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

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

Andrew Davis (NPI 1922012582)

Field	Value
Entity Type	Individual
Organization	Andrew Davis
Address	3855 W 7800 S Ste 100
City	West Jordan
State	UT
ZIP	84088
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	July 28, 2006

Payer Source	Total Paid
Medicare	$1.8M
Medicaid	$0

Key Findings

ANDREW DAVIS is operating as a retina specialist whose billing mix is dominated by intravitreal pharmacologic therapy and retinal imaging: the top Medicare codes are J2778 (ranibizumab), J2777 (faricimab), and 67028 (intravitreal injection), and the provider also bills substantial volume for retinal imaging codes such as 92134, 92250 and 92235. Claims counts and average payments—J2778 at 4.9K claims and $180 avg paid/claim, J2777 at 13K claims and $29 avg paid/claim, and 92134 at 1.4K claims and $28 avg paid/claim—support a clinic workflow centered on frequent injections with routine OCT and fundus imaging for monitoring. This pattern aligns with a medical-retina practice focused on repeated outpatient injections and diagnostic follow-up rather than high-volume surgery.

Revenue is highly concentrated in a small set of Medicare codes: the precomputed top-3 codes account for 79.2% of this provider's total Medicare revenue. In particular J2778 alone represents $874.6K of Medicare revenue (49.9% of this provider's total Medicare revenue), making a single biologic drug the single largest revenue driver in the practice. That concentration implies financial sensitivity to changes in utilization or reimbursement for a few drug administration codes.

Payer mix is effectively single-payer Medicare: lifetime Medicare revenue is $1.8M while there is no Medicaid billing on file. The absence of Medicaid activity means this provider’s revenue and utilization patterns should be analyzed primarily through a Medicare lens and any payer-contracted strategies would need to account for limited Medicaid exposure. Analysts should note the practice carries concentrated Medicare dependency for its revenue base.

On competitive standing for the top drug J2778, this provider ranks #46 of 1208 nationally (96th percentile) and is described as "notably above typical national volume," indicating a strong national position for ranibizumab administration among peers. That elevated ranking for J2778 contrasts with other drug and procedure rankings and signals this clinician is a relatively major national user of ranibizumab compared with peers. Such leadership on a single high-volume injectable strengthens the provider’s negotiating relevance for product- or drug-related contracts.

Other high-volume codes show more typical participation: J2777 ranks #804 of 2039 providers nationally (60th percentile) and is characterized as typical/unremarkable volume, while 67028 ranks #668 of 4255 (84th percentile) and is also noted as typical/unremarkable for this procedure. These placements suggest that outside of the exceptional J2778 activity, the provider’s injection and procedure volumes are within common ranges for retina specialists rather than broadly dominant across all service lines. Analysts should treat the practice as highly specialized in one drug while otherwise operating at expected specialty volumes.

Diagnostic and monitoring services are a meaningful secondary revenue stream: 92134 (1.4K claims, $28 avg paid/claim, $39.4K revenue) and 92250 (621 claims, $26 avg paid/claim, $16.1K revenue) rank in the 94th and 97th percentiles respectively and are labeled "notably above typical national volume." High relative volumes for OCT and fundus photography are consistent with protocol-driven follow-up for injection-treated retinal disease and support the clinical workflow inferred from the drug codes. Payers should expect recurring imaging utilization tied to ongoing injection regimens.

The provider shows occasional use of high-cost or unclassified drugs: J3490 appears with 49 claims at $1768 avg paid/claim accounting for $86.6K in revenue, indicating intermittent administration of items billed under unclassified drug codes. Combined with the dominant branded injectable J2778 and the presence of J2781 (pegcetacoplan) at 960 claims and $115.2K revenue, this pattern suggests exposure to multiple specialized intravitreal agents, which may have implications for pharmacy contract reviews and cost-management initiatives. These drug-level exposures create points of leverage (and risk) for payers managing ophthalmology drug spend.

The provider has long tenure in the Medicare program (NPI enumerated 2006-07-28, ~20 years ago) and modest overall scale: lifetime Medicare revenue is $1.8M and surgical procedures are rare (for example 67042 shows 11 claims and $8.5K revenue). The combination of long tenure with concentration in outpatient injections and imaging suggests an established retina-focused practice that performs few intraocular surgeries and derives most revenue from repeated outpatient services. For network planning or competitive assessments, treat this clinician as a stable, injection-centric retina provider rather than a high-volume surgical retina center.

Medicare: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2778	Injection, ranibizumab, 0.1 mg	4,860	$180	$874.6K
J2777	Injection, faricimab‑svoa, 0.1 mg	13,020	$30	$377.6K
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.	1,630	$80	$135K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	960	$120	$115.2K
J3490	Unclassified drugs	50	$1,770	$86.6K
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…	670	$90	$56.8K
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.	1,410	$30	$39.4K
92235	The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken…	190	$100	$18.7K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	620	$30	$16.1K
J7999	Compounded drug, not otherwise classified	210	$70	$14.6K

Showing 1–10 of 12

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Utah Distribution

Andrew Davis — 4 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. state median

12 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2777	13	20	13,140	$30	$523.9K
J2778	1	10	870	$180	$224.3K
J3490	19	30	80	$1,690	$199.5K
J2781	8	20	960	$120	$126.6K
67028	8	60	440	$90	$61.7K
67042	15	20	20	$1,100	$26.3K
J7999	8	20	120	$70	$16.9K
92014	19	330	140	$70	$16.6K
92134	13	250	70	$30	$7.6K
92235	1	20	30	$90	$5.4K

Showing 1–10 of 12

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Douglas Mehr	UT	Retina Specialist (Ophthalmology) Physician	$2.7M	$0
Christopher Gee	UT	Retina Specialist (Ophthalmology) Physician	$1.9M	$0
Rebekah Gensure	UT	Retina Specialist (Ophthalmology) Physician	$969.8K	$0
Salt Lake Retina, LLC	UT	Retina Specialist (Ophthalmology) Physician	$0	$768.8K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Utah Homecare LLC	UT	Home Health Agency	$0	$14.9M
Jordan Valley Medical Center LP	UT	Rehabilitation Hospital Unit	$0	$9.1M
Affinity Behavior And Mental Health Services, LLC	UT	Community/Behavioral Health Agency	$0	$7.4M
Jordan Valley Medical Center LP	UT	General Acute Care Hospital	$0	$7.3M
Wasatch Pediatrics, Inc	UT	Pediatrics Physician	$0	$5.8M
Family Surgical Suite	UT	Ambulatory Surgical Clinic/Center	$0	$4.8M
Kids Behavioral Health Of Utah, Inc	UT	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$4.1M
Jordan West Family Counseling Inc	UT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$1M
Valued Medical Care LLC	UT	Urgent Care Clinic/Center	$0	$836.2K
Southwest Children's Clinic	UT	Specialist	$0	$700.5K

Andrew Davis — 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