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

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

Justin Baynham (NPI 1750516928)

Field	Value
Entity Type	Individual
Organization	Justin Baynham
Address	2450 12th St Se
City	Salem
State	OR
ZIP	97302
Taxonomy	Ophthalmology Physician
NPI Enumerated	May 18, 2009

Payer Source	Total Paid
Medicare	$1.4M
Medicaid	$0

Key Findings

Medicare is effectively this provider’s only payer: the profile shows Total Medicare revenue of $1.4M and no Medicaid billing on file, so the practice operates with a single-payer footprint in the available data rather than a mixed Medicare/Medicaid payer mix. Analysts should treat Medicaid as absent for competitive or access comparisons in-state.

Revenue concentration is extremely high: the precomputed top-3 codes account for 90.0% of this provider’s Medicare revenue, with J0178 contributing $752.1K (55.6%), J2777 contributing $382.8K (28.3%), and 67028 contributing $81.4K (6.0%). This concentration indicates the practice’s financial performance is heavily dependent on a narrow set of intravitreal drug and injection services.

The code mix signals a retina/intravitreal-focused ophthalmology practice: J0178 (Injection, aflibercept) and J2777 (Injection, faricimab) together dominate revenue and 13.2K claims for J2777 and 1.1K claims for J0178 show a high volume of anti-VEGF and related biologic injections, while 67028 (vitreous injection) further confirms a procedure-centered injection workflow. Support services such as retinal imaging (92134) and diagnostic angiography (92235) appear in the profile, consistent with retina management and follow-up.

Competitive standing for the top revenue drivers is modest at a national level: J0178 ranks #1192 of 3204 (63th percentile) and is described as "typical, unremarkable volume," while J2777 ranks #788 of 2039 (61th percentile) and is also labeled "typical, unremarkable volume." The provider is not a national outlier or dominant center for intravitreal therapy based on these rank/percentile positions.

Certain diagnostic and evaluation services show relatively stronger placement against peers: 92134 (retinal OCT imaging) ranks #2061 of 26868 (92th percentile) and 92004 (comprehensive new-patient ophthalmological evaluation) ranks #2324 of 26467 (91th percentile), indicating higher-than-average volumes for imaging and new-patient comprehensive evaluations even though the plain-English labels for these codes remain "typical, unremarkable volume." These elevated percentiles suggest the practice supports its injection work with substantial diagnostic imaging and new-patient evaluations.

Ancillary and compounded drug use is present but not dominant: J7999 (Compounded drug) produced $24.6K (1.8% of Medicare revenue) over 346 claims and ranks #269 of 1333 (80th percentile), indicating above-average but not exceptional use of compounded medications relative to national peers. This could reflect practice-specific medication preparation choices tied to retinal treatments.

Tenure is long enough to reflect an established billing history: the provider’s NPI was enumerated 2009-05-18 (~17 years ago), so patterns in the Medicare data likely reflect an established clinical and business model rather than a short-term or newly opened practice. Analysts should consider this duration when evaluating stability of the current service mix.

No top Medicare codes in the provided list are flagged as extreme outliers; most are described using the dataset’s plain-English label "typical, unremarkable volume." This consistency argues against abrupt or unusual billing behavior in the top services and supports interpreting the profile as a focused, steady retina/injection practice rather than an anomalous billing pattern.

Medicare: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,100	$690	$752.1K
J2777	Injection, faricimab‑svoa, 0.1 mg	13,200	$30	$382.8K
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.	900	$90	$81.4K
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…	400	$80	$33.5K
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.	1,070	$30	$31.1K
J7999	Compounded drug, not otherwise classified	350	$70	$24.6K
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.	140	$100	$14.9K
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…	180	$60	$11.4K
92235	The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken…	80	$100	$7.3K
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…	80	$90	$7.2K

Showing 1–10 of 15

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Oregon Distribution

Justin Baynham — 0 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. state median

15 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	20	60	840	$680	$623.7K
J2777	13	30	10,050	$30	$527.6K
67028	27	70	580	$90	$72.3K
J7999	23	50	270	$70	$23.4K
92014	69	440	110	$80	$16K
92235	12	30	60	$100	$11.1K
99214	3,002	6,070	80	$70	$10.3K
92134	34	390	80	$30	$8.1K
92012	29	170	50	$60	$7.2K
99213	5,220	5,480	60	$50	$5.7K

Showing 1–10 of 15

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Retina Consultants, LLP	OR	Ophthalmology Physician	$0	$6.6M
Monica Michelotti	OR	Ophthalmology Physician	$2.5M	$0
Scott Mcclintic	OR	Ophthalmology Physician	$1.7M	$0
Andrew Westfall	OR	Ophthalmology Physician	$1.1M	$0
Jessica Weinstein	OR	Retina Specialist (Ophthalmology) Physician	$691.2K	$49.8K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Crc Health Oregon, LLC	OR	Methadone Clinic	$485.5K	$26.1M
Salem Psychiatric Associates PC	OR	Clinical Social Worker	$0	$22.7M
Shangri-la Corporation	OR	Mental Illness Community Based Residential Treatment Facility	$0	$13.5M
Cascade Infectious Diseases And Infusion LLC	OR	Infusion Therapy Clinic/Center	$0	$9.6M
Salem Pediatric Clinic	OR	Pediatrics Physician	$0	$9M
Silver Falls Dermatology, LLC	OR	Dermatology Physician	$0	$6.8M
Cascade Sleep Supply, LLC.	OR	Durable Medical Equipment & Medical Supplies	$0	$6.1M
Creating Pathways	OR	Speech-Language Pathologist	$0	$5.7M
Salem Pulmonary Associates P.C.	OR	Pulmonary Disease Physician	$0	$4.8M
Hhhkc Dental LLC	OR	Oral and Maxillofacial Surgery (Dentist)	$0	$4.7M

Justin Baynham — 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