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NPI 1235345414 · Little Rock, AR · Retina Specialist (Ophthalmology) Physician
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Cedric Pratt is a retina specialist (ophthalmology) physician provider located in Little Rock, Arkansas. This profile covers 20 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 | Cedric Pratt |
| Address | 9800 Baptist Health Dr Ste 501 |
| City | Little Rock |
| State | AR |
| ZIP | 72205 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | May 15, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.6M |
| Medicaid | $5.4K |
Medicare dominates this provider’s payer mix: reported Medicare revenue is $2.6M versus Medicaid revenue of $5.4K, so the provider is effectively a Medicare-focused practice with a very small Medicaid footprint. The Medicaid total is negligible relative to Medicare and does not materially diversify revenue sources.
Medicare revenue is highly concentrated in a narrow set of procedures: the precomputed top three Medicare codes account for 77.2% of Medicare revenue, led by J2777 (41.1%), J0178 (30.9%), and 67028 (5.2%). This concentration indicates the practice’s financial position is driven primarily by intravitreal biologic therapy and injections rather than a broad mix of surgical or non-procedural services.
The code mix and volumes point to a retina-focused, injection-driven outpatient operation: high-revenue codes J2777 and J0178 are anti-VEGF/retina biologic injections and 67028 is an intravitreal injection procedure, consistent with ongoing treatment of retinal disease. Support services for monitoring and follow-up are also prominent — diagnostic imaging and intermediate E/M codes appear frequently — implying a workflow centered on recurring injection visits coupled with retinal imaging.
Several individual codes show above-average national standing for volume. J2777 ranks #185 of 2039 providers nationally (91th percentile; typical, unremarkable volume), placing the provider well above many peers for faricimab injections, while J0178 ranks #1110 of 3204 providers (65th percentile; typical, unremarkable volume), a more middle-tier national position for aflibercept. The three-code concentration plus these ranks signal the provider is a meaningful national participant in newer biologic use but not an outlier leader across all biologics.
Diagnostic and follow-up services are extreme outliers relative to national peers, reflecting high throughput of monitoring visits: 92012 (intermediate E/M for established patients) has 1.3K claims and ranks #264 of 17177 providers (98th percentile; extreme outlier, far above typical national volume), and 92134 (retinal imaging) has 2.7K claims and ranks #524 of 26868 providers (98th percentile; extreme outlier, far above typical national volume). These volumes are consistent with a high-frequency, follow-up-heavy retina clinic supporting recurrent injection cycles.
The Medicaid billing footprint is narrowly concentrated and small: all Medicaid revenue (100.0%) is from 92134 (retinal imaging), which accounts for $5.5K and 127 claims, and ranks #29 of 43 providers in-state (33th percentile; typical, unremarkable volume). In-state competitive standing on Medicaid is modest, and the provider does not appear to be a major Medicaid retinal services provider.
Tenure supports an established referral base: the NPI was enumerated 2007-05-15 (~19 years ago), indicating a long-standing presence in the market that aligns with the sustained, high-volume monitoring and injection pattern observed. Longevity combined with the clinical mix suggests entrenched relationships with referring providers and repeat-treatment patients.
Operational and reimbursement sensitivity is notable given the revenue mix: with 77.2% of Medicare revenue coming from three codes dominated by high-cost biologic injections (J2777, J0178, 67028), the practice’s topline is sensitive to changes in biologic utilization, drug mix, or reimbursement policy. The unusually high volumes of monitoring codes (92134, 92012) imply capacity for high patient throughput, which is an operational strength but also concentrates financial exposure on the inject-and-monitor care pathway.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
20 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 37,380 | $30 | $1.1M |
| J0178 | Injection, aflibercept, 1 mg | 1,180 | $690 | $815.2K |
| 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. | 1,700 | $80 | $135.9K |
| J2778 | Injection, ranibizumab, 0.1 mg | 500 | $180 | $90.5K |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 480 | $160 | $75.7K |
| 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… | 1,280 | $60 | $71.7K |
| 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. | 2,740 | $30 | $71.3K |
| J3590 | Unclassified biologics | 30 | $2,120 | $61.5K |
| 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… | 670 | $80 | $50.5K |
| J3490 | Unclassified drugs | 20 | $1,770 | $40.7K |
Showing 1–10 of 20
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
20 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 10 | 30 | 390 | $690 | $538.3K |
| J2777 | 3 | 20 | 12,180 | $30 | $504.5K |
| J2778 | 5 | 20 | 270 | $180 | $85K |
| J2781 | 2 | 10 | 330 | $120 | $75.8K |
| 67028 | 7 | 40 | 270 | $80 | $51.1K |
| J7312 | 1 | 10 | 190 | $160 | $42.6K |
| J3590 | 2 | 10 | 40 | $850 | $32.4K |
| J7999 | 5 | 30 | 100 | $130 | $20.6K |
| 92014 | 43 | 370 | 150 | $70 | $19.1K |
| 67041 | 2 | 10 | 20 | $810 | $17.1K |
Showing 1–10 of 20
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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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. | 130 | $40 | $5.5K |
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. | 29 | 40 | 260 | $20 | $26.2K |
Other providers in the same ZIP code as Cedric Pratt, ranked by combined Medicare and Medicaid revenue.
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