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

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

Jacob Jones (NPI 1780720201)

Field	Value
Entity Type	Individual
Organization	Jacob Jones
Address	710 E. 24th St
City	Minneapolis
State	MN
ZIP	55404
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	January 30, 2007

Payer Source	Total Paid
Medicare	$2.3M
Medicaid	$0

Key Findings

This provider’s revenue is essentially single‑payer Medicare: lifetime Medicare revenue is $2.3M while Medicaid billing is listed as none, indicating no Medicaid footprint on file and that Medicare drives the practice’s scale and payer strategy. Analysts should treat this as a Medicare‑centric revenue profile when assessing reimbursement and utilization patterns.

Revenue is highly concentrated in a small set of injection and procedure codes: the top three Medicare codes account for 82.6% of the provider’s Medicare revenue, led by J0178 at 57.2%, Q5128 at 18.6%, and 67028 at 6.7%. That concentration signals dependency on intravitreal drug administration and related isolated injection procedures for the bulk of income.

Clinical service mix aligns with a retina/intravitreal injection practice: J0178 (aflibercept injection) is the single largest revenue driver ($1.3M revenue, $688 avg paid/claim) and 67028 (isolated intravitreal injection) is a top code, showing the practice performs high volumes of anti‑VEGF therapy as core activity. The presence of Q5128 (ranibizumab biosimilar) as the second largest revenue source further confirms routine use of multiple anti‑VEGF agents.

Diagnostic and clinic visit volumes are unusually high relative to peers: 92134 (retinal computerized diagnostic imaging) is reported as an extreme outlier, far above typical national volume and ranks in the 97th percentile, and 92012 (intermediate established patient exam) is notably above typical national volume at the 95th percentile. Together these patterns suggest substantial in‑office diagnostic capacity and high follow‑up/management throughput in addition to injection procedures.

Competitive standing on the primary drug and procedure codes is solid but not dominant nationally: J0178 ranks #560 of 3204 providers (82th percentile; typical, unremarkable volume), Q5128 ranks #66 of 373 (83th percentile; typical, unremarkable volume), and 67028 ranks #664 of 4255 (84th percentile; typical, unremarkable volume). These ranks indicate the provider operates at or above typical peer volume for high‑value retina codes but is not an outlier leader on those specific drugs.

The provider bills a diversified anti‑VEGF portfolio beyond the dominant aflibercept position: in addition to J0178 ($1.3M revenue), the file shows Q5128 ($437.1K revenue, $218 avg paid/claim), J2777 ($118.3K revenue), J2778 ($37.3K revenue) and J9035 ($31.8K revenue). This mix implies switching or concurrent use of branded, biosimilar, and alternative agents rather than exclusive reliance on a single drug.

Usage of several specific agents is relatively limited or selective compared with national peers: J2778 (ranibizumab) ranks #1095 of 1208 providers (9th percentile; typical, unremarkable volume) and Q5124 (ranibizumab‑nuna biosimilar) ranks #121 of 122 providers (1th percentile; typical, unremarkable volume), indicating narrow utilization of these formulations despite larger overall injection volumes. These low percentiles may reflect formulary preferences, procurement differences, or targeted clinical choices rather than overall low injection activity.

The provider has long tenure in the NPI registry (enumerated 2007-01-30 (~19 years ago)), consistent with an established clinical practice and likely mature referral relationships; combine that longevity with the Medicare concentration and high imaging/injection volumes to infer an entrenched retina specialty practice focused on Medicare beneficiaries.

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	1,950	$690	$1.3M
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	2,010	$220	$437.1K
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.	1,630	$100	$158K
J2777	Injection, faricimab‑svoa, 0.1 mg	4,080	$30	$118.3K
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.	2,290	$30	$66.3K
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…	770	$70	$50.5K
J3590	Unclassified biologics	220	$210	$47.7K
J2778	Injection, ranibizumab, 0.1 mg	210	$180	$37.3K
J9035	Injection, bevacizumab, 10 mg	590	$50	$31.8K
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…	350	$80	$27.4K

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. Minnesota Distribution

Jacob Jones — 3 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. state median

15 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	9	40	580	$690	$743.4K
J2777	20	20	6,120	$30	$411.1K
Q5128	6	20	1,410	$220	$393.8K
J2778	16	20	500	$180	$121K
J3590	4	10	220	$230	$73.7K
67028	10	80	420	$90	$64.8K
Q5124	6	10	200	$170	$49.2K
J9035	5	40	220	$50	$16.9K
92014	82	830	100	$80	$11.9K
92012	9	200	60	$60	$8.8K

Showing 1–10 of 15

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hennepin Healthcare System, Inc	MN	General Acute Care Hospital	$420.8K	$708.9M
Hennepin County	MN	Case Manager/Care Coordinator	$0	$34.9M
Vitreoretinal Surgery PLLC	MN	Ophthalmology Physician	$0	$27.8M
Hennepin Healthcare System, Inc	MN	Home Health Agency	$0	$23.2M
Hennepin Healthcare System, Inc	MN	Clinic/Center	$0	$12.3M
David Williams	MN	Retina Specialist (Ophthalmology) Physician	$5.5M	$0
David Parke	MN	Ophthalmology Physician	$4.8M	$0
Sundeep Dev	MN	Ophthalmology Physician	$4.5M	$0
John Davies	MN	Ophthalmology Physician	$3.9M	$0
Polly Quiram	MN	Ophthalmology Physician	$3.7M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nu-way House Inc	MN	Substance Abuse Rehabilitation Facility	$0	$200.8M
Childrens Health Care	MN	Children's Hospital	$0	$100M
Midwest Home Health Care, Inc.	MN	Home Health Agency	$0	$73.5M
Midwest Quality Home Care, Inc.	MN	Home Health Agency	$0	$66.7M
Regents Of The University Of Minnesota	MN	Federally Qualified Health Center (FQHC)	$0	$55.2M
Minnesota Professional Health Services,inc	MN	Home Health Agency	$0	$51.9M
Park Ave Center Inc	MN	Substance Use Disorder Rehabilitation Clinic/Center	$0	$50.8M
Minnesota Quality Care, Inc.	MN	Home Health Agency	$0	$48.4M
Direct Home Health Care, Inc.	MN	Home Health Agency	$0	$30.7M
Aaa A-z Friendly Languages Inc	MN	Interpreter	$0	$29.4M

Jacob Jones — 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