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

Why is the Medicaid comparison limited to South Carolina 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. South Carolina (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.

Derek Barker (NPI 1982662847)

Field	Value
Entity Type	Individual
Organization	Derek Barker
Address	1920 Pickens St
City	Columbia
State	SC
ZIP	29201
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	May 2, 2006

Payer Source	Total Paid
Medicare	$4.7M
Medicaid	$0

Key Findings

This provider operates as a retina-focused ophthalmology practice with a service mix dominated by intravitreal pharmacologic therapies and retina-specific procedures: J0178 ($2.4M, 50.5%), J2777 ($998.8K, 21.1%), and J2778 ($562.7K, 11.9%) together account for the bulk of Medicare revenue. Support services and follow-up care — including 67028 ($277K) injections, retinal imaging 92134 ($96.7K), and established-patient E/M codes 99214 ($107.9K) and 99213 ($102.6K) — align with an injection-and-imaging ambulatory retina practice rather than a broad multi‑specialty clinic.

Revenue is highly concentrated in a small number of drugs and injection codes: the top three Medicare codes by revenue account for 83.5% of this provider's total Medicare revenue. That degree of concentration indicates most Medicare dollars flow from repeated intravitreal drug administration rather than diversified procedural or facility-based services.

Payer mix is effectively single‑payer Medicare: lifetime Medicare revenue is $4.7M while Medicaid revenue is recorded as none, so the provider has no Medicaid billing on file. This creates exposure to Medicare policy and reimbursement changes for intravitreal drugs and associated office-based services.

On national competitive standing for the top revenue driver, J0178 ranks #110 of 3204 providers nationally (97th percentile) and is described as notably above typical national volume, signaling the provider is a major national-volume administrator of aflibercept relative to peers. J0178’s 3.5K claims and $682 avg paid/claim further underscore a high-volume procedural throughput for that drug.

The other leading drug codes show high-volume but more typical positioning: J2777 (34.4K claims, $998.8K revenue) ranks #232 of 2039 providers (89th percentile) and is characterized as typical/unremarkable, while J2778 ($562.7K) ranks #102 of 1208 providers (92th percentile) and is also described as typical/unremarkable. Together these rankings suggest the practice is a consistent high-volume injector but not uniformly dominant across all intravitreal agents.

Several non-drug codes are statistical outliers, reflecting heavy office and diagnostic activity: 99214 ranks #6513 of 479517 providers (99th percentile) and is labeled an extreme outlier, 99213 is at the 100th percentile and also an extreme outlier, and 92134 ranks #273 of 26868 providers (99th percentile) with the extreme outlier label. Those outlier statuses point to an established-patient workload and frequent retinal imaging consistent with ongoing management of chronic retinal disease.

Procedure-level data reinforce the injection-centric model: 67028 (isolated intravitreal injection) ranks #97 of 4255 providers (98th percentile) and is noted as notably above typical national volume, indicating many injections are billed as discrete procedures rather than bundled with other operative services. This pattern complements the high revenue share from the drug codes and supports an ambulatory injection clinic workflow.

The provider has a long tenure on Medicare billing with an NPI enumerated on 2006-05-02 (~20 years ago), which, combined with $4.7M in lifetime Medicare revenue and multiple high-percentile code rankings, suggests an established retina practice with sustained Medicare volume concentrated in intravitreal therapies. Absent any Medicaid billing, analyses of market position and risk should focus on Medicare policy, drug utilization trends, and retention of established Medicare patients.

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	3,510	$680	$2.4M
J2777	Injection, faricimab‑svoa, 0.1 mg	34,440	$30	$998.8K
J2778	Injection, ranibizumab, 0.1 mg	3,160	$180	$562.7K
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.	3,010	$90	$277K
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	$107.9K
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…	1,550	$70	$102.6K
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.	3,330	$30	$96.7K
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…	670	$90	$62K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	440	$120	$52.3K
J9035	Injection, bevacizumab, 10 mg	420	$60	$23K

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. South Carolina Distribution

Derek Barker — 3 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. state median

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	6	50	970	$690	$1.1M
J2777	7	40	15,960	$30	$594.7K
J2778	6	30	1,440	$180	$337.4K
J2781	13	20	720	$120	$128K
67028	4	50	1,140	$90	$110.3K
67042	11	30	20	$1,150	$32.3K
J9035	17	40	200	$50	$26.1K
92014	85	540	160	$80	$24.3K
99214	213	7,860	160	$80	$23.2K
92235	14	30	50	$100	$11K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbia Eye Surg Center Inc	SC	Ophthalmologic Surgery Clinic/Center	$3.5M	$1.2K
Philip Scharper	PA	Retina Specialist (Ophthalmology) Physician	$1.6M	$0
Edward Mintz	SC	Ophthalmology Physician	$359.2K	$0
Edward Crosswell	SC	Ophthalmology Physician	$330.2K	$0
Stephen Cross	SC	Ophthalmology Physician	$313.6K	$0
William Johnson	SC	Ophthalmology Physician	$303.2K	$0
Joshua Nunn	SC	Ophthalmology Physician	$291.4K	$0
Rudolph Newman	SC	Ophthalmology Physician	$247.3K	$0
Derrick Huey	SC	Ophthalmology Physician	$203.7K	$0
William Cain	SC	Ophthalmology Physician	$155.9K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Doctors Care, PA	SC	Family Medicine Physician	$0	$50.7M
Robertson Optical Laboratories Inc	SC	Eyewear Supplier	$0	$13.5M
Dhec Hemophilia-cshcn Program	SC	Pharmacy	$0	$13.3M
Addus Healthcare (south Carolina), Inc.	SC	In Home Supportive Care Agency	$0	$12.1M
Pruitthealth Hospice, Inc.	SC	Inpatient Hospice	$0	$11.8M
Prisma Health-midlands	SC	General Acute Care Hospital	$0	$11.8M
State Of South Carolina	SC	Public Health or Welfare Agency	$0	$10.4M
South Carolina Dept Of Mental Health Accounting Office	SC	Community/Behavioral Health Agency	$0	$8.8M
Palladium Hospice And Palliative Care, LLC	SC	Community Based Hospice Care Agency	$0	$8.2M
Lutheran Family Services In The Carolinas	SC	Community/Behavioral Health Agency	$0	$7.8M

Derek Barker — 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