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    OpenPayerNPI Medicare & MedicaidDavid Terrell
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    David Terrell — Billing Profile & Reimbursement Data

    NPI 1851702195 · Brattleboro, VT · Ophthalmology Physician

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    David Terrell is a ophthalmology physician provider located in Brattleboro, Vermont. This profile covers 16 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationDavid Terrell
    Address238 Western Ave
    CityBrattleboro
    StateVT
    ZIP05301
    TaxonomyOphthalmology Physician
    NPI EnumeratedMay 8, 2014

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$270.3K
    Medicaid$0

    Key Findings

    This provider’s lifetime Medicare receipts total $270.3K with no Medicaid billing on file, making the practice effectively single-payer (Medicare) in the available data. The absence of Medicaid activity suggests limited participation in state Medicaid programs or that Medicaid patients are not billed under this NPI.

    Revenue is highly concentrated in a small set of services: the top three Medicare codes (J0178, 92014, 66984) together account for 54.2% of the provider’s total Medicare revenue. Those three codes individually contribute $82.3K (J0178, 30.5%), $33.4K (92014, 12.4%), and $30.5K (66984, 11.3%), indicating the business is driven by injections, comprehensive exams, and cataract surgery.

    Clinical mix and service line inference: the largest single revenue line is J0178 (aflibercept injection) with 119 claims and $82.3K in revenue, supported by additional injection and surgical codes (J9035 bevacizumab 252 claims, $13.6K; 67028 intravitreal injection 282 claims, $24.5K) and high imaging volume (92134 885 claims, $24.8K). This pattern is consistent with an ophthalmology practice providing medical retina services (injections and OCT imaging) alongside cataract surgery and routine ophthalmic exams.

    Competitive standing on anti-VEGF therapy is mixed: J0178 (aflibercept) generates the largest revenue share but ranks #2926 of 3204 providers (9th percentile) and is described as "typical, unremarkable volume" for this code, indicating relatively low national volume for that specific agent. By contrast, J9035 (bevacizumab) ranks #562 of 1852 providers (70th percentile) and is characterized as "typical, unremarkable volume," suggesting more moderate relative use of bevacizumab in this panel.

    Utilization of diagnostic and general ophthalmic visits is relatively strong: 92134 (retinal OCT) shows 885 claims and $24.8K (9.2% of Medicare revenue) and ranks #2360 of 26868 providers (91st percentile), while 99213 has 423 claims and $25.4K (9.4%) and ranks #35782 of 457151 providers (92nd percentile). These percentiles (described in the source as typical) indicate above-average imaging and established-patient visit volumes compared with national peers, supporting a workflow that integrates frequent imaging with office-based management.

    Surgical cataract activity appears present but moderate: 66984 has 75 claims and $30.5K (11.3% of Medicare revenue) and ranks #9073 of 15965 providers (43rd percentile), while 66821 (YAG capsulotomy) has 47 claims and $10.8K (4.0%) and ranks #5040 of 10087 providers (49th percentile). Those median-level percentiles point to a routine cataract surgery practice but not a high-volume surgical center relative to national ophthalmology peers.

    Operational and revenue-concentration implications: with the top three codes making up 54.2% of Medicare revenue, the provider’s topline is sensitive to changes in utilization or reimbursement for injections, comprehensive exams, and cataract surgery. A shift in anti-VEGF mix, referral patterns, or surgeon availability could materially affect revenue given this concentration.

    Tenure and practice stability: the NPI was enumerated on 2014-05-08 (approximately 12 years ago), indicating a stable, established billing presence in Brattleboro, VT over about a decade. This length of enrollment supports interpreting the observed code mix as representative of an ongoing clinical practice rather than a short-term or newly started operation.

    Payer-mix and access note: because Medicaid revenue is recorded as none and Medicare totals $270.3K, this provider’s observable payor exposure is narrowly concentrated on Medicare beneficiaries. That profile has implications for patient access, population served, and revenue resilience if payer mix were to shift or if the provider sought to broaden commercial or Medicaid contracts.

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    16 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J0178Injection, aflibercept, 1 mg120$690$82.3K
    92014An 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…430$80$33.4K
    66984The 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…80$410$30.5K
    99213The 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…420$60$25.4K
    92134The 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.890$30$24.8K
    67028The 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.280$90$24.5K
    J9035Injection, bevacizumab, 10 mg250$50$13.6K
    66821The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.50$230$10.8K
    92012For 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…160$60$9.6K
    92004The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.50$100$5.3K

    Showing 1–10 of 16

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    16 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J0178510740$690$730.2K
    669841920180$210$121.4K
    670286101,220$80$90.1K
    9201414100200$80$19.6K
    J9035310250$50$17.5K
    6682182050$250$13.2K
    9921492196090$70$10.6K
    992136191080$50$6.7K
    92004389050$90$5.9K
    9201285050$60$5.8K

    Showing 1–10 of 16

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Brian LarsenILRetina Specialist (Ophthalmology) Physician$3.8M$197.6K
    Bluewater Emergency Partners Of Brunswick, LLCMEEmergency Medicine Physician$0$3.8M
    Southwestern Vermont Medical Center Inc.VTInternal Medicine Physician$0$2.9M
    Brattleboro Memorial HospitalVTGeneral Acute Care Hospital$0$2.4M
    Victoria CoraglioFLFamily Medicine Physician$1.3M$1M
    Naryan SabherwalILRetina Specialist (Ophthalmology) Physician$1.2M$949.6K
    Rima PatelAZRetina Specialist (Ophthalmology) Physician$1.8M$0
    Shivan TekwaniILOphthalmology Physician$1.7M$10.7K
    Elite Bor-shavitMARetina Specialist (Ophthalmology) Physician$1.5M$5.4K
    Dheeraj MahajanILInternal Medicine Physician$518.5K$958K

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Winston L. Prouty Center For Child Development, Inc.VTDevelopmentally Disabled Services Day Training Agency$0$5.5M
    Rescue Inc.VTAmbulance$1M$3.3M
    Habit Opco, LLCVTSubstance Use Disorder Rehabilitation Clinic/Center$463.1K$1.5M
    Lincare Inc.VTDurable Medical Equipment & Medical Supplies$0$915K
    Windham County Dental Center IncVTDental Clinic/Center$0$621.8K
    Youth Services, Inc.VTMental Health Counselor$0$600.4K
    Green Mountain Counseling AssociatesVTMental Health Counselor$0$598.2K
    Erin BerardVTMental Health Counselor$0$571.5K
    Timothy WhitneyVTMental Health Counselor$0$555.1K
    James CarewVTSocial Worker$0$489.1K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Vermont Distribution
    David Terrell — 0 of 16 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Vermont