Loading...
NPI 1275574287 · Lexington, KY · Retina Specialist (Ophthalmology) Physician
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Belinda Shirkey is a retina specialist (ophthalmology) physician provider located in Lexington, Kentucky. This profile covers 15 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 | Belinda Shirkey |
| Address | 120 N Eagle Creek Dr |
| City | Lexington |
| State | KY |
| ZIP | 40509 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | June 9, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.6M |
| Medicaid | $3.8K |
This provider is a retina specialist with a long Medicare enrollment history, enumerated since 2006-06-09 (~20 years). That tenure suggests an established clinical practice in Lexington, KY focused on retinal disease management and intraocular injections rather than a recent entrant or short-term provider. The specialist taxonomy and service mix align with subspecialty retinal care.
Medicare dominates this provider’s revenue: total Medicare revenue is $2.6M versus total Medicaid revenue of $3.8K, indicating effectively single-payer scale with minimal Medicaid activity. Analysts should treat Medicare claims as the primary source for utilization and revenue insights, as Medicaid contributes a negligible share of lifetime billed revenue.
Revenue concentration on Medicare is very high: the precomputed top 3 Medicare codes account for 88.2% of the provider’s Medicare revenue. Those codes are injectable biologics and related injection procedures (J0178, J2778, J2777) which signals a practice model focused on frequent intravitreal pharmacotherapy for retinal conditions rather than high-volume surgical retina or broad multispecialty outpatient care.
The single largest Medicare revenue driver is J0178 (aflibercept), which alone generates $1.6M and represents 63.0% of Medicare revenue. Nationally this provider ranks #357 of 3204 for J0178 (89th percentile), placing them above most peers in volume for this drug but not as an extreme outlier; this supports characterization as a high-volume regional aflibercept injector.
On Medicare, other high-volume injection codes include J2778 (ranibizumab) with $431K (16.5% of Medicare revenue) and J2777 (faricimab-svoa) with $227.9K (8.7% of Medicare revenue), completing the three-code concentration. Given these three codes account for 88.2% of Medicare revenue, the business implication is a procedure- and drug-centric retinal clinic model that relies on frequent, repeat intravitreal treatments.
Competitive standing varies by service: for retinal imaging 92134 the provider is notably above typical national volume on Medicare (96th percentile), indicating strong use of retinal imaging in care pathways and potentially robust diagnostics capacity relative to peers. In contrast, for several other therapeutic implants or surgeries (for example 67036) the provider ranks lower in national percentiles and appears to offer those services only occasionally.
Medicaid activity is minimal but concentrated: the top 3 Medicaid codes account for 100.0% of Medicaid revenue, with 92134 contributing $2.2K (57.3% of Medicaid revenue) and 67028 contributing $1.6K (42.7%). In-state rank for 92134 is #50 of 74 (33rd percentile) and for 67028 it is #31 of 31 (0th percentile), indicating the provider is not a major Medicaid retinal services provider in Kentucky and has limited footprint in the state Medicaid market.
Service-line implications for care delivery: the billing mix—high-volume intravitreal injections (J0178, J2778, J2777), moderate use of diagnostic retinal imaging (92134), and routine office E/M codes (99213/99214)—is consistent with a clinic model that manages chronic retinal diseases (e.g., wet AMD, diabetic macular edema) through regular imaging and repeat anti-VEGF dosing rather than primary surgical retina. This pattern suggests steady, recurring visit schedules centered on injections and imaging.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
15 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2,400 | $690 | $1.6M |
| J2778 | Injection, ranibizumab, 0.1 mg | 2,380 | $180 | $431K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 7,860 | $30 | $227.9K |
| 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. | 1,530 | $90 | $136.1K |
| 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. | 1,890 | $30 | $50.9K |
| 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… | 710 | $60 | $42.4K |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 150 | $150 | $23.6K |
| 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… | 220 | $90 | $19.5K |
| 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… | 90 | $110 | $10.1K |
| 67036 | The provider removes vitreous fluid from the eye to access the posterior segment of the eye and introduce surgical instruments through incisions in the pars plana. | 10 | $650 | $7.8K |
Showing 1–10 of 15
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
15 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 10 | 40 | 870 | $690 | $858.5K |
| J2777 | 20 | 30 | 11,040 | $30 | $399.1K |
| J2778 | 1 | 20 | 700 | $180 | $148.3K |
| 67028 | 10 | 50 | 650 | $90 | $72.9K |
| J7312 | 9 | 10 | 190 | $160 | $43.9K |
| 67036 | 16 | 20 | 20 | $910 | $28.1K |
| J3590 | 28 | 40 | 160 | $60 | $17K |
| 99214 | 2,041 | 7,230 | 110 | $70 | $14.1K |
| 99213 | 170 | 7,250 | 80 | $50 | $7.7K |
| 92134 | 15 | 410 | 50 | $30 | $6.3K |
Showing 1–10 of 15
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 |
|---|---|---|---|---|
| 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. | 70 | $30 | $2.2K |
| 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. | 10 | $120 | $1.6K |
How this provider's Medicaid billing volume and revenue compare to other Kentucky providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Kentucky median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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. | 31 | 30 | 350 | $70 | $165.3K |
| 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. | 50 | 70 | 210 | $20 | $29.2K |
Other providers in the same ZIP code as Belinda Shirkey, ranked by combined Medicare and Medicaid revenue.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.