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

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

James Luu (NPI 1174508071)

Field	Value
Entity Type	Individual
Organization	James Luu
Address	2770 N Union Blvd
City	Colorado Springs
State	CO
ZIP	80909
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	December 13, 2005

Payer Source	Total Paid
Medicare	$4.1M
Medicaid	$0

Key Findings

Revenue concentration is highly focused in intravitreal pharmacologic therapy: J2777 ($2.2M, 52.7% of Medicare revenue), J0178 ($1.3M, 30.5% of Medicare revenue), and 67028 ($219.8K, 5.4% of Medicare revenue) together account for 88.6% of this provider's total Medicare revenue. This concentration indicates the practice’s financial performance depends overwhelmingly on high-volume injection services rather than diversified procedure or ancillary revenue streams.

The CPT mix and code volumes identify a retina-focused, office-based practice model centered on anti-VEGF/anti-Ang-2 injections and high-throughput imaging visits. High utilization of diagnostic codes such as 92134 (2.8K claims, $88.5K revenue) and evaluation codes such as 92014 (1.4K claims, $131.3K revenue) supports a care pathway of repeated imaging and follow-up visits typical for medical retina management.

J2777 activity is a national-level outlier: 74.6K claims with $29 avg paid/claim generating $2.2M and the provider ranks #40 of 2039 nationally (98th percentile; notably above typical national volume for this code). That ranking signals the provider is a major national user of faricimab relative to peers, which has material implications for drug procurement, inventory, and payer negotiation on specialty drug administration.

By contrast, J0178 (1.8K claims, $686 avg paid/claim, $1.3M) ranks #615 of 3204 nationally (81th percentile; typical, unremarkable volume), indicating a more modest national footprint for aflibercept compared with faricimab. This split suggests a deliberate or practice-driven preference toward J2777 in the drug mix rather than uniformly high utilization across all anti-VEGF agents.

Several codes are statistical outliers in terms of visit and diagnostic volume: 92134 is an extreme outlier (98th percentile, “extreme outlier, far above typical national volume for this code”) and 99204 also appears as an extreme outlier (98th percentile), together implying both high imaging throughput and an elevated share of complex new patient evaluations. These patterns are consistent with a clinic that manages a large referral population requiring initial comprehensive assessments and frequent retinal imaging follow-up.

Payer mix is effectively single-payer Medicare scale: Total Medicare revenue is $4.1M while Total Medicaid revenue is none (no Medicaid billing on file). The absence of Medicaid billing indicates the provider’s reimbursement exposure and contracting strategy will be dominated by Medicare policies and fee schedules rather than state Medicaid arrangements.

The provider has long tenure on file (NPI enumerated 2005-12-13 (~21 years ago)), which combined with the $4.1M Medicare revenue run-rate and sustained high-volume injection codes suggests an established retinal specialty practice with an entrenched referral base. This longevity supports expectations of operational maturity in clinical workflows for intravitreal therapy.

Surgical and ancillary services are present but constitute a small share of revenue: codes such as 67042 (29 claims, $26.6K) and 67036 (28 claims, $18.5K) appear at modest volumes and typical national ranks, indicating occasional surgical retina interventions. Overall the pattern points to a practice that is primarily medical-retina and injection-driven with intermittent procedural surgery rather than a high-volume surgical retina center.

Medicare: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2777	Injection, faricimab‑svoa, 0.1 mg	74,640	$30	$2.2M
J0178	Injection, aflibercept, 1 mg	1,830	$690	$1.3M
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.	2,040	$110	$219.8K
92014	An 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…	1,370	$100	$131.3K
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.	2,770	$30	$88.5K
J2778	Injection, ranibizumab, 0.1 mg	450	$180	$78.3K
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…	470	$110	$51.5K
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…	220	$120	$26.7K
67042	In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina…	30	$920	$26.6K
J7999	Compounded drug, not otherwise classified	330	$70	$23.9K

Showing 1–10 of 15

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Colorado Distribution

James Luu — 5 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. state median

15 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	6	60	740	$690	$618.3K
J2777	1	40	8,910	$30	$456.1K
J2778	16	20	600	$180	$199.7K
67028	3	80	670	$100	$73.3K
67036	10	30	20	$1,100	$37.3K
67042	8	30	20	$1,140	$29.6K
J7999	12	50	230	$70	$21.5K
92014	2	670	100	$80	$15.2K
92235	3	50	50	$110	$12.2K
92134	3	440	60	$30	$7.8K

Showing 1–10 of 15

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Retina Consultants Of Southern Colorado P C	CO	Ophthalmology Physician	$0	$9M
Ramin Sarrafizadeh	CO	Retina Specialist (Ophthalmology) Physician	$3.4M	$0
Adam Martidis	CO	Retina Specialist (Ophthalmology) Physician	$3.4M	$0
Ryan Rich	CO	Ophthalmology Physician	$3.1M	$0
Stanford Taylor	CO	Retina Specialist (Ophthalmology) Physician	$2.7M	$0
Cecinio Ronquillo	CO	Ophthalmology Physician	$2.1M	$0
Steven Christiansen	CO	Ophthalmology Physician	$302.9K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Voyager Home Health Care LLC	CO	Home Health Agency	$0	$69.7M
Uch-mhs	CO	General Acute Care Hospital	$0	$69M
Rocky Mountain Health Care Services	CO	PACE Provider Organization	$0	$38.5M
Buck Jack LLC	CO	Speech-Language Pathologist	$0	$32.7M
Mountain View Home Care Inc.	CO	In Home Supportive Care Agency	$0	$19.3M
Emergency Medical Specialists, PC	CO	Emergency Medicine Physician	$0	$13.2M
Colorado Domestic Care Inc.	CO	Home Health Agency	$0	$11.6M
Radiology & Imaging Consultants PC	CO	Diagnostic Radiology Physician	$0	$9.5M
Hero Dental Of Springs PC	CO	General Practice Dentistry	$0	$9.3M
Akvc Central LLC	CO	Pediatric Optometrist	$0	$8.8M

James Luu — Billing Profile & Reimbursement Data

Sign up for James Luu — Billing Profile & Reimbursement Data policy alerts

James Luu — Billing Profile & Reimbursement Data

Sign up for James Luu — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References