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

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

Stephen Powell (NPI 1982777017)

Field	Value
Entity Type	Individual
Organization	Stephen Powell
Address	1255 Pineview Dr
City	Morgantown
State	WV
ZIP	26505
Taxonomy	Ophthalmology Physician
NPI Enumerated	November 16, 2006

Payer Source	Total Paid
Medicare	$525.5K
Medicaid	$0

Key Findings

This provider’s recorded payer mix is effectively single-payer: Total Medicare revenue is $525.5K and there is no Medicaid billing on file. That concentration means the practice’s financial footprint and payer negotiation leverage will be driven almost entirely by Medicare volume and reimbursement patterns.

Revenue concentration is high at the code level: the top three Medicare codes (66984, 92014, 99213) together account for 63.8% of Medicare revenue, with 66984 contributing $190.8K (36.3%), 92014 contributing $85.9K (16.3%), and 99213 contributing $58.7K (11.2%). Payers and network managers should treat those three codes as the primary drivers of the provider’s revenue base.

The code mix indicates a blended surgical and ambulatory ophthalmology practice: 66984 (cataract extraction with IOL) is the single largest revenue line, and other procedure codes that support cataract care — 66821 (laser capsulotomy) and 66982 (complex cataract/IOL cases) — also appear in the top lines. At the same time, high volumes of office E/M codes (92014, 99213, 99214) and diagnostic imaging (92133, 92134) point to a busy clinic workflow that combines surgery with ongoing outpatient management.

Competitive standing is mixed by service line: 66984 ranks #2869 of 15965 providers nationally (82th percentile) and is described as typical/unremarkable volume for cataract surgery, so this provider is a modest participant in surgical cataract nationally. By contrast, 92014 ranks #1876 of 35415 (95th percentile) and is described as notably above typical, while 99213 ranks #8473 of 457151 (98th percentile) and is an extreme outlier; these rankings indicate the provider has unusually high volume for routine ophthalmic E/M services compared with national peers.

Imaging and diagnostic testing are material and above-average relative to peers: 92133 shows 351 claims, $9.5K revenue (1.8%) and ranks in the 94th percentile where it is noted as notably above typical national volume. The presence of both 92133 and 92134 among top codes suggests sustained utilization of posterior-segment imaging (optic nerve and retina) that supports medical glaucoma and retinal follow-up in addition to surgical care.

The surgical portfolio is concentrated in cataract-related procedures: 66984 has 513 claims and $190.8K revenue (36.3%), 66821 has 175 claims and $55K revenue (10.4%), and 66982 contributes $13K (2.5%). This cluster of cataract codes plus supporting services (IOL axiom 92136 with 484 claims, $14.5K revenue) is consistent with a practice model in which cataract extraction and post-op management are a primary revenue engine.

Provider tenure is long-standing: the NPI was enumerated on 2006-11-16 (~20 years ago), indicating an established local presence. For payers and network planners, that tenure combined with a Medicare-only billing profile and concentrated code-level revenue highlights a stable but Medicare-dependent provider whose contracting and utilization patterns will be most meaningfully evaluated through the lens of cataract surgery and high-volume E/M and diagnostic services.

Medicare: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	510	$370	$190.8K
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…	940	$90	$85.9K
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…	890	$70	$58.7K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	180	$310	$55K
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…	250	$90	$22.8K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	160	$100	$16.3K
92136	The provider uses a noninvasive method to measure the patient’s eye or eyes to get information that the provider then uses to calculate the appropriate power for an intraocular lens (IOL). Selecting…	480	$30	$14.5K
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…	120	$120	$13.6K
92083	The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for an extended…	290	$50	$13.5K
66982	The provider inserts an intraocular lens prosthesis after extracapsular cataract extraction using complex techniques and devices. He may perform this by means of an iris expansion device, providing…	60	$220	$13K

Showing 1–10 of 22

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. West Virginia Distribution

Stephen Powell — 6 of 22 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. state median

22 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
66984	31	90	210	$70	$60.7K
66982	8	30	30	$400	$17.9K
92014	4	180	120	$70	$16.3K
66821	5	50	50	$190	$16.2K
15823	4	10	20	$560	$12.9K
99214	569	2,740	100	$70	$11.8K
99213	42	2,860	80	$50	$7.5K
92012	44	80	70	$50	$7.2K
92136	8	40	160	$20	$6.1K
92134	24	160	60	$30	$5.4K

Showing 1–10 of 22

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gary Miller	WV	Ophthalmology Physician	$6.3M	$0
Regional Eye Associates, Inc	WV	Ambulatory Surgical Clinic/Center	$1.5M	$67.7K
Heath Lemley	WV	Ophthalmology Physician	$512.8K	$0
Mark Mayle	WV	Ophthalmology Physician	$372.9K	$0
Brian Wood	WV	Ophthalmology Physician	$324.6K	$0
Edgar Gamponia	WV	Ophthalmology Physician	$256.6K	$0
Allison Bardes	WV	Ophthalmology Physician	$172.5K	$0
Lauren Digiovine	WV	Ophthalmology Physician	$164.2K	$0
Jennifer Talkington	WV	Certified Registered Nurse Anesthetist	$68.9K	$0
Stacy Commodore	WV	Certified Registered Nurse Anesthetist	$65.9K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Interim Healthcare Of Pittsburgh, Inc.	WV	Nursing Care Agency	$0	$23.1M
Monongalia County General Hospital Company	WV	General Acute Care Hospital	$0	$16.3M
Monongalia Emergency Medical Services Inc	WV	Ambulance	$1.4M	$11.3M
Gr&w, Inc	WV	Clinical Neuropsychologist	$0	$12.2M
Cardinal Pediatrics PLLC	WV	Pediatrics Physician	$0	$11.1M
Pace Training And Evaluation Center, Inc	WV	Developmentally Disabled Services Day Training Agency	$0	$9.2M
Therapy Services, LLC	WV	Speech-Language Pathologist	$0	$8.5M
Monongalia County General Hospital Company	WV	Specialist	$0	$6.8M
West Virginia Emergency Physicians, LLP	WV	Emergency Medicine Physician	$0	$4.7M
Renaissance Care Inc	WV	In Home Supportive Care Agency	$0	$3.1M

Stephen Powell — Billing Profile & Reimbursement Data

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Stephen Powell — 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