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

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

Lorna Grant (NPI 1720318710)

Field	Value
Entity Type	Individual
Organization	Lorna Grant
Address	200 Hawkins Dr
City	Iowa City
State	IA
ZIP	52242
Taxonomy	Ophthalmology Physician
NPI Enumerated	January 13, 2010

Payer Source	Total Paid
Medicare	$1.2M
Medicaid	$0

Key Findings

This provider’s Medicare revenue is concentrated in a small set of high-value ophthalmology services: the precomputed top 3 codes account for 87.4% of total Medicare revenue, and total Medicare revenue is $1.2M. There is no Medicaid billing on file, so this practice operates effectively as a Medicare-focused provider rather than a dual-payer practice.

Clinical/service-line mix is dominated by retina-directed medical therapy and intravitreal procedures. The largest single code is J0178 (aflibercept) with 1.3K claims, $687 avg paid/claim, and $882.1K revenue (74.2% of Medicare revenue), complemented by 67028 (intravitreal injection) with 592 claims, $93 avg paid/claim, and $55.1K revenue (4.6% of Medicare revenue), which together signal a practice built around frequent in-office injections for retinal disease.

Surgical cataract care is a secondary revenue stream but materially smaller than retinal therapies: 66984 (cataract extraction with IOL insertion) shows 260 claims, $395 avg paid/claim and $102.7K revenue (8.6% of Medicare revenue), consistent with an ophthalmologist who performs cataract cases but whose primary volume and revenue driver is injection-based retinal care. Routine ophthalmic E/M and diagnostic codes such as 99213 (303 claims, $62 avg, $18.8K) and 92014 (125 claims, $76 avg, $9.5K) appear as supplemental clinic activity.

Competitive standing for the practice’s top codes is broadly in the middle of national distributions rather than dominant. J0178 ranks #1011 of 3204 providers nationally (68th percentile; typical, unremarkable volume for this code), 66984 ranks #4462 of 15965 providers nationally (72th percentile; typical, unremarkable volume for this code), and 67028 ranks #2013 of 4255 providers nationally (53th percentile; typical, unremarkable volume for this code) — these placements indicate steady, typical participation rather than market leadership for any single procedure.

The provider shows above-typical utilization of retinal imaging and documentation relative to national peers, supporting the retina-focused service mix: 92134 has 683 claims, $30 avg paid/claim and $20.5K revenue (1.7% of Medicare revenue) and ranks #2802 of 26868 providers nationally (90th percentile; typical, unremarkable volume for this code); 92250 has 420 claims, $23 avg paid/claim and $9.7K revenue (0.8% of Medicare revenue) and ranks #1641 of 25087 providers nationally (93th percentile; typical, unremarkable volume for this code). This pattern is consistent with a practice that pairs frequent therapeutic injections with frequent retinal imaging and photography.

Revenue concentration creates exposure to changes in drug utilization or reimbursement: J0178 alone represents $882.1K and 74.2% of the provider’s Medicare revenue, and the top 3 codes together represent 87.4% of Medicare revenue. Any shifts in coverage, pricing, or clinical protocol for aflibercept or intravitreal management could materially affect practice revenue, given the lack of Medicaid revenue to diversify payer risk.

Operational tenure is long enough to suggest an established practice footprint: the NPI was enumerated 2010-01-13 (~16 years ago). That span supports the observed mix of recurring injection volume and a steady stream of cataract and diagnostic procedures rather than a newly established or transient billing pattern.

Medicare: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,280	$690	$882.1K
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…	260	$400	$102.7K
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.	590	$90	$55.1K
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.	680	$30	$20.5K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	80	$260	$20.5K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	300	$60	$18.8K
66982	The provider inserts an intraocular lens prosthesis after extracapsular cataract extraction using complex techniques and devices. He may perform this by means of an iris expansion device, providing…	20	$540	$12.9K
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…	120	$100	$11.7K
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…	140	$80	$10.7K
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,…	420	$20	$9.7K

Showing 1–10 of 20

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Iowa Distribution

Lorna Grant — 0 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. state median

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	11	40	640	$690	$760.2K
67028	24	60	420	$80	$80.6K
66984	34	340	50	$340	$50.4K
66982	39	60	40	$450	$39K
92014	331	500	200	$70	$19.8K
99214	1,900	4,690	100	$70	$14.4K
66821	34	130	40	$210	$14.4K
99213	570	4,740	100	$50	$8K
92136	16	80	190	$20	$7.8K
92134	35	450	80	$30	$6.8K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Judith Sabah	OR	Ophthalmology Physician	$270K	$2.1K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
State University Of Iowa	IA	Family Medicine Physician	$0	$103.8M
State University Of Iowa	IA	General Acute Care Hospital	$0	$90.4M
State University Of Iowa	IA	Dentist	$0	$25.8M
State University Of Iowa	IA	Dentist	$0	$5.6M
State University Of Iowa	IA	Psychologist	$0	$4.6M
Annalee Fencl	IA	Student in an Organized Health Care Education/Training Program	$0	$2.5M
Brandon Syme	IA	General Practice Dentistry	$0	$1.3M
State University Of Iowa	IA	Clinical Medical Laboratory	$163K	$338.8K
Tyler Risma	IA	Ophthalmology Physician	$423.2K	$0
Jessica Parkhurst	IA	Radiation Oncology Physician	$395.3K	$0

Lorna Grant — Billing Profile & Reimbursement Data

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Lorna Grant — 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