Loading...
NPI 1184633075 · Little Rock, AR · Retina Specialist (Ophthalmology) Physician
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Bradley Hughes is a retina specialist (ophthalmology) physician provider located in Little Rock, Arkansas. This profile covers 17 Medicare and 1 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Bradley Hughes |
| Address | 9800 Baptist Health Dr |
| City | Little Rock |
| State | AR |
| ZIP | 72205 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | August 7, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.1M |
| Medicaid | $3.3K |
This provider’s Medicare practice is heavily retina-focused and dominated by intravitreal biologic injections: three drug injection codes (J0178, J2777, J2778) and the intravitreal injection procedure 67028 together account for the majority of billing, with the precomputed top 3 Medicare codes by revenue representing 79.6% of total Medicare revenue. The prominence of J0178 (aflibercept) and J2777 (faricimab) indicates routine management of retinal vascular disease and wet age-related macular degeneration using high-volume anti-VEGF and related therapies.
Revenue concentration is high in Medicare: J0178 alone generates $1M (49.9% of Medicare revenue) and J2777 contributes $501.1K (24.0%), so these two codes together form a dominant share of the $2.1M lifetime Medicare revenue. By contrast, Medicaid billing is minimal and entirely concentrated in a single diagnostic imaging code: the precomputed top 3 Medicaid codes account for 100.0% of Medicaid revenue, with 92134 making up the full $3.3K.
Payer mix is effectively single-payer dominated by Medicare: lifetime Medicare revenue is $2.1M versus only $3.3K from Medicaid, signaling that this provider’s Medicare-facing practice scale far exceeds any Medicaid activity and that Medicaid represents a negligible share of lifetime revenue. Analysts should treat this entity as a Medicare-centric retina specialist for competitive and utilization benchmarking.
Competitive standing on key therapeutics is mixed: for J0178 the provider ranks #815 of 3204 nationally (75th percentile), and for J2777 ranks #623 of 2039 (69th percentile), indicating above-average but not rare national volumes for aflibercept and faricimab injections. However, the provider is an extreme outlier on retinal imaging 92134 in Medicare (rank #388 of 26868, 99th percentile), suggesting exceptionally high OCT usage relative to national ophthalmology peers.
Service-line implications beyond injections: regular use of evaluation and management eye visit codes (92012, 92014, 92004) and procedural retina surgery codes (67041, 67108, 67042) indicate the practice also performs office-based diagnostic follow-up and some surgical retina procedures, though surgical volumes are modest compared with injection volumes. This mix supports a business model built around recurring injection visits supplemented by diagnostic imaging and occasional surgery.
Tenure and continuity: the provider’s NPI has been enumerated since 2006-08-07 (~20 years), indicating long-term presence in the market which may explain established referral flows and sustained high imaging and injection volumes in Medicare. This longevity supports the interpretation that observed patterns are stable rather than transient.
State-level Medicaid positioning is modest: for 92134 in Medicaid the provider ranks #32 of 43 in-state (26th percentile), showing routine but unremarkable use of retinal imaging among Arkansas Medicaid retina/ophthalmology peers. The Medicaid volume is small in absolute dollars ($3.3K) despite similar code usage to Medicare, so statewide competitive impact is limited.
Utilization intensity signal: the combination of a very high percentile rank for Medicare 92134 (99th percentile, labeled an "extreme outlier") together with very large claim counts for injection codes (1.5K claims for J0178 and 17.3K claims for J2777 reported) points to a workflow oriented around frequent imaging-driven monitoring and high-frequency injection visits, which has implications for capacity planning, supply procurement (injectables), and prior authorization risk concentration.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
17 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1,510 | $690 | $1M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 17,280 | $30 | $501.1K |
| 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. | 1,600 | $80 | $119.9K |
| J2778 | Injection, ranibizumab, 0.1 mg | 530 | $180 | $95K |
| 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. | 3,040 | $30 | $79.1K |
| 92012 | For 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… | 1,100 | $60 | $65K |
| 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… | 870 | $70 | $63.2K |
| J7999 | Compounded drug, not otherwise classified | 420 | $70 | $27.2K |
| 92004 | The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits. | 280 | $100 | $26.6K |
| 67041 | In this procedure, the provider removes scar tissue from the retinal membrane that obscures vision. He removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical… | 20 | $810 | $17.9K |
Showing 1–10 of 17
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 Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 7 | 30 | 390 | $690 | $538.3K |
| J2777 | 8 | 20 | 12,180 | $30 | $504.5K |
| J2778 | 2 | 20 | 270 | $180 | $85K |
| 67028 | 9 | 40 | 270 | $80 | $51.1K |
| J7999 | 3 | 30 | 100 | $130 | $20.6K |
| 92014 | 21 | 370 | 150 | $70 | $19.1K |
| 67041 | 3 | 10 | 20 | $810 | $17.1K |
| 67036 | 2 | 10 | 20 | $620 | $10.5K |
| 67042 | 1 | 10 | 10 | $800 | $10.4K |
| 67108 | 1 | 10 | 10 | $790 | $10.3K |
Showing 1–10 of 17
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 90 | $40 | $3.3K |
How this provider's Medicaid billing volume and revenue compare to other Arkansas providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Arkansas median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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. | 32 | 40 | 260 | $20 | $26.2K |
Other providers in the same ZIP code as Bradley Hughes, ranked by combined Medicare and Medicaid revenue.
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.