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    OpenPayerNPI Medicare & MedicaidVictor Villegas
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    Victor Villegas — Billing Profile & Reimbursement Data

    NPI 1174771653 · San Juan, PR · Ophthalmology Physician

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    Victor Villegas is a ophthalmology physician provider located in San Juan, Puerto Rico. 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
    OrganizationVictor Villegas
    Address360 Calle Del Parque
    CitySan Juan
    StatePR
    ZIP00921
    TaxonomyOphthalmology Physician
    NPI EnumeratedSeptember 9, 2008

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

    Payer SourceTotal Paid
    Medicare$109.6K
    Medicaid$0

    Key Findings

    This NPI is an ophthalmology physician whose Medicare billing ($109.6K lifetime Medicare revenue) is concentrated in office-based diagnostic and treatment eye care, with the highest revenue coming from comprehensive established patient exams (92014: $39.6K revenue, 36.2% of Medicare revenue) and intravitreal medication procedures (67028: $26.8K revenue, 24.5% of Medicare revenue). The presence of J7999 (compounded drug, $12.6K, 11.5%) alongside injection procedure codes points to an office workflow that combines examinations, ocular imaging, and pharmacologic intravitreal therapy rather than surgical subspecialty work.

    Revenue concentration is high: the precomputed top-three codes account for 72.3% of this provider's total Medicare revenue, with specific top-code dollar amounts of $39.6K (92014), $26.8K (67028), and $12.6K (J7999) visible on the record. That degree of concentration signals that a small set of outpatient ophthalmology services drives the majority of billed Medicare dollars for this provider.

    Payer mix is effectively single-payer at the claim level: Medicare is the sole payer on file (Total Medicare revenue $109.6K) while there is no Medicaid billing on file, so the provider’s public-payer footprint is dominated by Medicare rather than a split Medicaid/Medicare practice.

    Competitive standing for the top exam code is modestly elevated but described as typical: 92014 ranks #5992 of 35415 nationally (83th percentile) and is labeled in the source as "typical, unremarkable volume for this code," indicating the provider sees a normal national-level volume of established comprehensive ophthalmology visits rather than an outlier or dominant position.

    The injection and drug-use profile is mixed: 67028 (intravitreal injection) accounts for $26.8K and is ranked #2831 of 4255 nationally (33th percentile; labeled "typical, unremarkable volume for this code"), while J7999 (compounded drug) is $12.6K and ranks #434 of 1333 (67th percentile; labeled "typical, unremarkable volume for this code"). Together these ranks suggest moderate use of intravitreal therapy and compounding relative to national peers, without statistical labeling that would indicate an extreme outlier.

    Imaging and diagnostic services are a meaningful secondary revenue stream: 92134 (retinal imaging) produced $11.7K (10.7% of Medicare revenue) and ranks #3948 of 26868 (85th percentile; labeled "typical, unremarkable volume for this code"), and 76512 (B–scan ultrasound) produced $6.4K (5.8%) and ranks #171 of 2292 (93th percentile; labeled "typical, unremarkable volume for this code"). These procedure counts and ranks are consistent with an ophthalmology practice that performs both posterior-segment imaging and targeted ultrasound, reinforcing a medical-retina or comprehensive office-based diagnostic model.

    Operationally the provider appears established: the NPI was enumerated 2008-09-09 (~18 years ago), so the billing history reflects a long-tenured practitioner rather than a recently entered provider. Despite tenure and a concentrated set of revenue-driving services, overall Medicare lifetime revenue is relatively modest at $109.6K, and several lower-revenue codes (for example J3301: $128, 0.1% of revenue, rank #21215 of 38702, labeled "typical, unremarkable volume for this code") indicate limited scale outside the core exam/injection/imaging mix.

    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
    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…460$90$39.6K
    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.270$100$26.8K
    J7999Compounded drug, not otherwise classified230$60$12.6K
    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.420$30$11.7K
    76512The provider uses B–scan ultrasound imaging, with or without a non–qualitative A–scan superimposed, to examine the intraocular and orbital structures.180$40$6.4K
    92100Code 92100 describes multiple measurements of intraocular pressure taken over a given time period on a single day in order to monitor response to treatment or document pressure changes throughout the…50$70$3.3K
    92202The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece…280$10$3.1K
    92004The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.30$90$2.8K
    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,…70$20$1.7K
    67515The provider inserts a needle into the Tenon’s capsule of the eye and injects medication into the Tenon’s capsule.30$40$1.1K

    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
    6702811060$90$7.7K
    J7999110100$60$6.4K
    9201428040$80$5.2K
    76512110130$30$3.7K
    92004227020$100$2.9K
    9213426050$30$2.2K
    9210011030$70$2K
    92250197040$20$1.3K
    6751511030$40$1.1K
    9220216030$10$640

    Showing 1–10 of 11

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Recinto De Ciencias MedicasPREmergency Medicine Physician$0$6.8M
    Recinto De Ciencias MedicasPRNeonatal-Perinatal Medicine Physician$0$5.4M
    Recinto De Ciencias MedicasPRDiagnostic Radiology Physician$0$4.2M
    Sandra Gracia-lopezPRNuclear Medicine Physician$26.7K$4.1M
    Hector Velez CortesPRHematology & Oncology Physician$4.3K$4M
    Recinto De Ciencias MedicasPRPediatrics Physician$0$4M
    Recinto De Ciencias MedicasPRObstetrics & Gynecology Physician$0$3.8M
    Recinto De Ciencias MedicasPRInternal Medicine Physician$0$3.4M
    Hiram OrtegaPRGastroenterology Physician$8.8K$3.1M
    Recinto De Ciencias MedicasPRPediatric Cardiology Physician$0$3.1M

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Jose Garcia GonzalezPRRetina Specialist (Ophthalmology) Physician$1.9M$3.4M
    Medical Pharmacy And LabPRExclusive Provider Organization$0$2.5M
    Metrohealth Radiation Oncology Group, Inc.PRSpecialist$0$2.5M
    Metropolitan Mri Associates PscPRNeuroradiology Physician$0$2.1M
    Pediatrics Management ServicesPRMedical Specialty Clinic/Center$0$1.8M
    Luis RodriguezPRDiagnostic Radiology Physician$2K$1.3M
    Metrohealth, Inc.PRGeneral Acute Care Hospital$0$905.1K
    Minerva NunezPRGeneral Practice Dentistry$0$761.4K
    Elizabeth Calderon-aliceaPRHematology & Oncology Physician$0$707.2K
    Las Lomas Laboratory Inc.PRClinical Medical Laboratory$29.6K$630.1K

    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. Puerto Rico Distribution
    Victor Villegas — 7 of 11 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Puerto Rico