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

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

Rocky Mountain Retina Consultants (NPI 1710980354)

Field	Value
Entity Type	Organization
Organization	Rocky Mountain Retina Consultants
Address	4400 S 700 E
City	Salt Lake City
State	UT
ZIP	84107
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	May 27, 2005

Payer Source	Total Paid
Medicaid	$690.7K
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	650	$660	$428.3K
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.	1,230	$120	$141.8K
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.	1,310	$60	$71.8K
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…	280	$150	$40.7K
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…	80	$80	$6.9K
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…	20	$90	$1.3K

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Utah providers billing the same CPT/HCPCS codes.

Claims Volume vs. Utah Distribution

Rocky Mountain Retina Consultants — 0 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. Utah median

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	Injection, aflibercept, 1 mg	3	10	460	$460	$282K
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…	603	1,340	200	$80	$144K
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.	7	10	1,350	$100	$124K
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…	90	160	120	$100	$55.5K
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…	219	270	80	$100	$41.6K
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.	8	20	430	$30	$36K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Rocky Mountain Retina Consultants, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
North Memorial Health Care	MN	Ambulance	$0	$112.8M
Fairview Health Services	MN	General Acute Care Hospital	$0	$90.4M
Regions Hospital	MN	General Acute Care Hospital	$0	$44.4M
Fairview Express Care	MN	Specialist	$0	$33.1M
North Memorial Health Care	MN	General Acute Care Hospital	$0	$32.5M
Fairview Health Services	MN	General Acute Care Hospital	$0	$30M
Fairview Health Services	MN	Emergency Medicine Physician	$0	$26.6M
Fairview Health Services	MN	General Acute Care Hospital	$0	$17.2M
University Of Minnesota Health Clinics And Surgery Center, Inc.	MN	Clinic/Center	$0	$16.3M
Regions Hospital	MN	Emergency Medicine Physician	$0	$15.1M

Nearby Providers

Other providers in the same ZIP code as Rocky Mountain Retina Consultants, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$68.7M
Ihc Health Services, Inc.	UT	Clinical Medical Laboratory	$2.7M	$17.9M
Alpine Home Medical Equipment LLC	UT	Oxygen Equipment & Supplies (DME)	$0	$18.6M
Ddi Vantage	UT	Developmentally Disabled Services Day Training Agency	$0	$18.4M
Utah Emergency Physicians	UT	Emergency Medicine Physician	$0	$14.5M
Home Caregivers Partnership, LLC	UT	Home Health Agency	$0	$10.4M
Gcs Foundation	UT	Supports Brokerage Agency	$0	$6.2M
Ihc Health Services Inc	UT	Diagnostic Radiology Physician	$0	$6.1M
Joel Herring	UT	Retina Specialist (Ophthalmology) Physician	$5.6M	$23.7K
Project Reality	UT	Mental Health Counselor	$0	$5.1M

Rocky Mountain Retina Consultants — Billing Profile & Reimbursement Data

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Rocky Mountain Retina Consultants — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References