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

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

Retina Specialists Of Idaho Partners, PLLC (NPI 1922425032)

Field	Value
Entity Type	Organization
Organization	Retina Specialists Of Idaho Partners, PLLC
Address	13923 W Wainwright Dr
City	Boise
State	ID
ZIP	83713
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	March 26, 2014

Payer Source	Total Paid
Medicaid	$363.2K
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	2,770	$40	$121.8K
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.	5,730	$20	$97.4K
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…	1,150	$50	$55.2K
J9035	Injection, bevacizumab, 10 mg	1,150	$40	$48.1K
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…	400	$50	$20.1K
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…	290	$50	$13.4K
J7999	Compounded drug, not otherwise classified	250	$20	$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	$100	$2.7K
92201	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…	20	$10	$260

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Idaho providers billing the same CPT/HCPCS codes.

Claims Volume vs. Idaho Distribution

Retina Specialists Of Idaho Partners, PLLC — 0 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	424	670	740	$40	$193.6K
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…	236	620	560	$60	$191.8K
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…	75	160	320	$90	$92.8K
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.	3	10	990	$50	$87.9K
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…	124	180	70	$110	$45.6K
J9035	Injection, bevacizumab, 10 mg	3	10	400	$60	$43.6K
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.	2	20	690	$20	$29.7K
J7999	Compounded drug, not otherwise classified	1	10	110	$10	$1.9K
92201	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…	2	10	40	$20	$660

Related Providers

Other providers that share a Tax Identification Number (TIN) with Retina Specialists Of Idaho Partners, PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
James Earl	ID	Retina Specialist (Ophthalmology) Physician	$3.1M	$0
Denton Roberts	ID	Ophthalmology Physician	$1.6M	$0
Daniel Gealy	TX	Ophthalmology Physician	$923.7K	$0

Nearby Providers

Other providers in the same ZIP code as Retina Specialists Of Idaho Partners, PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rise, Inc	ID	Voluntary or Charitable Agency	$0	$263.8M
Trivium Life Services Mountain West, LLC	ID	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3M
Trinity Mountain Health	ID	Home Health Agency	$0	$2.2M
Boise Toothtown Dentistry For Kids PLLC	ID	Pediatric Dentistry	$0	$2.1M
Mountain View Behavioral Health, LLC	ID	Community/Behavioral Health Agency	$0	$1.7M
Edgewood Spring Creek Boise, LLC	ID	Assisted Living Facility	$0	$1.6M
Edgewood Spring Creek Eagle Island LLC	ID	Assisted Living Facility	$0	$1.3M
Zrj Inc	ID	Physical Therapist	$0	$1.2M
Community Partnerships Of Idaho, Inc.	ID	Community/Behavioral Health Agency	$0	$1.2M
Blair Pediatric Dentistry PC	ID	Pediatric Dentistry	$0	$669.4K

Retina Specialists Of Idaho Partners, PLLC — Billing Profile & Reimbursement Data

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Retina Specialists Of Idaho Partners, PLLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References