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NPI 1265642482 · Metairie, LA · Ophthalmology Physician
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Patrick O'sullivan is a ophthalmology physician provider located in Metairie, Louisiana. This profile covers 17 Medicare and 8 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 | Patrick O'sullivan |
| Address | 2800 Veterans Memorial Blvd Ste 160 |
| City | Metairie |
| State | LA |
| ZIP | 70002 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | May 23, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1M |
| Medicaid | $500.6K |
Practice is retina-centric with an injection-and-imaging service line: the provider’s Medicare and Medicaid portfolios are dominated by intravitreal injection codes (J0178, J2777, 67028, J9035) alongside high volumes of retinal imaging (92134) and fluorescein angiography (92235). The mix of high-revenue biologic/injectable codes and imaging suggests an office-based retina practice that delivers frequent intravitreal treatments and ongoing retinal monitoring.
Medicare revenue is concentrated in a few injection and exam codes: total Medicare revenue is $1M and the top 3 Medicare codes by revenue account for 69.4% of that total, led by J0178 at $450.9K (43.8%), followed by J2777 at $135.7K (13.2%) and 92014 at $128.4K (12.5%). This concentration indicates the bulk of Medicare dollars flow from anti-VEGF/related injectable therapy and comprehensive established-patient visits.
Medicaid revenue is even more concentrated: total Medicaid revenue is $500.6K and the top 3 Medicaid codes by revenue account for 89.1% of that total, driven by 67028 at $236.4K (47.1%), J9035 at $151.2K (30.1%), and 92014 at $59.6K (11.9%). For Medicaid this profile underscores reliance on intravitreal procedures and bevacizumab-based therapy as the primary revenue drivers.
Payer mix shows Medicare is the larger payer by scale: the provider reports $1M in Medicare revenue versus $500.6K in Medicaid revenue, so Medicare constitutes the larger single-payer revenue stream while Medicaid remains a material secondary source. This split implies operational sensitivity to Medicare reimbursement trends but meaningful exposure to state Medicaid policy and utilization patterns for injection services.
National competitive standing on Medicare is mixed but includes strong outlier volumes for office exams and retinal imaging: 92014 ranks #587 of 35415 (98th percentile; extreme outlier, far above typical national volume for this code), and retinal imaging 92134 ranks #1131 of 26868 (96th percentile; notably above typical national volume). By contrast, the high-revenue biologic J0178 sits near typical national volume (rank #1681 of 3204; 47th percentile), indicating exceptional exam/imaging throughput more than exceptional aflibercept share relative to national peers.
State-level competitive standing on Medicaid shows the provider is a high-volume intravitreal injector: 67028 ranks #7 of 53 in-state (88th percentile; notably above typical state volume for this code) and J9035 ranks #3 of 39 in-state (95th percentile; notably above typical state volume). These ranks position the provider as a leading Medicaid injector in Louisiana, particularly for procedural administration and bevacizumab use.
The payer-specific drug mix diverges: Medicare revenue is driven most by J0178 (aflibercept) while Medicaid revenue is driven heavily by J9035 (bevacizumab) and 67028 procedure billing. This pattern suggests the practice adapts drug selection and billing behavior across payers, with lower-cost bevacizumab predominating in Medicaid-funded treatments and higher-revenue aflibercept represented in the Medicare population.
Provider tenure is long-established: the NPI was enumerated on 2007-05-23 (~19 years ago), indicating a sustained presence in Metaire, LA and likely operational stability that supports the high cumulative volumes and the concentrated injection/imaging service line across both Medicare and Medicaid.
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 | 660 | $680 | $450.9K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 4,680 | $30 | $135.7K |
| 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… | 1,530 | $80 | $128.4K |
| 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. | 1,060 | $90 | $92.3K |
| 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. | 1,910 | $30 | $55.4K |
| 92235 | The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken… | 520 | $90 | $47.9K |
| J7999 | Compounded drug, not otherwise classified | 700 | $60 | $42.5K |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 150 | $160 | $24.5K |
| 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… | 110 | $110 | $12.1K |
| 67228 | In retinopathy, tiny new vessels grow profusely and fibrous tissue proliferates in between the layers of the retina, which may extend into the optic nerve and vitreous, clear gel that fills the space… | 30 | $260 | $8K |
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 | 13 | 50 | 300 | $680 | $371.5K |
| J2777 | 17 | 30 | 6,660 | $30 | $309.4K |
| 67028 | 9 | 70 | 410 | $80 | $44.3K |
| J7312 | 5 | 10 | 200 | $150 | $39.1K |
| 92014 | 12 | 470 | 170 | $80 | $23.9K |
| J7999 | 2 | 20 | 140 | $40 | $16.6K |
| 67210 | 12 | 10 | 40 | $380 | $16.5K |
| 92012 | 207 | 350 | 100 | $60 | $11.7K |
| 92235 | 2 | 40 | 70 | $90 | $11.3K |
| 67228 | 7 | 10 | 30 | $250 | $8.2K |
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.
8 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. | 4,830 | $50 | $236.4K |
| J9035 | Injection, bevacizumab, 10 mg | 5,040 | $30 | $151.2K |
| 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… | 2,290 | $30 | $59.6K |
| 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. | 4,030 | $10 | $32.2K |
| 92235 | The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken… | 660 | $30 | $18.4K |
| 92226 | N/A | 450 | $10 | $2.7K |
| 92250 | Code 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,… | 50 | $20 | $1K |
| 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… | 100 | $1 | $390 |
How this provider's Medicaid billing volume and revenue compare to other Louisiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Louisiana median
8 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… | 201 | 660 | 1,070 | $60 | $129.3K |
| 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. | 7 | 50 | 470 | $60 | $95.8K |
| J9035 | Injection, bevacizumab, 10 mg | 3 | 40 | 240 | $30 | $34.1K |
| 92235 | The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken… | 6 | 20 | 200 | $30 | $21K |
| 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. | 19 | 130 | 490 | $10 | $19.4K |
| 92250 | Code 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,… | 164 | 210 | 200 | $20 | $17.5K |
| 92226 | N/A | 15 | 30 | 450 | $10 | $5.5K |
| 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… | 13 | 20 | 110 | $1 | $1.3K |
Other providers in the same ZIP code as Patrick O'sullivan, ranked by combined Medicare and Medicaid revenue.
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