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

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

Dana Graichen (NPI 1831176312)

Field	Value
Entity Type	Individual
Organization	Dana Graichen
Address	272 Cottage St
City	Sanford
State	ME
ZIP	04073
Taxonomy	Ophthalmology Physician
NPI Enumerated	December 27, 2005

Payer Source	Total Paid
Medicare	$649.6K
Medicaid	$0

Key Findings

This provider’s Medicare activity is modest in absolute scale: total Medicare revenue is $649.6K and there is no Medicaid billing on file, so the practice is effectively single‑payer (Medicare) in the available data. The NPI was enumerated 2005-12-27 (~21 years ago), indicating long-standing Medicare enrollment and likely established referral relationships in the local market.

Revenue is highly concentrated: the precomputed top three Medicare codes account for 79.8% of the provider’s total Medicare revenue, driven primarily by J0178 (66.5%), with J2777 (6.7%) and 92014 (6.7%) filling out the top three. This concentration means most Medicare dollars come from a small set of services rather than a broad mix of office visits and procedures.

The procedure mix points to a retina-focused ophthalmology practice: J0178 (aflibercept injections) is the dominant revenue driver ($432.5K revenue), supported by significant volumes of retinal imaging and injection-related codes such as 92134 (1.3K claims, $37K revenue, 5.7%) and 67028 (365 claims, $29.9K revenue, 4.6%). Together these codes suggest routine intravitreal therapy and diagnostic OCT imaging are central to the service line offered.

Competitive standing on the primary drug code is middling: J0178 ranks #1726 of 3204 providers nationally (46th percentile) and is described as typical, unremarkable volume, so the provider is neither a national leader nor an outlier for aflibercept administration. In contrast, some diagnostic/office exam codes show relatively higher standing versus peers, indicating strengths in follow‑up and imaging.

Imaging and evaluation codes show above‑typical relative volume: 92134 ranks #1773 of 26868 providers nationally (93th percentile; typical, unremarkable volume) and 92014 ranks #5371 of 35415 (85th percentile; typical, unremarkable volume), while 92012 is at the 89th percentile. These percentiles indicate the provider bills OCT imaging and established-patient exam codes at rates well above many peers, consistent with a practice that manages ongoing retinal disease.

There are contrasting claim-level economics across codes: J0178 carries a high average payment per claim ($680 avg paid/claim) yielding $432.5K in revenue, whereas J2777 shows 1.5K claims at a low $29 avg paid/claim for $43.5K revenue. This pattern underscores that a single drug code (J0178) produces the bulk of revenue while other high-count codes contribute more modest per‑claim revenue.

Some lower-ranked services are present at modest volumes and do not substantially move revenue: codes such as 92250 ($1.9K revenue, 74 claims) and 92235 ($1.5K revenue, 15 claims) are mid- to low-ranked nationally and constitute only a small share of Medicare revenue. The overall mix therefore reads as a concentrated retinal/injection practice with ancillary imaging and occasional ancillary testing.

The absence of any Medicaid billing on file indicates limited or no participation in that payer channel; combined with the heavy Medicare concentration, this creates a narrow payer mix that could make the practice sensitive to reimbursement changes or utilization shifts within the Medicare program.

Medicare: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	640	$680	$432.5K
J2777	Injection, faricimab‑svoa, 0.1 mg	1,500	$30	$43.5K
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…	500	$90	$43.3K
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.	1,280	$30	$37K
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…	490	$60	$31.4K
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.	370	$80	$29.9K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	60	$270	$16.3K
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.	110	$110	$12.4K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	70	$30	$1.9K
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…	20	$100	$1.5K

Showing 1–10 of 11

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Maine Distribution

Dana Graichen — 2 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. state median

11 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	10	20	990	$690	$652.2K
J2777	11	10	9,840	$30	$407.6K
67028	14	30	410	$90	$51.1K
66821	15	40	50	$200	$14.9K
92014	15	240	150	$80	$14.7K
92235	9	10	50	$90	$7.5K
92012	1	130	50	$60	$5.2K
92134	8	180	50	$30	$4.5K
92004	11	190	30	$90	$3.6K
92250	54	150	60	$20	$2.1K

Showing 1–10 of 11

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kinley Beck	NH	Retina Specialist (Ophthalmology) Physician	$4.2M	$0
Andre Witkin	MA	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Eyesight Ophthalmic Services PLLC	NH	Ophthalmology Physician	$0	$762.4K
Jason Szelog	NH	Ophthalmology Physician	$541.5K	$0
Timothy Sullivan	NH	Ophthalmology Physician	$471.2K	$0
Warren Goldblatt	NH	Ophthalmology Physician	$434K	$0
Claudia Bartolini	NH	Ophthalmology Physician	$320.9K	$0
Jennifer Ling	NH	Ophthalmology Physician	$264.7K	$0
Newton Peters	NH	Ophthalmology Physician	$262.4K	$0
Lucian Szmyd	NH	Ophthalmology Physician	$257.5K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Waypoint Maine, Inc.	ME	Case Management Agency	$0	$110.5M
Great Bay Services	ME	Developmental Disabilities Clinic/Center	$0	$7.1M
Milestones Family Services, LLC	ME	Case Management Agency	$0	$2.8M
City Of Sanford	ME	Land Ambulance	$277.3K	$1.8M
Montshire Sanford PC	ME	Pediatric Dentistry	$0	$1.4M
Great Bay Services	ME	Developmental Disabilities Clinic/Center	$0	$824.9K
Philip Russell	ME	Psychiatry Physician	$14.5K	$720.3K
City Of Sanford	ME	Local Education Agency (LEA)	$0	$733.4K
Associated Eye Care, P.A.	ME	Optometrist	$0	$687.3K
Children's Dentistry Of Sanford, LLP	ME	Pediatric Dentistry	$0	$673.4K

Dana Graichen — 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