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

Why is the Medicaid comparison limited to Wisconsin 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. Wisconsin (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.

Retina & Vitreous Consultants Of Wi, Ltd. (NPI 1114044435)

Retina & Vitreous Consultants Of Wi, Ltd. is a retina specialist (ophthalmology) physician provider located in Milwaukee, Wisconsin. This profile covers 0 Medicare and 23 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Retina & Vitreous Consultants Of Wi, Ltd.
Address	2600 N Mayfair Rd
City	Milwaukee
State	WI
ZIP	53226
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	March 23, 2007

Payer Source	Total Paid
Medicaid	$3.8M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	3,590	$670	$2.4M
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.	12,790	$60	$793K
J9035	Injection, bevacizumab, 10 mg	7,900	$30	$252.9K
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.	12,880	$10	$154.6K
67228	In retinopathy, tiny new vessels grow profusely and fibrous tissue proliferates in between the layers of the retina, which may extend into the optic nerve and vitreous, clear gel that fills the space…	180	$310	$54.9K
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…	3,200	$10	$44.8K
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…	840	$30	$21.7K
92235	The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken…	380	$50	$19.2K
99203	The 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…	290	$30	$9.6K
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…	200	$30	$6.8K

Showing 1–10 of 23

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.

Claims Volume vs. Wisconsin Distribution

Retina & Vitreous Consultants Of Wi, Ltd. — 5 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

23 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	Injection, aflibercept, 1 mg	1	10	660	$500	$479.6K
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…	581	1,630	270	$40	$205.3K
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…	339	1,760	250	$40	$173.2K
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.	1	30	1,140	$60	$116.9K
J9035	Injection, bevacizumab, 10 mg	1	10	470	$30	$62.4K
99203	The 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…	145	440	90	$50	$41K
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…	126	330	110	$70	$37.7K
67228	In retinopathy, tiny new vessels grow profusely and fibrous tissue proliferates in between the layers of the retina, which may extend into the optic nerve and vitreous, clear gel that fills the space…	1	10	110	$280	$31.7K
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	50	410	$10	$20.9K
92235	The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken…	2	10	380	$50	$17K

Showing 1–10 of 23

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital Of Wisconsin, Inc.	WI	Children's Hospital	$0	$262.3M
Froedtert Memorial Lutheran Hospital, Inc.	WI	General Acute Care Hospital	$0	$157.8M
The Medical College Of Wisconsin, Inc.	WI	Internal Medicine Physician	$17.8K	$74.8M
Emergency Medicine Specialists, S.c.	WI	Emergency Medicine Physician	$0	$35.3M
Wisconsin Diagnostic Laboratories LLC	WI	Clinical Medical Laboratory	$2.3M	$22.7M
Childrens Hospital Of Wisconsin, Inc.	WI	Pediatrics Physician	$0	$19M
Children's Hospital And Health System, Inc.	WI	Urgent Care Clinic/Center	$0	$17.7M
Option Care Home Care Inc	WI	Pharmacy	$0	$12.5M
Curative Care Network, Inc.	WI	Rehabilitation Clinic/Center	$0	$12.2M
Children's Specialty Group, Inc.	WI	Pediatrics Physician	$0	$10.4M

Retina & Vitreous Consultants Of Wi, Ltd. — Billing Profile & Reimbursement Data

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Retina & Vitreous Consultants Of Wi, Ltd. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nicholas Tosi	WI	Retina Specialist (Ophthalmology) Physician	$4.9M	$0
Sharath Raja	WI	Retina Specialist (Ophthalmology) Physician	$3.3M	$0
Lincoln Shaw	WI	Retina Specialist (Ophthalmology) Physician	$832.5K	$0
Razek Georges Coussa	WI	Retina Specialist (Ophthalmology) Physician	$556.7K	$0