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.

James Ness (NPI 1831230150)

Field	Value
Entity Type	Individual
Organization	James Ness
Address	2860 E Beltline Ave Ne
City	Grand Rapids
State	MI
ZIP	49525
Taxonomy	Optometrist
NPI Enumerated	February 9, 2007

Payer Source	Total Paid
Medicare	$71K
Medicaid	$0

Medicare: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	330	$110	$37K
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…	220	$90	$20.3K
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…	210	$70	$13.9K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Michigan Distribution

James Ness — 1 of 3 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

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
92014	298	1,080	100	$80	$14.8K
92012	73	460	50	$60	$6.8K
92004	5	690	30	$90	$4.2K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Luxottica Of America Inc.	OH	Point of Service	$0	$7.7M
Luxottica Of America Inc.	NV	Eyewear Supplier	$0	$3.9M
Jeffrey L. Morer, Od, PC	CT	Optometrist	$0	$1.8M
Bradley Grant	IL	Optometrist	$232K	$1.4M
Maancy Mehta	IL	Optometrist	$104.1K	$536.4K
Douglass Fruin	IL	Optometrist	$174.1K	$373.3K
Chad Fellows	VT	Optometrist	$91.6K	$395.8K
Tod Gerhardt	IA	Optometrist	$63.5K	$337.1K
Jason St Peter	CT	Optometrist	$377.4K	$4K
Gary Baziz	MD	Optometrist	$146.7K	$220.4K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Advanced Radiology Services PC	MI	Diagnostic Radiology Physician	$0	$60M
Clm Enterprises, Inc.	MI	Home Health Agency	$0	$13.4M
Stephanie Sweebe	MI	Behavior Analyst	$0	$12.4M
West Michigan Anesthesia, PC	MI	Anesthesiology Physician	$0	$9.9M
Blue Sky Vision Eye Care, P.C	MI	Ophthalmology Physician	$0	$9.4M
Infusion Associates PLLC	MI	Internal Medicine Physician	$0	$6.1M
Ebsc, LLC	MI	Ambulatory Surgical Clinic/Center	$1.2M	$953.3K
Parin Gohel	MI	Ophthalmology Physician	$1.6M	$0
Andrea Gillon	MI	Family Nurse Practitioner	$1.4M	$0
Kimberly Agim	MI	Nurse Practitioner	$1.1M	$0

James Ness — Billing Profile & Reimbursement Data

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James Ness — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References