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

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

Carmelina Gordon (NPI 1952399297)

Field	Value
Entity Type	Individual
Organization	Carmelina Gordon
Address	850 W North St Ste 100
City	Jackson
State	MI
ZIP	49202
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	October 11, 2005

Payer Source	Total Paid
Medicare	$1.4M
Medicaid	$0

Key Findings

This provider’s billings are effectively single‑payer Medicare: lifetime Medicare revenue is $1.4M and there is no Medicaid billing on file, indicating Medicaid does not contribute to the payer mix for this NPI. The NPI was enumerated on 2005-10-11 (~21 years ago), so this pattern reflects a long-established practice footprint concentrated in Medicare billing.

Revenue is highly concentrated in a small set of services: the precomputed top 3 Medicare codes account for 78.4% of total Medicare revenue, with a single code, J0178, making up 64.2% of revenue ($922.1K). This level of concentration indicates the practice derives the majority of its Medicare income from a narrow set of therapies rather than a broad mix of procedural or ancillary services.

Clinical mix and service line suggest a medical‑retina, injection‑focused practice: J0178 (aflibercept) has 1.4K claims and $922.1K revenue and other injectable biologics and intravitreal items — J2777 (faricimab), J2778 (ranibizumab), J7312 (dexamethasone implant), and J3299 (triamcinolone) — also appear in the top codes. Procedural injection code 67028 appears as well (1.1K claims, $95.5K), so the workflow is consistent with frequent office‑based intravitreal injections and follow‑up visits rather than primarily operating‑room surgical volume.

Office visit intensity is an outlier relative to peers: 99214 accounts for $108K (7.5% of Medicare revenue) across 1.2K claims and the code is labeled an "extreme outlier," ranking #6495 of 479517 providers nationally (99th percentile). That combination of very high established‑patient E/M volume plus high injection volume is consistent with frequent monitoring and follow‑up visits tied to chronic anti‑VEGF treatment schedules.

Imaging and monitoring are significant supporting services: 92134 (retinal imaging/OCT) shows 1.3K claims, $36K revenue (2.5%) and ranks #1763 of 26868 providers nationally (93th percentile; notably above typical national volume for this code). Other diagnostic imaging such as 92250 (fundus photography) also appears in the top codes (379 claims, $9.5K, 0.7% revenue, 92th percentile), supporting a model of active disease surveillance.

Surgical retina work is present but limited: pars plana vitrectomy codes 67036 and 67042 appear at low counts (21 claims, $14K and 14 claims, $12.2K respectively), representing a small fraction of Medicare revenue. These volumes suggest the provider performs occasional surgical procedures but operates primarily as an outpatient, clinic‑based injector and diagnostician rather than as a high‑volume vitreoretinal surgeon.

Competitive standing is mixed across codes: for the primary drug code J0178 the provider ranks #928 of 3204 (71th percentile; typical, unremarkable volume), indicating a solid but not dominant national position for aflibercept administration, while 99214’s 99th percentile ranking marks the provider as an extreme outlier for E/M visits. Other codes reflect variation — for example, J2777 shows substantial claim count (2.9K claims) but a low peer percentile (9th), implying many peers report higher volumes for that product despite the raw claim count here.

A few codes reflect niche or unusually sparse peer presence: J3299 (297 claims, $11.3K) ranks #16 of 17 providers nationally (6th percentile) and 0465T (12 claims, $5.1K) ranks #14 of 14 (0th percentile). These low peer percentiles suggest the provider bills certain less‑common biologic or technology codes that few other providers report, which may reflect specific treatment choices or coding patterns limited to a small group of peers.

Medicare: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,360	$680	$922.1K
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…	1,240	$90	$108K
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.	1,110	$90	$95.5K
J2777	Injection, faricimab‑svoa, 0.1 mg	2,940	$30	$85.3K
J2778	Injection, ranibizumab, 0.1 mg	230	$180	$41.2K
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.	1,290	$30	$36K
J7312	Injection, dexamethasone, intravitreal implant, 0.1 mg	190	$160	$29.7K
J3590	Unclassified biologics	370	$70	$25.9K
67036	The provider removes vitreous fluid from the eye to access the posterior segment of the eye and introduce surgical instruments through incisions in the pars plana.	20	$670	$14K
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…	10	$870	$12.2K

Showing 1–10 of 21

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Michigan Distribution

Carmelina Gordon — 1 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. state median

21 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	26	110	680	$690	$630.2K
J2777	52	60	7,200	$30	$321K
J2778	46	50	730	$180	$240.5K
67028	31	160	440	$90	$57.6K
J7312	11	10	230	$150	$36.1K
J3590	18	80	140	$80	$19.6K
67042	19	30	20	$1,030	$18.6K
67036	5	10	20	$910	$16.4K
67210	9	10	30	$430	$12.9K
99214	64	15,470	80	$80	$11.4K

Showing 1–10 of 21

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Surendar Purohit	MI	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Tarek Hassan	MI	Retina Specialist (Ophthalmology) Physician	$2.1M	$0
William Rhoades	MI	Retina Specialist (Ophthalmology) Physician	$1.9M	$0
Jonathan Bernstein	OH	Retina Specialist (Ophthalmology) Physician	$1.2M	$0
Joseph Crapotta	NY	Retina Specialist (Ophthalmology) Physician	$605.9K	$6.7K
Mahmoud El-yassir	MI	Ophthalmology Physician	$359.4K	$0
Neal Tolchin	OH	Ophthalmology Physician	$358.7K	$0
Paul Ernest	MI	Ophthalmology Physician	$284.6K	$0
Rashawn Venerable	MI	Ophthalmology Physician	$274.4K	$0
Anthony Sensoli	MI	Ophthalmology Physician	$256.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jackson-hillsdale Community Mental Health Board	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$57.8M
Christ Centered Homes, Inc.	MI	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$47.4M
Recovery Technology,llc	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$33.2M
Pdhcrc, Inc.	MI	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$27.9M
Integro LLC	MI	Mental Health Counselor	$0	$14.2M
Victory Clinical Services Iii LLC	MI	Multi-Specialty Clinic/Center	$179.3K	$14M
Highfields	MI	Community/Behavioral Health Agency	$0	$13.1M
Comprehensive Speech And Therapy Center, Inc	MI	Rehabilitation Clinic/Center	$0	$12.8M
D2 Dental Of Michigan	MI	General Practice Dentistry	$0	$7.2M
A.r.e. Inc., Of Jackson	MI	Developmentally Disabled Services Day Training Agency	$0	$5.2M

Carmelina Gordon — 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