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    v1.0.28
    OpenPayerNPI Medicare & MedicaidRaul Pena
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    Raul Pena — Billing Profile & Reimbursement Data

    NPI 1164456943 · Mcallen, TX · Ophthalmology Physician

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    Raul Pena is a ophthalmology physician provider located in Mcallen, Texas. This profile covers 14 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.

    (source: NPPES NPI Registry)

    Table of contents

    Progress1 / 7

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    Provider details
    FieldValue
    Entity TypeIndividual
    OrganizationRaul Pena
    Address1400 E Ridge Rd Ste 10
    CityMcallen
    StateTX
    ZIP78503
    TaxonomyOphthalmology Physician
    NPI EnumeratedJuly 10, 2006

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

    Payer SourceTotal Paid
    Medicare$147.5K
    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.

    14 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    66984The 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…150$390$57.4K
    66821The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.160$240$39.3K
    92012For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…180$70$11.7K
    66982The 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…20$540$9.7K
    67031The provider uses a laser to remove vitreous material that is obstructing a patient’s vision.30$300$7.5K
    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…70$100$6.5K
    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…70$80$5.8K
    92136The 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…140$30$4.8K
    92286In this procedure, the provider examines the structures in the anterior, or front, segment of the eye. He identifies abnormalities in the vasculature, such as those associated with neoplasia. He then…50$30$1.4K
    92025The provider measures the curvature of one or both corneas, interprets the findings, and prepares a report.50$30$1.2K

    Showing 1–10 of 14

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    14 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    66984365990100$560$113.9K
    6698219527020$650$23.4K
    920141,5442,700100$80$21K
    668218970050$230$20K
    920125051,69080$60$10.9K
    6703131030$270$9K
    921341,3311,69070$30$8.3K
    992043,91816,38030$110$5.6K
    92136301650130$20$5.1K
    920831,3061,59050$40$4.1K

    Showing 1–10 of 14

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Volver A Casa Home Health Services, Inc.TXPersonal Care Attendant$0$27M
    Columbia Rio Grande Healthcare, L.P.TXGeneral Acute Care Hospital$0$17.7M
    Med Care Emergency Medical Services IncTXAmbulance$1.2M$10.9M
    Omar GonzalezTXEmergency Medicine Physician$2M$0
    Billie MarekTXMedical Oncology Physician$1.6M$0
    Abdulrahman RagehTXOphthalmology Physician$956.9K$429.9K
    Endoscopy Center At Ridge Plaza LPTXAmbulatory Surgical Clinic/Center$187.9K$564.3K
    Sanjeeb BhandariTXOphthalmology Physician$678.1K$0
    Javier LealTXPhysical Therapist$478.5K$0
    Nyan PhyoTXNephrology Physician$350K$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. Texas Distribution
    Raul Pena — 0 of 14 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Texas