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    OpenPayerNPI Medicare & MedicaidJohn O'keefe
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    John O'keefe — Billing Profile & Reimbursement Data

    NPI 1073576377 · Richmond, VA · Ophthalmology Physician

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    John O'keefe is a ophthalmology physician provider located in Richmond, Virginia. This profile covers 17 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
    OrganizationJohn O'keefe
    Address8720 Stony Point Pkwy Ste 105
    CityRichmond
    StateVA
    ZIP23235
    TaxonomyOphthalmology Physician
    NPI EnumeratedApril 8, 2006

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

    Payer SourceTotal Paid
    Medicare$4.8M
    Medicaid$0

    Key Findings

    This provider bills almost exclusively to Medicare ($4.8M total Medicare revenue) and has no Medicaid billing on file, making their tangible payer exposure effectively single-payer. The precomputed concentration metric shows the top three Medicare codes by revenue account for 89.6% of total Medicare revenue, indicating their near-term financial performance and utilization profile are tightly linked to a small set of services.

    Revenue is overwhelmingly driven by intravitreal drug administration: J0178 accounts for $3.9M (80.0% of Medicare revenue), with 67028 ($279.7K, 5.8%) and J2777 ($182.7K, 3.8%) completing the top three that sum to 89.6%. This concentration implies the practice’s economics are highly dependent on anti-VEGF or related intravitreal therapies and associated injection encounters.

    The code mix and descriptions point to a retina-focused ophthalmology operation: high-volume drug injection codes (J0178, J2777, J2778, J9035) plus procedure code 67028 for isolated vitreous injections, and diagnostic imaging codes 92134 and 92250 for retinal imaging and fundus photography. Frequent use of these codes alongside comprehensive ophthalmology visits (92014) suggests chronic retinal disease management (e.g., wet AMD or diabetic macular edema) as the core service line.

    John O'Keefe is a national outlier for aflibercept administration: J0178 ranks #19 of 3204 providers nationally and is labeled an "extreme outlier" at the 99th percentile, signaling volume far above typical peers for that drug. 67028 also ranks highly (#99 of 4255, 98th percentile; "notably above typical national volume"), so the provider is a dominant participant nationally for key injection procedures.

    Several ancillary services also appear at exceptional national volumes, reinforcing the retina-centric profile: 92014 ranks #659 of 35415 (98th percentile; "extreme outlier") for comprehensive established exams, 92134 ranks #651 of 26868 (98th percentile; "extreme outlier") for retinal imaging, and 92250 ranks #46 of 25087 (100th percentile; "extreme outlier") for fundus photography. These high ranks indicate consistent, high-frequency diagnostic follow-up and documentation accompanying the injection workstream.

    Despite the procedural and injection dominance, the practice also reports nontrivial evaluation-and-management and surgical activity: 99204 is $26.6K (229 claims) and ranks #3254 of 227068 (99th percentile; "extreme outlier"), while surgical retinal codes such as 67113 ($12.7K, 13 claims) and 67042 ($11.4K, 14 claims) exist but represent small shares of total Medicare revenue (each ~0.2–0.3%). This pattern suggests episodic complex surgical care complements a high-volume outpatient injection and imaging business.

    The provider’s NPI was enumerated on 2006-04-08 (~20 years ago), indicating long tenure in the Medicare program; that longevity supports interpretation of the high injection and imaging volumes as an established practice pattern rather than a short-term spike. Longitudinal tenure is a relevant context for assessing whether the current utilization mix reflects mature service-line specialization.

    For payers and network planners, the combination of extreme national ranks for high-cost drug delivery (J0178) and no Medicaid activity has two practical implications: contracted spend and utilization risk are concentrated in a small set of high-cost administration codes (notably $3.9M tied to J0178), and there is limited Medicaid exposure to offset Medicare-driven cost pressure. Benchmarking utilization of J0178 and associated injection and imaging codes against local networks could identify targets for utilization management or alternative contracting strategies.

    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.

    17 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J0178Injection, aflibercept, 1 mg5,570$690$3.9M
    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.3,010$90$279.7K
    J2777Injection, faricimab‑svoa, 0.1 mg6,300$30$182.7K
    J2778Injection, ranibizumab, 0.1 mg720$180$130.9K
    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…1,460$80$121.3K
    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.2,520$30$68.1K
    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,…1,820$30$49.1K
    J9035Injection, bevacizumab, 10 mg800$50$43.3K
    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…230$120$26.6K
    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$60$13.1K

    Showing 1–10 of 17

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    17 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J01781801,400$690$1.1M
    J2777416013,200$30$517.1K
    J27781540560$180$171.5K
    670283901,000$90$107.1K
    67042192020$1,130$33.8K
    9201448870170$80$32.8K
    992146,72112,890140$80$21K
    J9035860170$50$19.9K
    6711351020$940$16K
    992132,76712,44090$60$10K

    Showing 1–10 of 17

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with John O'keefe, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Virginia Eye Consultants IncVAOphthalmology Physician$0$8.3M
    Juan AstrucVAOphthalmology Physician$4.7M$0
    Rohit AdyanthayaVAOphthalmology Physician$4.1M$0
    Bryan SchwentVAOphthalmology Physician$3.7M$0
    Thomas JenkinsVAOphthalmology Physician$2.8M$0
    David SalibVAOphthalmology Physician$2.5M$0
    Evan BergerVARetina Specialist (Ophthalmology) Physician$2M$0
    Ali TabassianVAOphthalmology Physician$1.7M$0
    Kori ElkinsVARetina Specialist (Ophthalmology) Physician$1.7M$670
    Andrew MichaelVAOphthalmology Physician$760.3K$0

    Nearby Providers

    Other providers in the same ZIP code as John O'keefe, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Lighthouse Behavioral Health Center, LLCVACommunity/Behavioral Health Agency$0$16.5M
    Radiology Associates Of Richmond IncVADiagnostic Radiology Physician$0$14.2M
    Hobby Home Care, LLCVAHome Health Agency$0$12M
    The Pediatric Connection, IncVANursing Care Agency$0$11.7M
    Caremed, IncVAHome Health Agency$0$10.7M
    Care Advantage, IncVAHome Health Agency$0$10.7M
    Family Guidance Of VirginiaVACommunity/Behavioral Health Agency$0$9.6M
    Daily Grace, LLCVACommunity/Behavioral Health Agency$0$9.1M
    Trinity Care LLCVACommunity/Behavioral Health Agency$0$7.8M
    Stony Point Surgery Center, L.L.CVAAmbulatory Surgical Clinic/Center$4.9M$1.4M

    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. Virginia Distribution
    John O'keefe — 5 of 17 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Virginia