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.

David Switzer (NPI 1891931572)

Field	Value
Entity Type	Individual
Organization	David Switzer
Address	1221 N 26th St
City	Billings
State	MT
ZIP	59101
Taxonomy	Ophthalmology Physician
NPI Enumerated	December 30, 2008

Payer Source	Total Paid
Medicare	$2.7M
Medicaid	$0

Key Findings

The provider’s Medicare activity is heavily concentrated in retinal therapeutic and diagnostic services, consistent with an ophthalmology/retina practice. J0178 (aflibercept injection) accounts for 3.1K claims and $2.2M revenue (80.9% of Medicare revenue), while 67028 (intravitreal injection) has 2.5K claims and $228.2K revenue (8.6%), and 92134 (posterior segment imaging/OCT) shows 3.6K claims and $103.9K revenue (3.9%).

Medicare revenue is highly concentrated: the precomputed top-three codes together account for 93.3% of this provider’s total Medicare revenue, with J0178 alone representing 80.9% of the $2.7M Medicare total. This degree of concentration indicates the practice’s financial reliance on anti‑VEGF administration and closely related procedures.

On national competitive standing the provider ranks at the high end for multiple injection and imaging codes, indicating unusually large Medicare volumes. J0178 ranks #166 of 3204 providers (95th percentile, notably above typical national volume), 67028 ranks #170 of 4255 (96th percentile, notably above typical national volume), and 92134 ranks #208 of 26868 (99th percentile; extreme outlier, far above typical national volume for this code).

Ancillary service patterns support a high-throughput injection clinic model: J7999 (compounded drug) has 1.3K claims and $93.2K revenue and ranks #29 of 1333 providers (98th percentile; notably above typical national volume), while 99213 shows 972 claims and $61.2K revenue and ranks #6876 of 457151 providers (98th percentile; extreme outlier, far above typical national volume). These volumes suggest substantial use of compounded medications and frequent established-patient follow-ups alongside injections.

The provider is effectively a single-payer Medicare practice for the dataset shown: total Medicare revenue is $2.7M and there is no Medicaid billing on file. This lack of Medicaid activity means payer mix decisions, contracting, and utilization review should be framed primarily around Medicare relationships and fee schedules rather than dual‑payer strategies.

Operationally, claim counts across key codes imply sustained high throughput: 3.1K J0178 claims and 3.6K 92134 claims reflect both frequent therapeutic visits and routine imaging capacity. For network planners and ambulatory operations teams, these volumes imply needs for regular medication supply, injection-room capacity, and retinal imaging resources.

Tenure data show the provider’s NPI was enumerated on 2008-12-30 (~18 years ago), indicating an established practice footprint in Billings, MT. This longevity, combined with high national percentiles on injection and imaging codes, suggests an entrenched referral base and operational experience in retinal care.

From a payer oversight and contracting perspective, the provider’s prominence on J0178 and related injection codes makes them a strategically important regional source of anti‑VEGF services. Given the 80.9% revenue share of J0178 and top-three concentration at 93.3%, payers may want targeted monitoring of utilization trends for J0178 and consideration of inclusion in networks focused on retina treatment capacity.

Medicare: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	3,110	$690	$2.2M
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.	2,540	$90	$228.2K
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.	3,580	$30	$103.9K
J7999	Compounded drug, not otherwise classified	1,310	$70	$93.2K
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…	970	$60	$61.2K
92202	The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece…	970	$10	$10.7K
99203	The provider sees a new 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 provider…	60	$80	$4.2K
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…	30	$110	$2.9K
67145	The provider prevents the detachment of the retina in the presence of small tears or thinning of the edges (lattice degeneration) by applying an intense light (such as a laser) to create scar tissue…	10	$190	$2.5K
99214	The provider sees an established 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…	20	$80	$1.6K

Showing 1–10 of 11

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Montana Distribution

David Switzer — 5 of 11 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

11 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	1	20	460	$680	$663.4K
67028	2	20	390	$90	$73.7K
J7999	2	10	470	$70	$45.4K
99214	1,648	1,810	100	$70	$12.4K
92134	1	160	100	$30	$7.8K
99213	15	1,730	90	$50	$7.2K
92202	1	10	490	$10	$5.6K
99204	432	780	30	$100	$4.8K
67145	6	10	20	$170	$4.2K
99203	196	700	30	$70	$3.1K

Showing 1–10 of 11

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
George Hatch	MT	Ophthalmology Physician	$155.5K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Billings Clinic	MT	General Practice Physician	$0	$53.8M
Rimrock Foundation	MT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$44.9M
Scl Health Medical Group - Billings LLC	MT	Clinic/Center	$0	$32.2M
Residential Support Services	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$30.6M
Billings Public School District 2	MT	Local Education Agency (LEA)	$0	$19.2M
South Central Montana Regional Mental Health Center	MT	Clinic/Center	$0	$16.6M
Billings Clinic	MT	Emergency Care Clinic/Center	$0	$15.7M
Community Solutions Incorporated	MT	Clinical Medical Laboratory	$0	$14.1M
Scl Health Montana	MT	General Acute Care Hospital	$0	$13.5M
Benefis Community Care, Inc.	MT	Case Management Agency	$0	$10.8M

David Switzer — Billing Profile & Reimbursement Data

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David Switzer — 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