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.

James Kohler (NPI 1720585854)

Field	Value
Entity Type	Individual
Organization	James Kohler
Address	5169 S Cottonwood St Ste 630
City	Murray
State	UT
ZIP	84107
Taxonomy	Ophthalmology Physician
NPI Enumerated	April 5, 2018

Payer Source	Total Paid
Medicare	$6.8K
Medicaid	$0

Medicare: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	40	$70	$2.3K
67036	The provider removes vitreous fluid from the eye to access the posterior segment of the eye and introduce surgical instruments through incisions in the pars plana.	20	$110	$1.7K
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…	10	$130	$1.5K
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…	10	$70	$870
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.	20	$20	$410

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Utah Distribution

James Kohler — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
67028	73	60	440	$90	$61.7K
67042	13	20	20	$1,100	$26.3K
67036	6	20	20	$1,010	$24.2K
99214	9,721	4,080	80	$80	$11.6K
92134	430	250	70	$30	$7.6K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Joel Herring	UT	Retina Specialist (Ophthalmology) Physician	$5.6M	$23.7K
Victoria Knudsen	UT	Retina Specialist (Ophthalmology) Physician	$2.4M	$0
Robert Kwun	UT	Retina Specialist (Ophthalmology) Physician	$2.3M	$0
Kirk Winward	UT	Retina Specialist (Ophthalmology) Physician	$2.2M	$0
James Howard	UT	Retina Specialist (Ophthalmology) Physician	$2M	$0
Eric Brinton	UT	Retina Specialist (Ophthalmology) Physician	$1.3M	$0
Rick Nordgren	UT	Retina Specialist (Ophthalmology) Physician	$888.1K	$0
Gregory Brinton	UT	Retina Specialist (Ophthalmology) Physician	$673.5K	$0
Retina Associates Of Utah, PLLC	UT	Retina Specialist (Ophthalmology) Physician	$0	$653.5K
Rachael Jacoby	UT	Ophthalmology Physician	$137K	$0

James Kohler — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Frequently Asked Questions

References