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

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

William Rhoades (NPI 1750692703)

Field	Value
Entity Type	Individual
Organization	William Rhoades
Address	1801 W Maumee St
City	Adrian
State	MI
ZIP	49221
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	June 24, 2010

Payer Source	Total Paid
Medicare	$1.9M
Medicaid	$0

Key Findings

WILLIAM RHOADES is a retina specialist (Ophthalmology) with an NPI enumerated 2010-06-24 (~16 years ago) and $1.9M in lifetime Medicare revenue. There is no Medicaid billing on file, making the provider effectively a single-payer (Medicare) biller at scale in the available data set.

Revenue is highly concentrated in a small set of injection and evaluation services: the top 3 Medicare codes by revenue account for 88.6% of this provider's total Medicare revenue, with J0178 generating $1.4M (70.5%), J2778 generating $196.2K (10.1%), and 92014 generating $156.7K (8.0%). This concentration indicates that a very large share of Medicare income is driven by anti-VEGF drug administration and high-volume established eye examinations.

The code mix is consistent with a medical-retina practice that runs a high-volume intravitreal injection program: J0178 has 2K claims with an average paid/claim of $684 and J2778 has 1.1K claims with an average paid/claim of $180, while 67028 (intravitreal injection procedure) appears with 1.2K claims and $108.7K in revenue. High utilization of imaging and evaluation codes — 92134 with 2.3K claims ($62.7K) and 92014 with 1.9K claims ($156.7K) — supports a workflow centered on frequent monitoring plus regular injection visits.

Competitive standing is mixed by code: J0178 ranks #537 of 3204 (83th percentile; typical, unremarkable volume), and J2778 ranks #402 of 1208 (67th percentile; typical, unremarkable volume), indicating the provider is a solid but not dominant national participant for anti-VEGF drugs. By contrast, 92014 ranks #305 of 35415 (99th percentile; extreme outlier, far above typical national volume) and 92134 ranks #775 of 26868 (97th percentile; extreme outlier, far above typical national volume), signaling unusually high volume of established comprehensive exams and retinal imaging relative to national peers.

Operationally, the pairing of very high volumes for 92014 and 92134 with heavy J0178 use implies a patient panel that requires frequent follow-up and imaging — typical for chronic retinal diseases such as AMD or diabetic macular edema that require recurring anti-VEGF therapy. The presence of 67028 (1.2K claims, $108.7K, 5.6% of Medicare revenue) underscores that injections are often performed as discrete ocular procedures rather than solely bundled visits.

Payer exposure is concentrated: all reported revenue is Medicare ($1.9M) and there is no Medicaid activity to diversify payer mix. This lack of Medicaid billing on file means reimbursement and patient access risk should be evaluated primarily through the Medicare lens for this provider.

The provider’s coding breadth includes additional retina-specific procedures at modest levels (for example, 67228 with 38 claims and $9.4K revenue, ranked #146 of 648, 77th percentile; and 92235 with 85 claims and $8.2K revenue, ranked #710 of 2192, 67th percentile). These entries indicate the practice performs some laser and angiographic services in addition to injections and imaging, consistent with a comprehensive retina specialty practice rather than a narrow procedure-only operation.

Medicare: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,010	$680	$1.4M
J2778	Injection, ranibizumab, 0.1 mg	1,090	$180	$196.2K
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…	1,890	$80	$156.7K
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.	1,250	$90	$108.7K
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.	2,320	$30	$62.7K
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	$13.7K
J3590	Unclassified biologics	160	$70	$11.2K
67228	In retinopathy, tiny new vessels grow profusely and fibrous tissue proliferates in between the layers of the retina, which may extend into the optic nerve and vitreous, clear gel that fills the space…	40	$250	$9.4K
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…	90	$100	$8.2K
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…	60	$90	$4.7K

Showing 1–10 of 12

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Michigan Distribution

William Rhoades — 3 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. state median

12 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	14	110	680	$690	$630.2K
J2778	20	50	730	$180	$240.5K
67028	26	160	440	$90	$57.6K
J3590	36	80	140	$80	$19.6K
92014	2	1,080	100	$80	$14.8K
99214	9,716	15,470	80	$80	$11.4K
92235	24	100	40	$100	$7.8K
92134	14	820	60	$30	$7.1K
67228	5	30	30	$250	$6.7K
92004	27	690	30	$90	$4.2K

Showing 1–10 of 12

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Associated Retinal Consultants, PC	MI	Ophthalmology Physician	$0	$21.1M
Sandeep Randhawa	MI	Retina Specialist (Ophthalmology) Physician	$7M	$0
Scott Pendergast	OH	Retina Specialist (Ophthalmology) Physician	$6M	$0
Ramon Lee	IL	Retina Specialist (Ophthalmology) Physician	$4M	$8.5K
Jeremy Wolfe	MI	Retina Specialist (Ophthalmology) Physician	$3.7M	$0
Christianne Wa	CA	Retina Specialist (Ophthalmology) Physician	$3.5M	$0
Douglas Covert	MI	Retina Specialist (Ophthalmology) Physician	$3.2M	$0
Nathan Farley	MI	Retina Specialist (Ophthalmology) Physician	$3M	$0
Surendar Purohit	MI	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Scott Sneed	MI	Retina Specialist (Ophthalmology) Physician	$2.8M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Renaissance Community Homes	MI	Mental Illness Community Based Residential Treatment Facility	$0	$84.9M
Lenawee Community Mental Health Authority	MI	Community/Behavioral Health Agency	$0	$32M
Emma L. Bixby Medical Center	MI	General Acute Care Hospital	$0	$18.4M
Hospice Of Lenawee, Inc.	MI	Community Based Hospice Care Agency	$0	$9M
Goodwill Industries Of Southeastern Michigan, Inc.	MI	Community/Behavioral Health Agency	$0	$6.6M
4m Monroe Medical Services PLLC	MI	Emergency Medicine Physician	$0	$6.4M
Jlc Care Services	MI	In Home Supportive Care Agency	$0	$6M
Mccullough, Vargas, & Associates, Inc.	MI	Addiction (Substance Use Disorder) Counselor	$0	$5.7M
City Of Adrian	MI	Land Ambulance	$317.7K	$1.3M
Lawrence Desjarlais	MI	Dermatology Physician	$346.4K	$0

William Rhoades — 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