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    OpenPayerNPI Medicare & MedicaidBilal Yousufzai
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    Bilal Yousufzai — Billing Profile & Reimbursement Data

    NPI 1023458916 · Washington, DC · Ophthalmology Physician

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    Bilal Yousufzai is a ophthalmology physician provider located in Washington, District of Columbia. This profile covers 13 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationBilal Yousufzai
    Address110 Irving St Nw
    CityWashington
    StateDC
    ZIP20010
    TaxonomyOphthalmology Physician
    NPI EnumeratedJune 25, 2013

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$1.6M
    Medicaid$0

    Key Findings

    This provider’s Medicare activity represents the entirety of recorded public-payer revenue: Total Medicare revenue is $1.6M and there is no Medicaid billing on file, so the practice is effectively single-payer (Medicare) in the dataset. The NPI was enumerated 2013-06-25 (~13 years ago), indicating an established billing history rather than a new registrant.

    Revenue is highly concentrated in a very small set of codes — the precomputed top 3 Medicare codes account for 84.3% of this provider's total Medicare revenue. Those top three are J0178 ($776.3K, 49.9%), J2777 ($395K, 25.4%), and 92014 ($139.7K, 9.0%), which together drive the bulk of receipts and therefore represent primary operational and reimbursement risk areas.

    The CPT/HCPCS mix indicates a procedure- and retina-focused ophthalmology practice: large shares come from intravitreal injection codes J0178 (aflibercept) and J2777 (faricimab), supported by vitreous injection 67028 and retinal imaging 92134. High revenue and claim counts for anti-VEGF biologics (J0178, J2777) plus imaging (92134) are consistent with a practice oriented toward recurrent therapeutic injections and retina disease management rather than general primary eye care.

    Competitive standing for the principal injection codes is modest nationally: J0178 ranks #1151 of 3204 providers (64th percentile) and J2777 ranks #766 of 2039 providers (62th percentile), each labeled as "typical, unremarkable volume" in the supplied data. By contrast, 92014 is an outlier in exam volume — it ranks #604 of 35415 providers (98th percentile) and is flagged an "extreme outlier," indicating this provider bills far more comprehensive established exams than nearly all national peers.

    Imaging and diagnostic services are also elevated relative to peers: 92134 has 1.7K claims and $53.8K revenue (3.5% of Medicare revenue) and ranks #1291 of 26868 providers (95th percentile), described as "notably above typical national volume." This combination of above-typical retinal imaging and high comprehensive exam volume suggests both active diagnostic throughput and follow-up visit capacity that support the sustained injection program.

    The practice’s revenue mix skews heavily to drug administration and procedure codes rather than office E/M visits: 99214 and 99213 together account for only $10K and $2.1K respectively (0.6% and 0.1% of Medicare revenue), while drug/injection codes account for the lion’s share. That pattern implies the business model is centered on recurring procedural care (injections and imaging) rather than generating revenue primarily through E/M encounters.

    There is limited use of unclassified biologics and alternative agents: J3590 shows 28 claims and $59.2K revenue (3.8% of Medicare revenue) and J9035 (bevacizumab) contributes $4.1K, but the dominant biologic revenue is from J0178 and J2777. This suggests occasional use of other products or billing pathways, but those are small contributors compared with the two leading anti-VEGF codes.

    Absence of Medicaid billing on file is a notable business and access signal: with "none below" reported for Medicaid CPT/HCPCS, the provider lacks Medicaid-derived revenue in the record, which reduces payer diversification and may reflect limited participation in Medicaid or a patient base concentrated in Medicare-eligible populations. For payer/market analysts, this single-payer concentration (Medicare only) combined with the 84.3% top-3-code concentration highlights both revenue predictability tied to Medicare policy and vulnerability to shifts in reimbursement or biologic utilization patterns.

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    13 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J0178Injection, aflibercept, 1 mg1,130$690$776.3K
    J2777Injection, faricimab‑svoa, 0.1 mg13,620$30$395K
    92014An 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…1,520$90$139.7K
    67028The 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.810$100$78K
    J3590Unclassified biologics30$2,120$59.2K
    92134The 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.1,740$30$53.8K
    J2778Injection, ranibizumab, 0.1 mg170$190$31.6K
    99214The 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…120$90$10K
    J9035Injection, bevacizumab, 10 mg70$60$4.1K
    92004The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.20$110$2.6K

    Showing 1–10 of 13

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    13 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J0178210160$690$390.2K
    J27771105,460$30$215.2K
    J359011030$2,120$59.3K
    J2778210220$180$41K
    92014350100$90$26.2K
    67028210170$100$25K
    992145761,40090$100$15.3K
    992138111,20050$70$8.5K
    92134250120$30$8.3K
    92004143030$100$5.9K

    Showing 1–10 of 13

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Marietta Eye Clinic, PAGAOphthalmologic Surgery Clinic/Center$2.5M$0
    Annal MelethGAOphthalmology Physician$2.2M$0
    Lakshmana KooragayalaGAOphthalmology Physician$1.8M$0
    Jared CoxGAOptometrist$23.3K$525.1K
    Justin WilkinGAOphthalmology Physician$354.5K$0
    Puneet PandaGAOphthalmology Physician$257.2K$0
    Andre CohenGAOphthalmology Physician$239.2K$0
    Byron LongGAOphthalmology Physician$208.2K$0
    Charles HoGAOphthalmology Physician$186.3K$0
    Denise JohnsonGAOphthalmology Physician$165.1K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Children's HospitalDCChildren's Hospital$0$243.1M
    Medstar Washington Hospital CenterDCGeneral Acute Care Hospital$0$239M
    Children's HospitalDCPediatrics Physician$0$115.3M
    Whc Physician Group LLCDCGeneral Practice Physician$0$93.8M
    Medstar Medical Group Radiology, LLCDCDiagnostic Radiology Physician$0$17.5M
    National Rehabilitation Hospital IncDCRehabilitation Hospital$0$16.9M
    Hero Dental Of Washington Dc PCDCGeneral Practice Dentistry$0$11.7M
    Medstar Heart Institute LLCDCSurgery Physician$0$4.8M
    Bio-medical Applications Of Columbia Heights, Inc.DCEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center$0$4.6M
    Washington Hospital Center CorpDCGeneral Practice Physician$0$3.7M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. District of Columbia Distribution
    Bilal Yousufzai — 3 of 13 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — District of Columbia