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

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

Michelle Young (NPI 1932122264)

Field	Value
Entity Type	Individual
Organization	Michelle Young
Address	99 Swift St Ste 200
City	South Burlington
State	VT
ZIP	05403
Taxonomy	Ophthalmology Physician
NPI Enumerated	July 26, 2006

Payer Source	Total Paid
Medicare	$2.1M
Medicaid	$0

Key Findings

This provider’s Medicare practice is highly concentrated around intravitreal pharmacologic therapy: J0178 (aflibercept) generates $1.6M and accounts for 78.3% of the provider’s Medicare revenue, and the precomputed top three Medicare codes by revenue account for 91.3% of this provider's total Medicare revenue. That concentration indicates the operation is primarily delivering high-volume, drug-based retinal care rather than a broadly diversified ophthalmology practice.

The code mix and volumes point to an interventional retina focus: J0178 (2.4K claims, $692 avg paid/claim) and 67028 (1.8K claims, $83 avg paid/claim) together show frequent intravitreal injections, while 92134 (1.8K claims, $29 avg paid/claim) indicates routine use of retinal imaging to guide therapy. These patterns are consistent with recurring injection regimens that require serial imaging for disease monitoring and treatment decisions.

Payer mix is effectively single-payer Medicare: total Medicare revenue is $2.1M and there is no Medicaid billing on file. This means Medicaid is not a material part of the revenue base, so competitive or access questions should be evaluated primarily against Medicare activity and local private payer dynamics rather than state Medicaid volume.

Competitive standing versus national Medicare peers is mixed by service line. For the principal drug code J0178 the provider ranks #364 of 3204 (89th percentile; typical, unremarkable volume for this code), indicating solid but not dominant national standing in aflibercept administration, whereas for office E/M code 99214 the provider ranks #4328 of 479517 (99th percentile; extreme outlier), signaling an unusually high E/M visit volume compared with national peers.

The provider shows notably elevated imaging activity: 92134 (computerized retinal imaging) has 1.8K claims and $51.4K revenue and ranks #1255 of 26868 (95th percentile; notably above typical national volume). High OCT utilization alongside frequent injections suggests active monitoring and follow-up of chronic retinal disease, supporting the inference of a retina-focused ambulatory practice workflow.

Procedural and surgical diversity is limited outside the injection and imaging bundle: other codes such as 67041 (12 claims, $10.5K) and various diagnostic codes appear only at low volumes and small shares of revenue. This concentration reduces exposure to broader procedural mixes and ties financial performance closely to standing injection volumes and reimbursement for high-cost intraocular drugs.

The provider’s billing footprint includes substantial E/M activity in addition to injections: 99214 accounts for $123K (5.8% of Medicare revenue) with 1.4K claims and is described as an "extreme outlier" in national volume. That elevated E/M count may reflect frequent follow-up visits associated with injection protocols or a practice model that schedules separate billable encounters for medication management and monitoring.

Tenure in national enrollment is long-standing: the NPI was enumerated 2006-07-26 (~20 years ago). This longevity combined with concentrated, repeatable services (serial injections and imaging) suggests the provider operates an established retinal-treatment workflow with a patient panel that likely requires ongoing, recurring care.

Medicare: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,380	$690	$1.6M
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.	1,820	$80	$151.3K
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…	1,410	$90	$123K
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.	1,770	$30	$51.4K
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…	360	$100	$35.6K
J9035	Injection, bevacizumab, 10 mg	610	$50	$32.8K
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…	180	$120	$20.6K
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…	250	$80	$20K
67041	In this procedure, the provider removes scar tissue from the retinal membrane that obscures vision. He removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical…	10	$870	$10.5K
92020	The provider examines the angle of the anterior chamber of the eye (the angle where the iris and cornea meet) using a special lens (goniolens) and slit–lamp or operating microscope to diagnose and…	210	$20	$4.3K

Showing 1–10 of 15

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Vermont Distribution

Michelle Young — 6 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. state median

15 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	1	10	740	$690	$730.2K
67028	1	10	1,220	$80	$90.1K
92014	39	100	200	$80	$19.6K
67041	2	10	20	$1,200	$18.1K
J9035	1	10	250	$50	$17.5K
92235	2	10	30	$90	$13.1K
99214	2	960	90	$70	$10.6K
92012	27	50	50	$60	$5.8K
92134	2	90	50	$20	$4.3K
99204	8	330	30	$100	$4.1K

Showing 1–10 of 15

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
David Weissgold	VT	Ophthalmology Physician	$1.7M	$0
John Hinkle	VT	Ophthalmology Physician	$807.4K	$940
Retina Center Of Vermont, Inc	VT	Ophthalmology Physician	$0	$533.4K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nfi Vermont, Inc	VT	Clinic/Center	$0	$33.6M
Bla Partners, LLC	VT	Clinical Medical Laboratory	$0	$15.2M
Timberlane Dental Group	VT	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$7.5M
Tms Vt, LLC	VT	Durable Medical Equipment & Medical Supplies	$0	$2.9M
Howard Center Inc	VT	Psychiatry Physician	$0	$2M
Vermont Eye Surgery & Laser Center	VT	Ambulatory Surgical Clinic/Center	$1.8M	$2.7K
Surgi-care Inc	VT	Prosthetic/Orthotic Supplier	$0	$1.7M
City Of So Burlington	VT	Ambulance	$400.9K	$1M
Green Mountain Pediatric Dentistry, PLLC	VT	Pediatric Dentistry	$0	$1.3M
Lindsay Jernigan	VT	Clinical Psychologist	$0	$1.2M

Michelle Young — Billing Profile & Reimbursement Data

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Michelle Young — 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