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

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

Michael Patterson (NPI 1851654867)

Field	Value
Entity Type	Individual
Organization	Michael Patterson
Address	15 Iris Ln
City	Crossville
State	TN
ZIP	38555
Taxonomy	Ophthalmology Physician
NPI Enumerated	June 25, 2012

Payer Source	Total Paid
Medicare	$2.9M
Medicaid	$0

Key Findings

This ophthalmology physician has recorded $2.9M in total Medicare revenue and no Medicaid billing on file, making the practice effectively single-payer (Medicare) in the claims data available. Absence of Medicaid activity means any analysis of payer mix or Medicaid-dependent service lines is not supported by the records provided.

Revenue concentration is high: the platform notes the top 3 Medicare codes by revenue account for 65.7% of this provider's total Medicare revenue, indicating a small set of services dominates financial performance. Those top-generating codes include high-volume intravitreal drug injections and associated evaluation services, so revenue is concentrated in medical retina treatment and related office care.

The single largest revenue contributor is J2777 (faricimab), which accounts for $1.2M and 42.2% of the provider's Medicare revenue and sits at the 92th percentile nationally (rank #158 of 2039). This placement indicates the provider administers faricimab at a level that is typical but toward the higher end of national peers for this code, supporting a service-line emphasis on anti-VEGF/retinal injection therapy.

Aflibercept injections (J0178) and unclassified drug claims (J3490) are the other components of the top revenue mix, with J0178 contributing $489K (17.2%) and J3490 $180.3K (6.4%) of Medicare revenue. Together with J2777 these drug and supply codes drive the majority of revenue, suggesting the practice’s business model is materially reliant on intravitreal pharmacologic therapy rather than surgical cataract volume.

Although surgical and procedural ophthalmology services appear in the billing mix (for example 66984 cataract extraction with lens implant at $179.1K and 67028 intravitreal injection code at $101.8K), the provider’s procedural volumes are generally described as “typical, unremarkable” nationally for most surgery codes, whereas several office-based codes are statistical outliers. Notably, 92014 (comprehensive established exam) and 99213 (established outpatient E/M) are labeled extreme outliers and together represent substantial visit volume ($137.7K and $98K respectively), indicating heavy ongoing medical management of established Medicare patients.

Competitive standing varies by code: for retina drug administration the provider ranks in the mid-to-high percentiles (J2777 at 92th, J0178 at 50th), marking them as a meaningful regional provider of intravitreal therapies but not a national outlier in all anti-VEGF agents. In contrast, evaluation and management and several diagnostic imaging codes (92014 at 99th percentile; 92136 at 98th; 92134 at 95th) are far above typical national volume, implying the provider has an unusually large throughput of office visits and retinal imaging relative to other ophthalmologists.

The provider has been NPI enumerated since 2012-06-25 (about 14 years), establishing a long tenure in Medicare billing data. This multi-year presence supports that the observed patterns—high injection volume, concentrated drug revenue, and heavy established-patient visit counts—are likely part of an established practice profile rather than a short-term anomaly.

Medicare: Complete Services Breakdown

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

40 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2777	Injection, faricimab‑svoa, 0.1 mg	41,280	$30	$1.2M
J0178	Injection, aflibercept, 1 mg	720	$680	$489K
J3490	Unclassified drugs	100	$1,770	$180.3K
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…	460	$390	$179.1K
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…	1,740	$80	$137.7K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	960	$120	$114.2K
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.	1,050	$100	$101.8K
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…	1,610	$60	$98K
15823	In this procedure, the provider surgically trims excessive skin that weighs down the upper eyelid, typically to improve the cosmetic appearance of the face and due to the interference of the tissue…	100	$600	$62.5K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	230	$230	$51.3K

Showing 1–10 of 40

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 40 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Tennessee Distribution

Michael Patterson — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. state median

40 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	41	80	790	$680	$769.8K
J2777	7	50	15,060	$30	$592.1K
67028	44	80	1,130	$90	$98.5K
66984	154	450	170	$120	$89.5K
J2781	6	20	560	$120	$82.5K
J3490	24	60	70	$400	$41.9K
15823	10	60	50	$490	$33K
65756	8	20	20	$1,170	$30.5K
65820	7	20	20	$930	$26.1K
66988	2	10	30	$780	$23.4K

Showing 1–10 of 40

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cataract And Laser Center, LLC	TN	Ophthalmologic Surgery Clinic/Center	$2M	$164.4K
Andrew Johnson	TN	Ophthalmology Physician	$1.9M	$0
Larry Patterson	TN	Ophthalmology Physician	$929.6K	$0
Cory Bosanko	TN	Low Vision Rehabilitation Optometrist	$143K	$186.8K
Matthew Page	TN	Optometrist	$164.6K	$43.1K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hilltoppers, Inc.	TN	Developmentally Disabled Services Day Training Agency	$0	$16.5M
Plateau Pediatrics, Plc	TN	Rural Health Clinic/Center	$0	$10.6M
Cumberland Medical Center, Inc.	TN	General Acute Care Hospital	$0	$6.1M
Cumberland County Finance	TN	Land Ambulance	$1.3M	$3M
Mohammad Koucheki	TN	Pediatrics Physician	$0	$3.2M
William E Smith Obstetrics & Gynecology	TN	Obstetrics & Gynecology Physician	$0	$3M
Dirk Davidson	TN	Specialist	$2.7M	$0
Ryan Grover	TN	Radiation Oncology Physician	$2.2M	$0
Sivalingam Kanagasegar	TN	Rheumatology Physician	$1.5M	$46.5K
Mark Hendrixson	TN	Medical Oncology Physician	$1.1M	$56.4K

Michael Patterson — Billing Profile & Reimbursement Data

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Michael Patterson — 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