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

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

Monica Michelotti (NPI 1871882456)

Field	Value
Entity Type	Individual
Organization	Monica Michelotti
Address	2450 12th St Se
City	Salem
State	OR
ZIP	97302
Taxonomy	Ophthalmology Physician
NPI Enumerated	April 4, 2011

Payer Source	Total Paid
Medicare	$2.5M
Medicaid	$0

Key Findings

Provider profile and payer mix: MONICA MICHELOTTI is an ophthalmology physician enumerated on 2011-04-04 (~15 years ago) and has $2.5M in lifetime Medicare revenue with no Medicaid billing on file, making this effectively a single-payer (Medicare-focused) billing profile. The absence of Medicaid activity indicates the provider’s public-payer exposure is concentrated in Medicare beneficiaries rather than a mixed Medicaid/Medicare practice.

Revenue concentration: Revenue is highly concentrated in intravitreal drug administration and related procedures — the precomputed top-3 Medicare codes account for 87.3% of this provider's total Medicare revenue. The three revenue drivers are J0178 ($1.4M; 58.4% of Medicare revenue), J2777 ($572.5K; 23.1%), and 67028 ($143.7K; 5.8%), indicating a small set of codes dominates the practice’s Medicare income.

Service-line implications: The code mix is consistent with a retina-focused ophthalmology practice emphasizing intravitreal injections and retina imaging rather than general comprehensive ophthalmology. High revenue from J0178 (aflibercept) and J2777 (faricimab) together with procedural billing for 67028 (intravitreal injection as a separate procedure) suggests the clinic’s core service line is medical retina care and recurrent injectable therapies.

Competitive standing on major drug codes: For the primary drug J0178 the provider ranks #490 of 3204 providers nationally (85th percentile; typical, unremarkable volume for this code), and for J2777 the provider ranks #541 of 2039 providers nationally (73th percentile; typical, unremarkable volume for this code). These positions indicate above-average but not dominant national volume for the principal reimbursed drugs, consistent with a mid-to-high activity retina injector rather than a top national outlier.

Procedure and imaging intensity: Retinal imaging via 92134 shows notable intensity — 1.5K claims and $44.6K revenue with a national rank of #1478 of 26868 providers (95th percentile; notably above typical national volume for this code), which supports the interpretation that diagnostic OCT-based imaging is heavily used alongside injections. Routine ophthalmology E/M and comprehensive visit codes such as 92014 (603 claims, $52.5K revenue) also appear but at typical volumes (92… rank #4183 of 35415; 88th percentile), suggesting outpatient visits accompany the injection/imaging workflow.

Atypical drug and billing notes: J3490 (Unclassified drugs) generated $49.5K on 27 claims with a high average paid/claim of $1832 and ranks #2361 of 2838 providers (15th percentile; typical, unremarkable volume for this code). The small claim count but high average payment points to occasional high-cost miscellaneous drug billings; this pattern merits attention when reconciling drug administrations and inventory or payer adjudication practices.

E/M mix and higher-acuity new patient visits: The practice reports measurable new-patient high-complexity E/M activity (99204: 133 claims, $16.1K revenue) and ranks #14298 of 227068 providers (94th percentile; notably above typical national volume for this code), which indicates the provider handles a meaningful share of moderate-complexity new-patient consults relative to peers. Established-patient E/M (99214, 99213) volumes are present but broadly typical in scale, consistent with a service model built around procedural and imaging revenue rather than heavy office-based chronic management alone.

Operational and payer-risk implications: Given that $2.5M of lifetime revenue is driven predominantly by a few high-value intravitreal drug codes (top-3 = 87.3%), the provider’s revenue stream is sensitive to changes in drug utilization, reimbursement, or prior‑authorization rules affecting J0178 and J2777. The lack of Medicaid billing further concentrates payer exposure to Medicare policy and coverage trends, so analysts should monitor drug-class policy shifts, competitive local injector capacity, and utilization management actions that could materially affect reimbursement.

Medicare: Complete Services Breakdown

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,110	$690	$1.4M
J2777	Injection, faricimab‑svoa, 0.1 mg	19,740	$30	$572.5K
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.	1,560	$90	$143.7K
J2778	Injection, ranibizumab, 0.1 mg	400	$170	$67.7K
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…	600	$90	$52.5K
J3490	Unclassified drugs	30	$1,830	$49.5K
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.	1,540	$30	$44.6K
J7999	Compounded drug, not otherwise classified	420	$70	$29.3K
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…	340	$70	$22.6K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	130	$120	$16.1K

Showing 1–10 of 17

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Oregon Distribution

Monica Michelotti — 2 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. state median

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	5	60	840	$680	$623.7K
J2777	7	30	10,050	$30	$527.6K
J2778	9	20	400	$180	$87.8K
67028	9	70	580	$90	$72.3K
J3490	37	50	40	$640	$42.9K
J7999	16	50	270	$70	$23.4K
92014	23	440	110	$80	$16K
92235	16	30	60	$100	$11.1K
99214	1,338	6,070	80	$70	$10.3K
92134	23	390	80	$30	$8.1K

Showing 1–10 of 17

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Retina Consultants, LLP	OR	Ophthalmology Physician	$0	$6.6M
Scott Mcclintic	OR	Ophthalmology Physician	$1.7M	$0
Justin Baynham	OR	Ophthalmology Physician	$1.4M	$0
Andrew Westfall	OR	Ophthalmology Physician	$1.1M	$0
Jessica Weinstein	OR	Retina Specialist (Ophthalmology) Physician	$691.2K	$49.8K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Crc Health Oregon, LLC	OR	Methadone Clinic	$485.5K	$26.1M
Salem Psychiatric Associates PC	OR	Clinical Social Worker	$0	$22.7M
Shangri-la Corporation	OR	Mental Illness Community Based Residential Treatment Facility	$0	$13.5M
Cascade Infectious Diseases And Infusion LLC	OR	Infusion Therapy Clinic/Center	$0	$9.6M
Salem Pediatric Clinic	OR	Pediatrics Physician	$0	$9M
Silver Falls Dermatology, LLC	OR	Dermatology Physician	$0	$6.8M
Cascade Sleep Supply, LLC.	OR	Durable Medical Equipment & Medical Supplies	$0	$6.1M
Creating Pathways	OR	Speech-Language Pathologist	$0	$5.7M
Salem Pulmonary Associates P.C.	OR	Pulmonary Disease Physician	$0	$4.8M
Hhhkc Dental LLC	OR	Oral and Maxillofacial Surgery (Dentist)	$0	$4.7M

Monica Michelotti — 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