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

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

Marta King (NPI 1861594970)

Field	Value
Entity Type	Individual
Organization	Marta King
Address	2600 Wilson St
City	Miles City
State	MT
ZIP	59301
Taxonomy	Ophthalmology Physician
NPI Enumerated	September 1, 2006

Payer Source	Total Paid
Medicare	$356.2K
Medicaid	$0

Key Findings

This provider’s commercial scale is concentrated entirely in Medicare: total Medicare revenue is $356.2K and there is no Medicaid billing on file, so MARTA KING effectively operates as a single‑payer (Medicare) billing profile in the available data. The absence of any Medicaid entries indicates limited or no Medicaid patient volume reflected in claims data.

Revenue is highly concentrated in a very small set of services: the top three Medicare codes (J0178, 92012, 67028) account for 88.8% of this provider's total Medicare revenue. J0178 (injection, aflibercept) alone represents $257.4K (72.2% of Medicare revenue), while 92012 and 67028 contribute $41.4K (11.6%) and $18.1K (5.1%) respectively, underscoring reliance on drug‑delivery and associated ophthalmic visit codes.

The clinical/service mix is consistent with a retina-focused ophthalmology practice that delivers intravitreal anti‑VEGF therapy and performs routine and diagnostic ophthalmic visits: the dominant revenue driver J0178 is an aflibercept injection, supported by high volumes of intermediate established‑patient exams (92012) and intravitreal injection procedure coding (67028). High utilization of retinal imaging and visual field testing codes (92134, 92133, 92083) further supports a practice centered on retinal disease management and monitoring.

Volume and payment details show how that concentration manifests operationally: J0178 has 372 claims with an average paid/claim of $692, 92012 has 714 claims at $58 avg paid/claim, and 67028 has 210 claims at $86 avg paid/claim. The combination of relatively high per‑claim payment for J0178 and large claim counts for 92012 indicates a workflow driven by frequent follow‑up visits paired with medication administration.

National competitive standing is mixed across the key codes. For the primary revenue driver J0178 the provider ranks #2181 of 3204 (32th percentile; typical, unremarkable volume for this code), indicating a modest national position in aflibercept administration despite it representing the bulk of revenue.

By contrast, the provider is a relatively strong outlier for office visit volume: 92012 ranks #961 of 17177 (94th percentile; notably above typical national volume), showing an especially high throughput of established‑patient intermediate ophthalmology exams compared with national peers. This suggests the practice captures above‑average established patient visit volume even if drug administration ranks are modest.

Other diagnostic codes also show above‑typical national placement for imaging: 92134 ranks #3167 of 26868 (88th percentile; typical, unremarkable volume) and 92133 ranks #2560 of 24968 (90th percentile; typical, unremarkable volume), indicating the provider consistently uses retinal and optic nerve imaging as part of care pathways. These imaging volumes align with the retina/medical retina service line implied by the injection and visit codes.

Operational and business implications include concentrated financial exposure and limited payer diversification: with $356.2K in Medicare revenue and no Medicaid revenue on file, the provider’s revenue stream is sensitive to changes in anti‑VEGF utilization, reimbursement for J0178, or shifts in referral patterns. The NPI was enumerated 2006-09-01 (~20 years ago), indicating long tenure in the Medicare program but also suggesting that any strategic shifts (e.g., expanding payer mix) would materially affect the practice’s stability given the current concentration.

Medicare: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	370	$690	$257.4K
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…	710	$60	$41.4K
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.	210	$90	$18.1K
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.	580	$30	$16.1K
92083	The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for an extended…	150	$40	$6.7K
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…	80	$80	$6.6K
92133	The provider performs computerized diagnostic imaging of the optic nerve in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both…	250	$20	$6.1K
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.	30	$90	$2.6K
92002	The provider performs an intermediate level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program.	30	$40	$1.3K
92025	The provider measures the curvature of one or both corneas, interprets the findings, and prepares a report.	20	$30	$460

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 10 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Montana Distribution

Marta King — 1 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. state median

10 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	11	20	460	$680	$663.4K
67028	16	20	390	$90	$73.7K
92014	127	170	190	$80	$22.7K
92012	4	50	80	$60	$11.9K
92134	17	160	100	$30	$7.8K
92004	105	150	40	$80	$4.4K
92083	19	130	50	$40	$3.5K
92133	7	140	50	$20	$2K
92025	11	20	20	$20	$930
92002	1	10	20	$50	$850

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eastern Montana Industries	MT	Developmentally Disabled Services Day Training Agency	$0	$19.9M
Eastern Montana Community Mental Health Center	MT	Clinic/Center	$0	$13.7M
Miles City Public Schools	MT	Local Education Agency (LEA)	$0	$4.6M
Developmental Educational Assistance Program	MT	Local Education Agency (LEA)	$0	$1.4M
Eastern Mt Community Mental Health Cdu Prog	MT	Clinic/Center	$0	$956.4K
Carrie David	MT	Professional Counselor	$0	$652.1K
Yerger Family Dental, PC	MT	Dentist	$0	$570K
Holy Rosary Healthcare	MT	Critical Access Hospital	$0	$564.7K
Miles City Vision Clinic P C	MT	Optometrist	$0	$563.3K
Pamela Colombik	MT	Mental Health Counselor	$0	$418.5K

Marta King — 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

Nearby Providers

Frequently Asked Questions

References