mg	610	$150	$93.2K
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…	70	$830	$53.8K
J2778	Injection, ranibizumab, 0.1 mg	260	$180	$45.9K
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…	310	$110	$32.9K
J9035	Injection, bevacizumab, 10 mg	550	$60	$30.9K

Showing 1–10 of 27

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 27 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Oklahoma Distribution

Brian Phelps — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oklahoma

Full comparison — all codes billed, vs. state median

27 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	1	30	790	$690	$801.2K
J2777	8	20	23,040	$30	$781.1K
J2778	7	10	420	$180	$173.2K
67028	5	40	720	$80	$88.9K
J7312	1	10	340	$150	$54.8K
67042	1	10	30	$980	$37.1K
J9035	11	30	330	$50	$23.5K
67036	4	10	20	$900	$19.9K
92235	11	20	60	$100	$19.5K
67108	8	10	20	$1,020	$19.5K

Showing 1–10 of 27

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jason Ysasaga	TX	Ophthalmology Physician	$9.9M	$0
Ryan Rush	TX	Ophthalmology Physician	$9.7M	$0
Christopher Fisher	OK	Internal Medicine Physician	$7.6M	$0
Antonio Aragon	TX	Ophthalmology Physician	$7.3M	$0
Sandeep Shah	OK	Retina Specialist (Ophthalmology) Physician	$3.9M	$0
Ryan Ridges	OK	Retina Specialist (Ophthalmology) Physician	$3.6M	$0
Christopher Fuller	TX	Ophthalmology Physician	$3.6M	$0
Constantine Saadeh	TX	Rheumatology Physician	$3.6M	$0
Michael Hood	OK	Retina Specialist (Ophthalmology) Physician	$3.5M	$0
Jim Lu	IL	Anatomic Pathology Physician	$2.7M	$584.1K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Specialty Care Pediatrics, Inc.	OK	Home Health Agency	$0	$44.8M
Medical Resource Management, LLC	OK	Urgent Care Clinic/Center	$0	$14.9M
Oklahoma Arthritis Center, P.C.	OK	Rheumatology Physician	$0	$10.1M
Craig Carson	OK	Rheumatology Physician	$9.7M	$0
Sand Lily Healthcare, Inc.	OK	In Home Supportive Care Agency	$0	$8.9M
Summit Medical Center	OK	General Acute Care Hospital	$0	$7.1M
Ana Kumar	OK	Rheumatology Physician	$4.1M	$0
Pathways Professional Counseling LLC	OK	Community/Behavioral Health Agency	$0	$3.4M
Keshav Panday	OK	Specialist	$3.3M	$0
Stanbro Healthcare Group LLC	OK	Child & Adolescent Psychiatry Physician	$0	$2.9M

Brian Phelps — 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