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

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

Nicholas Anderson (NPI 1972509297)

Field	Value
Entity Type	Individual
Organization	Nicholas Anderson
Address	1342 Old Weisgarber Rd
City	Knoxville
State	TN
ZIP	37909
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	June 22, 2005

Payer Source	Total Paid
Medicare	$3M
Medicaid	$0

Key Findings

NICHOLAS ANDERSON presents as a retina-focused ophthalmology practice whose Medicare code mix is dominated by intravitreal pharmaceutical injections and advanced posterior-segment imaging. The top revenue generators are clearly anti-VEGF and novel intravitreal agents (J2778, J2777, J0178) alongside high-volume OCT imaging (92134), which together shape a procedure-centric retina service line rather than a clinic driven by high-volume office E/M visits.

Revenue concentration is high: this provider reports Total Medicare revenue: $3M and the precomputed top 3 Medicare codes by revenue account for 72.2% of this provider's total Medicare revenue. That level of concentration around a few high-cost drug/injection codes implies financial dependence on intravitreal therapy throughput and supply reimbursement.

Payer mix is effectively single-payer Medicare — Total Medicaid revenue: none (no Medicaid billing on file) — so commercial and Medicaid exposure are not visible in this dataset. For analysts, that means benchmarking and network negotiations should be oriented to Medicare experience and national comparators rather than to mixed Medicaid performance.

J2778 is the single largest Medicare revenue driver with $947.1K revenue (31.4% of this provider's total Medicare revenue) and ranks #38 of 1208 providers nationally (97th percentile; notably above typical national volume). This ranking indicates a nationally high-volume ranibizumab practice and positions the provider as a major user of that specific therapy relative to peers.

J2777 ($722.1K revenue (23.9% of this provider's total Medicare revenue)) and J0178 ($511.3K revenue (16.9% of this provider's total Medicare revenue)) complete the top-three revenue mix; J2777 ranks in the ~81st percentile and J0178 around the ~53rd percentile nationally. Together these top three codes account for the precomputed 72.2% share, showing the practice’s business model is concentrated on administered ocular pharmaceuticals with mixed national standing across specific agents.

The provider is an extreme outlier on OCT imaging: 92134 reports $83.6K revenue (2.8% of this provider's total Medicare revenue) and ranks #362 of 26868 providers nationally (99th percentile; extreme outlier, far above typical national volume). That very high OCT rank suggests heavy diagnostic imaging throughput consistent with ongoing injection follow-up and disease monitoring workflows.

Unclassified drug billing is also material: J3490 shows $355.1K revenue (11.8% of this provider's total Medicare revenue) and ranks #312 of 2838 providers nationally (89th percentile). Because J3490 can aggregate miscellaneous drug or supply charges, this level of revenue warrants careful review of claim-level detail when evaluating drug mix, billing practices, or contracting for buy-and-bill reimbursement.

Routine E/M activity is a small share of Medicare revenue (99213: $25.8K revenue (0.9%); 99214: $21.4K revenue (0.7%)), which reinforces that the practice operation is procedure- and drug-centric rather than visit-volume centric. Combined with a long NPI tenure (NPI enumerated: 2005-06-22 (~21 years ago)), these patterns are consistent with an established retina clinic with stable referral and treatment throughput focused on intravitreal therapies and imaging.

Medicare: Complete Services Breakdown

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2778	Injection, ranibizumab, 0.1 mg	5,320	$180	$947.1K
J2777	Injection, faricimab‑svoa, 0.1 mg	24,900	$30	$722.1K
J0178	Injection, aflibercept, 1 mg	790	$640	$511.3K
J3490	Unclassified drugs	210	$1,690	$355.1K
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.	1,810	$90	$161.2K
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.	3,100	$30	$83.6K
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…	880	$90	$74.8K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	570	$120	$68.4K
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…	450	$60	$25.8K
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…	240	$90	$21.4K

Showing 1–10 of 18

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Tennessee Distribution

Nicholas Anderson — 1 of 18 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. state median

18 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	38	80	790	$680	$769.8K
J2777	14	50	15,060	$30	$592.1K
J2778	5	40	1,340	$180	$370.2K
67028	18	80	1,130	$90	$98.5K
J2781	9	20	560	$120	$82.5K
J3490	7	60	70	$400	$41.9K
67042	32	40	20	$1,020	$34.5K
92014	48	810	120	$80	$19.2K
J9035	49	70	140	$50	$17.1K
99214	3,402	11,370	120	$80	$16.6K

Showing 1–10 of 18

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
James Miller	TN	Retina Specialist (Ophthalmology) Physician	$3.9M	$0
Devon Ghodasra	TN	Retina Specialist (Ophthalmology) Physician	$3.6M	$0
Rohan Shah	TN	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Scott Barb	TN	Ophthalmology Physician	$2.8M	$0
Robert Shuler	TN	Retina Specialist (Ophthalmology) Physician	$2.6M	$0
Tod Mcmillan	TN	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
Ailee Laham	TN	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
Stephen Perkins	TN	Retina Specialist (Ophthalmology) Physician	$2.3M	$0
Francis Decroos	TN	Retina Specialist (Ophthalmology) Physician	$2.3M	$0
Cristoforo Larzo	TN	Retina Specialist (Ophthalmology) Physician	$2.2M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Omni Community Health, Inc.	TN	Community/Behavioral Health Agency	$0	$77.7M
Summit Medical Group, PLLC	TN	Internal Medicine Physician	$0	$44.5M
Allergy Associates, P.A.	TN	Specialist	$0	$26.5M
Knoxville Pediatric Dentistry, PLLC	TN	General Practice Dentistry	$0	$11.2M
The Florence Crittenton Agency Inc	TN	Community/Behavioral Health Agency	$0	$10.7M
Bsp Enterprises, LLC	TN	In Home Supportive Care Agency	$0	$8M
Associated Pain Specialists, PC	TN	Pain Medicine Physician	$0	$6.8M
Jeremiah Bivins	TN	Allergy & Immunology Physician	$419.4K	$4.6M
Westbrook Medical Center, PLLC	TN	Family Medicine Physician	$0	$4M
Pcet Surgery Center LLC	TN	Ambulatory Surgical Clinic/Center	$1.7M	$60K

Nicholas Anderson — 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