Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Kentucky for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Kentucky only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Kentucky (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Romulo Albuquerque (NPI 1265726905)

Field	Value
Entity Type	Individual
Organization	Romulo Albuquerque
Address	University Of Kentucky & Affiliates
City	Lexington
State	KY
ZIP	40536
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	May 29, 2011

Payer Source	Total Paid
Medicare	$3.8M
Medicaid	$0

Key Findings

This provider is effectively Medicare-centric: Total Medicare revenue is $3.8M while Total Medicaid revenue is none (no Medicaid billing on file), indicating the practice operates without a Medicaid billing footprint and is functionally single‑payer at present. Analyses of payer exposure and network contracting should treat Medicare trends as the primary driver of financial performance.

Revenue is highly concentrated in a small set of services: the precomputed top three Medicare codes account for 87.6% of this provider's Medicare revenue, driven by J2777, J0178, and 67028. That concentration indicates the business economics are dominated by a few high‑value injections and a related procedural code rather than a broad mix of low‑value office visits.

The clinical/service mix is characteristic of a retina specialty practice focused on intravitreal biologic injections and retinal imaging: J2777 (faricimab) generated $1.6M from 55.6K claims and J0178 (aflibercept) generated $1.5M from 2.2K claims, while imaging code 92134 has 2.8K claims. Supplementary retinal procedure and exam codes such as 67028 (1.8K claims, $169.4K revenue) and 92014 (1.4K claims, $121.5K revenue) further support a workflow centered on injections and diagnostic retinal care.

J2777 is a national high‑volume outlier for this provider: it ranks #84 of 2039 providers nationally (96th percentile; notably above typical national volume for this code), signaling major scale in faricimab administration compared with peers. By contrast, J0178 ranks #418 of 3204 providers (87th percentile; typical, unremarkable volume), so the provider pairs one exceptionally high‑volume biologic with other injection activity at more typical peer volumes.

Diagnostic imaging and comprehensive eye exams are also high relative to peers and support the injection workload: 92134 ranks #469 of 26868 providers nationally (98th percentile; extreme outlier) and 92014 ranks #771 of 35415 providers nationally (98th percentile; notably above typical national volume). These percentile placements indicate outsized OCT and exam throughput that align with a high‑volume retinal injection practice rather than a low‑volume consult service.

Office evaluation and management activity is comparatively limited relative to procedure and drug revenue: 99214 represents 238 claims and $20.9K in revenue (0.6% of Medicare revenue), and lower‑level E/M codes show minimal revenue contribution. This mix suggests revenue and utilization management focus should be on procedure and drug lines rather than traditional office visit rates.

The provider’s lifetime enrollment shows stability: NPI enumerated 2011-05-29 (~15 years ago), which is consistent with an established specialty practice that has developed a concentrated injection and imaging business over time. Tenure supports interpreting the observed high volumes as sustained operational scale rather than a transient surge.

For payer contract, utilization review, or network decisions, the practical levers are clear: two drug codes (J2777 and J0178) together generate the vast majority of dollars (J2777 $1.6M, J0178 $1.5M) and should be the primary focus for reimbursement policy and utilization oversight given the overall top‑3 share of 87.6%. Given the provider’s lack of Medicaid activity, any risk or savings tied to these codes will primarily affect Medicare spend and network negotiations rather than state Medicaid budgets.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2777	Injection, faricimab‑svoa, 0.1 mg	55,620	$30	$1.6M
J0178	Injection, aflibercept, 1 mg	2,240	$680	$1.5M
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.	1,770	$100	$169.4K
J2778	Injection, ranibizumab, 0.1 mg	670	$180	$122.6K
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…	1,380	$90	$121.5K
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.	2,840	$30	$82.3K
J7312	Injection, dexamethasone, intravitreal implant, 0.1 mg	410	$160	$64.6K
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…	240	$90	$20.9K
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	$900	$18.9K
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…	150	$100	$15.6K

Showing 1–10 of 14

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Kentucky Distribution

Romulo Albuquerque — 3 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. state median

14 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	11	40	870	$690	$858.5K
J2777	1	30	11,040	$30	$399.1K
J2778	9	20	700	$180	$148.3K
67028	7	50	650	$90	$72.9K
J7312	4	10	190	$160	$43.9K
67041	5	10	20	$1,020	$24.5K
99214	1,862	7,230	110	$70	$14.1K
92014	5	420	90	$80	$14K
99213	7,187	7,250	80	$50	$7.7K
92012	36	110	60	$50	$6.8K

Showing 1–10 of 14

Related Providers

Other providers that share a Tax Identification Number (TIN) with Romulo Albuquerque, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vistar Eye Center, Inc	VA	Specialist	$0	$11.4M
Michael Mcclintock	VA	Retina Specialist (Ophthalmology) Physician	$5.4M	$0
Timothy Byrnes	VA	Retina Specialist (Ophthalmology) Physician	$4.7M	$0
Vishak John	NC	Ophthalmology Physician	$4.3M	$0
Anna Mackin	VA	Retina Specialist (Ophthalmology) Physician	$3.1M	$0
Craig Hartranft	VA	Ophthalmology Physician	$2.8M	$0
Frank Cotter	VA	Ophthalmology Physician	$683.7K	$0
Chad Albright	VA	Ophthalmology Physician	$560.3K	$0
Will Griffeth	VA	Ophthalmology Physician	$484.5K	$0
Tad Schoedel	VA	Ophthalmology Physician	$478.6K	$0

Nearby Providers

Other providers in the same ZIP code as Romulo Albuquerque, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of Kentucky	KY	General Acute Care Hospital	$0	$716.8M
Kentucky Medical Services Foundation	KY	Nurse Practitioner	$0	$12.5M
University Of Kentucky	KY	Dentist	$0	$4.3M
Kentucky Medical Services Foundation	KY	Physician Assistant	$0	$3.4M
Kentucky Medical Services Foundation	KY	Pediatrics Physician	$0	$3.3M
Kentucky Medical Services Foundation	KY	Clinical Pathology/Laboratory Medicine Physician	$0	$3M
Jameson Dupree	KY	Ophthalmology Physician	$1.5M	$0
Elena Samoilova	KY	Anatomic Pathology & Clinical Pathology Physician	$110.7K	$974.6K
Sun Yi	KY	Radiation Oncology Physician	$646.6K	$0
Frances Martin	KY	Urology Physician	$532.8K	$0

Romulo Albuquerque — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References