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

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

Erica Ballard (NPI 1922447853)

Field	Value
Entity Type	Individual
Organization	Erica Ballard
Address	1229 E Seminole St Ste 430
City	Springfield
State	MO
ZIP	65804
Taxonomy	Ophthalmology Physician
NPI Enumerated	June 25, 2013

Payer Source	Total Paid
Medicare	$1.4M
Medicaid	$0

Key Findings

This provider is heavily focused on intravitreal pharmacologic therapy and retina care: J0178 (1.2K claims, $691 avg paid/claim, $861K revenue, 60.0% of Medicare revenue), J2777 (7.2K claims, $29 avg paid/claim, $208.8K revenue, 14.6%), and 67028 (1.3K claims, $88 avg paid/claim, $112.6K revenue, 7.8%) together drive the clinical mix and revenue profile; the top 3 Medicare codes by revenue account for 82.4% of this provider's total Medicare revenue, signaling a concentrated specialty practice centered on retinal injections and related procedures.

Revenue concentration is pronounced: a single drug code, J0178, represents 60.0% of Medicare revenue and the top three codes account for 82.4% of Total Medicare revenue: $1.4M. That level of concentration implies most billing and reimbursement risk is tied to intravitreal anti-VEGF and related retina services rather than a broad primary-care or multi‑specialty visit mix.

Payer mix is effectively single-payer Medicare: Total Medicare revenue is $1.4M while there is no Medicaid billing on file, so the provider operates without a recorded Medicaid presence and depends on Medicare as the primary public payer. This absence of Medicaid activity should be considered when assessing access, referral sources, and possible contract negotiations with state Medicaid plans.

Competitive standing on drug and procedure volumes is mixed. J0178 ranks #1049 of 3204 providers nationally (67th percentile; typical, unremarkable volume for this code) and 67028 ranks #1025 of 4255 (76th percentile; typical, unremarkable volume), indicating solid but not dominant national participation in core retina services; by contrast, J2777 ranks #1256 of 2039 providers nationally (38th percentile; typical, unremarkable volume), showing more modest national activity for that newer drug code.

Certain ancillary and diagnostic services show above‑typical national volume: 92134 (2.1K claims, $28 avg paid/claim, $57.6K revenue) ranks #988 of 26868 providers nationally (96th percentile; notably above typical national volume), suggesting the provider performs a high volume of retinal imaging and diagnostic interpretation relative to peers and supports the high injection volume with substantial retinal imaging capacity.

Although most activity is outpatient injections and diagnostics, the provider performs surgical retina procedures at lower volumes. Codes like 67042 (25 claims, $835 avg paid/claim, $20.9K revenue) and 67108 (18 claims, $792 avg paid/claim, $14.3K revenue) are present but account for small shares of revenue, indicating surgical capability exists but is not the primary revenue driver.

Office evaluation-and-management volumes are meaningful for continuity of care: 99214 (599 claims, $80 avg paid/claim, $47.9K revenue) ranks #35660 of 479517 providers nationally (93th percentile; typical, unremarkable volume), and 99213 (209 claims, $59 avg paid/claim, $12.3K revenue) ranks #93607 of 457151 (79th percentile; typical, unremarkable volume), showing a stable stream of established‑patient visits that likely support ongoing injection and monitoring follow-up.

Provider tenure is well-established: the NPI was enumerated on 2013-06-25 (~13 years ago), indicating over a decade of Medicare participation, which aligns with sustained patterns in high-volume retinal imaging (92134) and anti-VEGF injection billing and supports interpretation of these volume trends as persistent rather than transient.

Medicare: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,250	$690	$861K
J2777	Injection, faricimab‑svoa, 0.1 mg	7,200	$30	$208.8K
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.	1,280	$90	$112.6K
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.	2,060	$30	$57.6K
J9035	Injection, bevacizumab, 10 mg	920	$60	$50.4K
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…	600	$80	$47.9K
67042	In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina…	30	$840	$20.9K
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…	160	$90	$14.8K
67108	The provider repairs a detached retina using heat produced by a laser beam or by freezing the tissues. He may attach a scleral buckle to simplify the passage of fluid through and behind the retina or…	20	$790	$14.3K
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…	210	$60	$12.3K

Showing 1–10 of 20

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Missouri Distribution

Erica Ballard — 1 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. state median

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	18	60	820	$690	$683.3K
J2777	29	50	11,730	$30	$388.9K
67028	17	80	600	$90	$69.7K
67042	10	30	20	$1,070	$26.8K
J9035	6	40	170	$60	$21.8K
67108	7	20	10	$1,060	$18K
92014	294	730	120	$80	$18K
99214	465	8,960	100	$80	$13.9K
67210	6	10	20	$400	$13.7K
92012	274	330	70	$60	$8.8K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Hospital Springfield	MO	General Acute Care Hospital	$0	$64.5M
Mercy Clinic Springfield Communities	MO	Family Medicine Physician	$0	$51.5M
Mercy Hospital Joplin	MO	General Acute Care Hospital	$0	$46.7M
Mercy Hospital Springfield	MO	Land Ambulance	$0	$46.7M
Mercy Clinic Joplin LLC	MO	Family Medicine Physician	$0	$20.4M
Mercy Hospital Carthage	MO	Critical Access Hospital	$0	$18.8M
Mercy Clinic Springfield Communities	MO	Family Medicine Physician	$0	$15.1M
Mercy Hospital Springfield	MO	General Acute Care Hospital	$0	$6.6M
Mercy Hospital Springfield	MO	Air Ambulance	$0	$6.5M
Adam Carver	MO	Ophthalmology Physician	$2.2M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Burrell, Inc.	MO	Community/Behavioral Health Agency	$0	$758.9M
Phoenix Home Care, LLC	MO	Nursing Care Agency	$0	$199.5M
Phoenix Home Care, LLC	MO	In Home Supportive Care Agency	$0	$149M
Integrity Home Care, LLC	MO	Home Health Agency	$0	$115.7M
Preferred Family Healthcare, Inc.	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$23M
Premier Home Health Care, Inc.	MO	Home Health Agency	$0	$12.1M
Burrell, Inc.	MO	Community/Behavioral Health Agency	$0	$9.1M
2gethertech, LLC	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$7.5M
Easter Seals Midwest	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$5.7M
Elite Pain Management, LLC	MO	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$0	$3.5M

Erica Ballard — 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