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

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

Nathan Welch (NPI 1801059605)

Field	Value
Entity Type	Individual
Organization	Nathan Welch
Address	526 Shoup Ave Ste H
City	Twin Falls
State	ID
ZIP	83301
Taxonomy	Ophthalmology Physician
NPI Enumerated	July 2, 2008

Payer Source	Total Paid
Medicare	$1.1M
Medicaid	$0

Key Findings

This provider is effectively single‑payer: reported lifetime Medicare revenue is $1.1M and there is no Medicaid billing on file, so the practice’s revenue is concentrated entirely in the Medicare program rather than split across Medicaid and Medicare. Analysts should treat this profile as Medicare‑dependent when modeling payer exposure or forecasting effects from Medicare drug or procedure policy changes.

Revenue concentration is tightly focused: the precomputed top‑3 Medicare codes (J0178, J2777, 66984) account for 78.9% of the provider’s total Medicare revenue. In particular, J0178 alone contributes $496.3K (43.8% of Medicare revenue) and J2777 contributes $341K (30.1%), indicating that a small set of high‑value injectable codes drive the bulk of payments.

The code mix indicates a practice centered on intravitreal medical retina care with a surgical cataract component. High revenue from J0178 (injection, aflibercept) and J2777 (injection, faricimab) along with cataract extraction / IOL insertion code 66984 suggests the provider performs frequent anti‑VEGF/anti‑VEGF‑class injections and also offers cataract surgery, combining procedural medical retina work with operative ophthalmology services.

Competitive standing on the top codes is middle of the distribution nationally: J0178 ranks #1585 of 3204 providers (50th percentile) and is characterized as typical/unremarkable, J2777 ranks #892 of 2039 providers (56th percentile) and is characterized as typical/unremarkable, and 66984 ranks #6573 of 15965 providers (59th percentile) and is characterized as typical/unremarkable. These ranks indicate modest, peer‑level volume rather than dominance in these lines.

Supplementary service mix supports a clinic‑based continuity model: established E/M and diagnostic codes such as 92014 ($35.9K, 473 claims; 84th percentile, described as typical/unremarkable) and 99214 ($33.1K, 380 claims; 84th percentile, described as typical/unremarkable), plus retinal imaging 92134 ($28K, 1K claims; 92th percentile, described as typical/unremarkable) point to ongoing outpatient follow‑up and imaging in support of injection therapy. These procedure and E/M volumes align with a practice that manages chronic retinal disease on an outpatient basis.

Operational and revenue risk is concentrated in drug/injection reimbursement and utilization: injectable drug codes J0178 and J2777 together represent $496.3K and $341K in revenue respectively and make up the majority of billings, exposing the provider to shifts in Medicare drug payment policies, utilization management, or changes in retail drug supply. Given there is no Medicaid billing, any changes to Medicare reimbursement would have an outsized effect on the provider’s total revenue.

Tenure and stability: the NPI was enumerated on 2008-07-02 (~18 years ago), indicating a long‑established Medicare billing history. That duration supports the interpretation that observed patterns (high injectable volumes plus cataract procedures and steady E/M work) reflect a stable, mature clinical practice rather than a short‑term or newly formed operation.

Medicare: Complete Services Breakdown

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

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	730	$680	$496.3K
J2777	Injection, faricimab‑svoa, 0.1 mg	11,760	$30	$341K
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…	150	$390	$57.2K
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.	600	$90	$52.8K
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…	470	$80	$35.9K
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…	380	$90	$33.1K
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.	1,000	$30	$28K
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…	350	$60	$20.7K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	60	$220	$13.5K
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	$520	$12.1K

Showing 1–10 of 25

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 25 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Idaho Distribution

Nathan Welch — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. state median

25 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	12	20	670	$690	$541.7K
J2777	6	10	8,640	$30	$454.7K
66984	42	150	40	$520	$76K
67028	10	30	470	$90	$66.6K
66982	11	20	30	$690	$28.3K
J7999	16	20	200	$70	$18.9K
66821	26	60	60	$200	$18.3K
15823	16	20	40	$490	$18.1K
92014	30	230	120	$70	$15.5K
99214	255	2,690	90	$70	$10.4K

Showing 1–10 of 25

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Lukes Clinic-treasure Valley LLC	ID	Family Medicine Physician	$0	$59.2M
St Luke's Clinic LLC	ID	Family Medicine Physician	$0	$39.5M
St Lukes Clinic-treasure Valley LLC	ID	Family Medicine Physician	$0	$6.9M
St Lukes Clinic-treasure Valley LLC	OR	Rural Health Clinic/Center	$0	$2.1M
Jeffrey Stevens	CA	Retina Specialist (Ophthalmology) Physician	$1.8M	$0
Pejman Rohani	MD	Vascular Surgery Physician	$1M	$0
Michael Taylor	ID	Ophthalmology Physician	$946.5K	$0
Welch And Allan, Md PA	ID	Ophthalmology Physician	$0	$729.6K
Evan Allan	OK	Ophthalmology Physician	$602.3K	$0
St Luke's Magic Valley Regional Medical Center Ltd	ID	Critical Access Hospital	$0	$573.7K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Homestyle Direct LLC.	ID	Home Delivered Meals	$0	$65.4M
Primary Therapy Source, LLC	ID	Physical Therapist	$0	$11.7M
Wright Physical Therapy Limited Partnership	ID	Physical Therapist	$0	$8.8M
Smiles 4 Kids, LLC	ID	Pediatric Dentistry	$0	$8.7M
Family Health Services Corporation	ID	Federally Qualified Health Center (FQHC)	$0	$8.1M
St. Luke's Magic Valley Regional Medical Center, Ltd.	ID	General Acute Care Hospital	$0	$7.9M
Twin Falls School District #411	ID	Local Education Agency (LEA)	$0	$6.6M
Sunshine Therapy LLC	ID	Behavior Analyst	$0	$5.7M
Magic Valley Paramedics L L C	ID	Land Ambulance	$976.6K	$4.6M
Twin Falls Senior Living LLC	ID	Assisted Living Facility	$0	$4.6M

Nathan Welch — Billing Profile & Reimbursement Data

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Nathan Welch — 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