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NPI 1205091097 · Merrillville, IN · Ophthalmology Physician
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James Eadie is a ophthalmology physician provider located in Merrillville, Indiana. This profile covers 21 Medicare and 10 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 | James Eadie |
| Address | 8679 Connecticut St Ste A |
| City | Merrillville |
| State | IN |
| ZIP | 46410 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | July 22, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.2M |
| Medicaid | $251.1K |
This provider reports $2.2M in lifetime Medicare revenue and $251.1K in lifetime Medicaid revenue, so Medicare is the dominant payer on file while the provider maintains a meaningful but much smaller Medicaid presence. Both payers show activity in intravitreal injections and retina imaging, so the practice is not single-payer but is clearly Medicare-led in scale.
Clinical and service-line mix is strongly retina-focused: Medicare revenues are driven by intravitreal injection products and office visits (notably J0178, J2777 and 99214), and Medicaid is similarly dominated by the intravitreal injection procedure 67028 plus E/M and retinal imaging codes. The presence of high-revenue injection codes (J0178 and J2777) together with retinal imaging codes (92134, 92202) indicates a service model built around anti-VEGF therapy, in-office injection workflow, and diagnostic imaging for posterior-segment disease.
Medicare revenue is highly concentrated: the precomputed top-three Medicare codes (J0178, J2777, 99214) account for 81.6% of the provider’s total Medicare revenue. Within that mix, J0178 represents $1.2M (55.3% of Medicare revenue), J2777 $433.3K (19.3%), and 99214 $156K (7.0%), showing that a single drug code represents the majority of Medicare dollars.
Medicaid revenue is even more concentrated around a few procedures: the precomputed top-three Medicaid codes (67028, 99214, 92134) account for 84.8% of the provider’s total Medicaid revenue. Specifically, 67028 is $143.8K (57.2% of Medicaid revenue), 99214 is $38.2K (15.2%), and 92134 is $31.3K (12.4%), which points to a Medicaid book of business dominated by intravitreal injections and supportive imaging/E/M services.
Competitive standing differs by service: for Medicare injection codes the provider is a typical participant—J0178 ranks #635 of 3204 (80th percentile; typical, unremarkable volume) and J2777 ranks #716 of 2039 (65th percentile; typical, unremarkable volume). By contrast, the provider is an extreme outlier on the Medicare E/M code 99214 (rank #2009 of 479,517; 100th percentile; extreme outlier, far above typical national volume), indicating unusually high office-visit billing intensity relative to national peers.
State-level (Medicaid) positioning is modest: the primary Medicaid procedure 67028 ranks #33 of 55 in-state (41st percentile; typical, unremarkable volume), 92134 ranks #35 of 84 (59th percentile; typical, unremarkable volume), and 99214 ranks #1094 of 2122 (48th percentile; typical, unremarkable volume). These ranks indicate the provider is an active but not dominant in-state performer for injections and retinal imaging under Medicaid.
Diagnostic and procedure intensity is notable in imaging and ophthalmoscopy: Medicare 92134 ranks #1206 of 26868 (96th percentile; notably above typical national volume) and Medicare 92202 ranks #100 of 2327 (96th percentile; notably above typical national volume), suggesting heavier-than-typical use of posterior-segment imaging and extended ophthalmoscopy in the Medicare population. Operationally, that pattern is consistent with sustained management of chronic retinal disease requiring regular imaging and follow-up.
The provider’s NPI was enumerated on 2008-07-22 (~18 years ago), indicating an established practice tenure. Coupled with the heavy revenue concentration (top three Medicare codes = 81.6% and top three Medicaid codes = 84.8%), this longevity plus code concentration suggests the practice has sustained a focused retina/injection service line but could be sensitive to changes in reimbursement or drug utilization for the limited set of high-impact codes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
21 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1,800 | $690 | $1.2M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 14,940 | $30 | $433.3K |
| 99214 | The provider sees an established 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… | 1,790 | $90 | $156K |
| 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. | 1,570 | $90 | $141K |
| J2778 | Injection, ranibizumab, 0.1 mg | 560 | $180 | $97.1K |
| 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. | 1,810 | $30 | $50.8K |
| J3590 | Unclassified biologics | 350 | $80 | $28K |
| 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… | 140 | $120 | $16.6K |
| 67108 | The provider repairs a detached retina using heat produced by a laser beam or by freezing the tissues. He may attach a scleral buckle to simplify the passage of fluid through and behind the retina or… | 20 | $860 | $16.2K |
| 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… | 1,310 | $10 | $14.4K |
Showing 1–10 of 21
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
21 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 14 | 60 | 830 | $690 | $868.8K |
| J2777 | 12 | 40 | 6,750 | $30 | $395.6K |
| J2778 | 7 | 10 | 560 | $180 | $150K |
| 67028 | 18 | 80 | 550 | $80 | $78.6K |
| 67108 | 8 | 20 | 20 | $1,150 | $32.2K |
| J3590 | 17 | 50 | 220 | $60 | $24.5K |
| J9035 | 14 | 30 | 200 | $50 | $19.2K |
| 92235 | 19 | 40 | 90 | $100 | $15.8K |
| 99214 | 24 | 10,540 | 110 | $80 | $15.5K |
| 67228 | 8 | 20 | 30 | $230 | $9.8K |
Showing 1–10 of 21
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.
10 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 620 | $230 | $143.8K |
| 99214 | The provider sees an established 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… | 800 | $50 | $38.2K |
| 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. | 1,160 | $30 | $31.3K |
| J9035 | Injection, bevacizumab, 10 mg | 230 | $70 | $16K |
| 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… | 350 | $40 | $12.8K |
| 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… | 80 | $70 | $5.8K |
| 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… | 470 | $10 | $3.3K |
| 92226 | N/A | 10 | $40 | $420 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 10 | $0 | $0 |
| G9903 | Patient screened for tobacco use and identified as a tobacco non-user | 10 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Indiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Indiana median
10 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99214 | The provider sees an established 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… | 1,094 | 2,120 | 870 | $60 | $450.6K |
| 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… | 349 | 690 | 360 | $70 | $110.9K |
| 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. | 33 | 60 | 1,260 | $50 | $108.4K |
| 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… | 511 | 790 | 150 | $90 | $99.4K |
| J9035 | Injection, bevacizumab, 10 mg | 26 | 30 | 700 | $40 | $46.4K |
| 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. | 35 | 80 | 680 | $20 | $34.5K |
| 92226 | N/A | 12 | 10 | 170 | $10 | $15.6K |
| 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… | 4 | 20 | 110 | $10 | $5.3K |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 176 | 190 | 250 | $0 | $0 |
| G9903 | Patient screened for tobacco use and identified as a tobacco non-user | 44 | 50 | 250 | $0 | $0 |
Other providers in the same ZIP code as James Eadie, ranked by combined Medicare and Medicaid revenue.
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