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    OpenPayerNPI Medicare & MedicaidNicole Pumariega
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    Nicole Pumariega — Billing Profile & Reimbursement Data

    NPI 1053793182 · Morgantown, WV · Ophthalmology Physician

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    Nicole Pumariega is a ophthalmology physician provider located in Morgantown, West Virginia. This profile covers 11 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
    OrganizationNicole Pumariega
    Address1 Medical Center Dr
    CityMorgantown
    StateWV
    ZIP26506
    TaxonomyOphthalmology Physician
    NPI EnumeratedJune 25, 2015

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

    Payer SourceTotal Paid
    Medicare$99.7K
    Medicaid$0

    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.

    11 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    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…430$70$29.4K
    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.360$70$25K
    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.670$20$11.4K
    99213The 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…230$50$10.6K
    67036The 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$610$9.8K
    99204The 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…80$90$7.6K
    92250Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…140$20$2.2K
    67145The provider prevents the detachment of the retina in the presence of small tears or thinning of the edges (lattice degeneration) by applying an intense light (such as a laser) to create scar tissue…10$160$1.8K
    99203The provider sees a new 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 provider…10$60$780
    76512The provider uses B–scan ultrasound imaging, with or without a non–qualitative A–scan superimposed, to examine the intraocular and orbital structures.30$20$570

    Showing 1–10 of 11

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    11 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    670281110770$80$94.4K
    992142472,740100$70$11.8K
    6703611010$740$10.4K
    9223571070$90$9K
    992135382,86080$50$7.5K
    921341116060$30$5.4K
    992041181,22030$100$4.1K
    9920381594030$60$2.8K
    922502815050$20$2.1K
    6714521010$160$2.1K

    Showing 1–10 of 11

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    West Virginia University Medical CorporationWVFamily Medicine Physician$0$162.1M
    United Hospital Center, IncWVGeneral Acute Care Hospital$0$63.3M
    United Hospital Center, Inc.WVInternal Medicine Physician$0$13.7M
    Inderjit MehmiCAHematology & Oncology Physician$2.3M$0
    City Hospital, Inc.WVInternal Medicine Physician$0$1.9M
    Randall J. Hill, M.d., P.L.L.C.WVSpecialist$0$1.9M
    United Hospital CenterWVInternal Medicine Physician$0$1.5M
    E. Ronald Salvitti, M.d., Inc.PAAmbulatory Surgical Clinic/Center$986.7K$20.9K
    Edward KiggunduWVRadiation Oncology Physician$835.2K$0
    David WeberPASpecialist$292.8K$498.8K

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    West Virginia University Hospitals, IncWVGeneral Acute Care Hospital$0$124.1M
    West Virginia University Hospitals, Inc.WVSubstance Abuse Rehabilitation Facility$0$15.4M
    West Virginia University Dental CorporationWVDentist$0$5.9M
    West Virginia University Hospitals, IncWVEmergency Medicine Physician$0$3M
    Heather BooWVNeuroradiology Physician$596.8K$0
    Arijit ChakravartyWVNephrology Physician$281K$0
    Adeem AkbarWVNephrology Physician$162.7K$0
    Robert MarshWVNeurological Surgery Physician$152.1K$0
    Mark LisleWVDiagnostic Radiology Physician$150.1K$710
    Brian HamlinWVAdult Reconstructive Orthopaedic Surgery Physician$148.2K$0

    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. West Virginia Distribution
    Nicole Pumariega — 0 of 11 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — West Virginia