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NPI 1184667792 · Manati, PR · Ophthalmology Physician
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Luma Al-attar is a ophthalmology physician provider located in Manati, Puerto Rico. This profile covers 6 Medicare and 2 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 | Luma Al-attar |
| Address | Carretera Number 2 |
| City | Manati |
| State | PR |
| ZIP | 00674 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | June 13, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $117.1K |
| Medicaid | $3K |
This provider’s book of business is heavily Medicare-weighted: reported lifetime Medicare revenue is $117.1K versus Medicaid revenue of $3K, so Medicare dominates the revenue mix and Medicaid represents a very small portion of billed activity. The scale difference indicates the practice is effectively single-payer dominant (Medicare) for revenue generation.
Revenue concentration on Medicare is extreme at the code level: the top 3 Medicare codes by revenue account for 94.6% of this provider's total Medicare revenue, and J0178 alone represents 80.5% of Medicare revenue. This pattern indicates the practice’s financial profile is driven overwhelmingly by a single high-cost injectable therapy (J0178 – aflibercept), with much smaller contributions from intravitreal injection procedures (67028) and routine E/M visits (99213).
The clinical/service mix implied by the top Medicare codes is a retina-focused ophthalmology operation: J0178 (aflibercept injection) and 67028 (vitreous chamber injection) point to intravitreal anti-VEGF therapy as the primary service line, while 99213 (office E/M) and 92134 (retinal imaging) support ongoing monitoring and follow-up care. This code mix suggests the practice models around recurring, procedure-driven retinal care rather than high-volume general ophthalmology exams.
Medicare competitive standing on the primary revenue code is modest: J0178 is ranked #2840 of 3204 providers nationally (11th percentile) and is characterized as typical, unremarkable volume for this code. The other Medicare procedure codes follow a similar pattern of being modest participants nationally (67028 at the 17th percentile, 99213 at the 68th percentile), so the provider is not a market leader on these services but participates at typical volumes for its peers.
On the Medicaid side the provider’s activity is very limited and concentrated: the top Medicaid codes account for 100.0% of total Medicaid revenue, split between 92014 (66.5%) and 92134 (33.5%). Both Medicaid codes rank low in-state (92014 #107 of 124, 13th percentile; 92134 #77 of 83, 7th percentile), indicating a modest to minimal Medicaid footprint relative to in-state peers.
Operational volume and reimbursement profile reinforce the revenue concentration: J0178 shows 136 claims with a $692 avg paid/claim generating $94.1K revenue, whereas 99213 also shows 136 claims but at $60 avg paid/claim producing $8.2K. This contrast highlights reliance on a smaller number of high-reimbursement injectable encounters versus a larger number of lower-reimbursement office visits to sustain revenue.
The provider has long tenure in the NPI registry (NPI enumerated on 2006-06-13 (~20 years ago)), which indicates an established presence in the market. Despite long tenure, the overall lifetime revenues reported ($117.1K Medicare, $3K Medicaid) point to a modest billing scale rather than a high-volume practice.
From a business-risk and strategic perspective, the practice’s dependence on a single drug code for the majority of Medicare revenue creates vulnerability to changes in drug utilization, reimbursement, or patient referral patterns; coupled with a very small Medicaid revenue base, payer diversification appears limited. Any payer or network evaluation should weigh this concentration when assessing financial resiliency and negotiating participation or reimbursement terms.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 140 | $690 | $94.1K |
| 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. | 100 | $80 | $8.3K |
| 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… | 140 | $60 | $8.2K |
| 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. | 160 | $30 | $4.6K |
| 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… | 20 | $100 | $1.6K |
| 92202 | The 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… | 10 | $10 | $140 |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.
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.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 20 | $100 | $2K |
| 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. | 30 | $40 | $1K |
How this provider's Medicaid billing volume and revenue compare to other Puerto Rico providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Puerto Rico median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 107 | 120 | 180 | $80 | $62.9K |
| 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. | 77 | 80 | 650 | $20 | $43.1K |
Other providers in the same ZIP code as Luma Al-attar, ranked by combined Medicare and Medicaid revenue.
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