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 U.S. Virgin Islands for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to U.S. Virgin Islands 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. U.S. Virgin Islands (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.

Kidane Assefa (NPI 1720185184)

Field	Value
Entity Type	Individual
Organization	Kidane Assefa
Address	The Eye Clinic
City	St. Thomas
State	VI
ZIP	00803
Taxonomy	Ophthalmology Physician
NPI Enumerated	September 20, 2006

Payer Source	Total Paid
Medicare	$26.6K
Medicaid	$0

Key Findings

This is a small, Medicare-focused ophthalmology profile: the provider reported Total Medicare revenue of $26.6K and has no Medicaid billing on file, making the practice effectively single-payer from the claims data available. The absence of Medicaid billing (none below) means Medicaid does not factor into payer-mix or network impact for this clinician.

Revenue is highly concentrated in a few outpatient eye-care services: the precomputed top-3 Medicare codes account for 82.2% of this provider's total Medicare revenue, driven by 92014 ($10K revenue, 37.4%), 92012 ($9.1K revenue, 34.2%), and 66821 ($2.8K revenue, 10.6%). This concentration indicates most Medicare dollars are tied to routine ophthalmic exams for established patients and a small volume of a specific post‑operative laser procedure.

The code mix points to an office-based ophthalmology practice focused on established patient evaluations and cataract follow-up: 92014 (156 claims, $64 avg paid/claim) and 92012 (234 claims, $39 avg paid/claim) together dominate billing, while 66821 (14 claims, $202 avg paid/claim) reflects periodic Nd:YAG capsulotomy procedures for secondary membranous cataract. Secondary services billed include visual field testing (92083: 39 claims, $34 avg paid/claim) and fundus photography (92250: 51 claims, $21 avg paid/claim), consistent with diagnostic workup and disease surveillance rather than high-volume surgical practice.

Claim-level detail shows a higher count of intermediate established-patient visits than comprehensive established exams: 92012 has 234 claims versus 156 claims for 92014, implying the practice sees more visits coded at the intermediate level even though both codes are major revenue contributors. The average payments reported ($39 avg paid/claim for 92012 and $64 avg paid/claim for 92014) align with that service mix and the revenue split between those two codes.

National competitive standing across the top codes is modest and described as typical or unremarkable: 92014 ranks #15564 of 35415 providers nationally (56th percentile; typical, unremarkable volume), 92012 ranks #4325 of 17177 (75th percentile; typical, unremarkable volume), and 66821 ranks #9484 of 10087 (4th percentile; typical, unremarkable volume). These rankings indicate the provider is not a dominant national player for these services and mostly operates at volumes comparable to many peers.

New-patient activity and diagnostic services are present but limited: 92004 (23 claims, $69 avg paid/claim; $1.6K revenue, 5.9% of total Medicare revenue) and 92002 (32 claims, $24 avg paid/claim; $768 revenue, 2.9% of total Medicare revenue) show occasional new-patient evaluations, while visual field and imaging codes (92083, 92250) each contribute smaller shares. This pattern supports an established-patient-centered clinic that takes new patients intermittently and performs routine diagnostic testing as part of follow-up care.

Tenure in the Medicare program is long: the NPI was enumerated on 2006-09-20 (~20 years ago), indicating the provider has been registered for roughly two decades despite the relatively small lifetime Medicare revenue reported. Long enrollment with low lifetime Medicare revenue suggests either a low-volume independent practice or a clinician with limited Medicare panel participation.

From a payer analytics and network perspective, this clinician represents a low-revenue, outpatient ophthalmology resource: Total Medicare revenue of $26.6K and concentrated dependence on a few eye‑exam and capsulotomy codes mean this provider is unlikely to be a high-impact cost center for Medicare, and the lack of Medicaid billing (none below) removes the provider from Medicaid network considerations in-state. Payers should treat this profile as a modest-volume specialist with routine ophthalmic service lines rather than a high-throughput surgical practice.

Medicare: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	160	$60	$10K
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…	230	$40	$9.1K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	10	$200	$2.8K
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.	20	$70	$1.6K
92083	The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for an extended…	40	$30	$1.3K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	50	$20	$1.1K
92002	The provider performs an intermediate level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program.	30	$20	$770

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. U.S. Virgin Islands Distribution

Kidane Assefa — 1 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — U.S. Virgin Islands

Full comparison — all codes billed, vs. state median

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
66821	2	10	40	$240	$10K
92014	3	10	120	$70	$9.2K
92083	3	10	90	$40	$5.3K
92012	1	10	70	$40	$4.5K
92004	4	10	30	$80	$3.3K
92250	3	10	50	$20	$1.6K
92002	1	10	30	$20	$760

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Julie Wolf	VI	Optometrist	$1.8K	$0

Kidane Assefa — Billing Profile & Reimbursement Data

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Kidane Assefa — 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

Nearby Providers

Frequently Asked Questions

References