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    OpenPayerNPI Medicare & MedicaidAndrew Barrett
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    Andrew Barrett — Billing Profile & Reimbursement Data

    NPI 1306899059 · Wilmington, DE · Ophthalmology Physician

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    Andrew Barrett is a ophthalmology physician provider located in Wilmington, Delaware. This profile covers 17 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationAndrew Barrett
    Address3501 Silverside Road
    CityWilmington
    StateDE
    ZIP19810
    TaxonomyOphthalmology Physician
    NPI EnumeratedMay 17, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$671.1K
    Medicaid$0

    Key Findings

    This provider’s revenue is effectively single‑payer: Total Medicare revenue is $671.1K and there is no Medicaid billing on file, indicating the practice operates almost entirely on Medicare revenue for the payers in this dataset. That concentration suggests reimbursement exposure is driven by Medicare policy and beneficiary volume rather than state Medicaid contracts.

    Revenue concentration is highly focused: the top three Medicare codes account for 73.4% of the provider’s Medicare revenue, led by 66984 at 38.3%, followed by 92014 at 21.1% and 66982 at 14.0%. This degree of concentration indicates a small set of services—primarily cataract surgery and comprehensive ophthalmic exams—drive the majority of cashflow from Medicare.

    The service mix is surgery‑forward with supporting diagnostics: high revenue from 66984 and 66982 (lens insertion after cataract extraction and complex intraocular lens prosthesis insertion) together with substantial billing for 66821 (YAG capsulotomy) and 76519 (A‑scan biometry) points to an operative cataract practice that also performs routine post‑op procedures and pre‑operative IOL calculations. The presence of 76519 at scale (1.1K claims) reinforces that these are not isolated surgeries but a steady surgical workflow requiring pre‑op measurements.

    92014 (comprehensive established eye exam) is a major volume and revenue driver: the provider billed 1.7K claims for 92014 generating $141.8K (21.1% of Medicare revenue) and is classified as an extreme outlier, far above typical national volume for this code. That unusually high volume of comprehensive established exams suggests either a large Medicare patient panel returning for routine follow‑up or dominant ownership of longitudinal medical eyecare services in the practice.

    Statistical standing is mixed by service line: surgery code 66984 (613 claims, $256.8K) is described as a typical, unremarkable volume nationally (84th percentile), and 66982 (163 claims, $93.7K) is likewise characterized as typical and unremarkable despite its high rank; by contrast, diagnostic/prep code 76519 (1.1K claims, $25.2K) is an extreme outlier, far above typical national volume. These labels imply the practice’s exam and biometry activity is unusually concentrated even if its cataract procedure volumes sit closer to the national middle.

    Competitive positioning: for the high‑volume exam code 92014 the provider ranks #406 of 35415 (99th percentile), indicating a dominant role nationally in established comprehensive ophthalmic visits, while cataract surgery and related procedure ranks (66984 rank #2582 of 15965, 66982 rank #136 of 4580) are reported as typical volumes and do not alone indicate market dominance in surgical share at a national level. In other words, the provider punches above average on office exam throughput but is a more modest national participant on standard cataract procedural volume.

    Business implications and operational focus: the combination of very high comprehensive exam volume and high pre‑op biometry suggests the practice model emphasizes longitudinal medical management and surgical throughput—likely scheduling high numbers of office visits that feed a steady cataract surgery pipeline. Payers assessing network value should view the provider as a high‑touch Medicare ophthalmology node whose referrals and follow‑up volume may be more valuable than raw surgical counts alone.

    Tenure: the NPI has been enumerated since 2006-05-17 (~20 years ago), indicating an established provider with long‑standing Medicare billing history; this duration supports the interpretation that current patterns are stable practice behaviors rather than transient billing artifacts.

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    17 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    66984The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…610$420$256.8K
    92014An 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…1,730$80$141.8K
    66982The provider inserts an intraocular lens prosthesis after extracapsular cataract extraction using complex techniques and devices. He may perform this by means of an iris expansion device, providing…160$580$93.7K
    66821The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.240$250$58.1K
    92012For 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…560$60$34.4K
    76519The provider uses A scan ultrasound echography to measure the axial length of the eye and determine the intraocular lens, or IOL calculation prior to cataract surgery.1,100$20$25.2K
    92004The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.170$90$15.1K
    92083The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for an extended…300$40$12.3K
    92134The 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.340$30$9.6K
    99214The 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…80$90$7.7K

    Showing 1–10 of 17

    Medicare: Competitive Analysis & Benchmarks

    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 CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    66984105070$590$163.6K
    6698232060$700$60K
    66821930140$230$37.1K
    920142120250$80$29.9K
    992141,1881,830150$80$25.5K
    92012940230$60$21.4K
    76519110580$30$14.7K
    992131,4981,810120$60$13.6K
    921342110080$30$7.5K
    9920459595030$110$6.5K

    Showing 1–10 of 17

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Christiana Care Health Services, Inc.DEGeneral Acute Care Hospital$0$99.4M
    Christiana Care Health Services IncDEHospitalist Physician$0$13.6M
    Mercy Health System CorporationWIMulti-Specialty Clinic/Center$0$13.2M
    Christiana Care Health Services IncDEObstetrics & Gynecology Physician$0$9.9M
    Christiana Care Health Services IncDENeonatal-Perinatal Medicine Physician$0$8.9M
    Christiana Care Health Services IncDEFamily Medicine Physician$0$5.6M
    Christiana Care Health Services IncDENeurology Physician$0$5.1M
    Christiana Care Health Services, IncDEFamily Medicine Physician$0$5.1M
    Christiana Care Health Services IncDEStudent Health Clinic/Center$0$3.9M
    Christiana Care Health Services, IncDEPsychiatry Physician$0$2.9M

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Rachel A Maher,dmd, PADEDentist$0$4.5M
    Brandywine Pediatric Dentistry, P.A.DEPediatric Dentistry$0$4M
    Jason KaplanDEOphthalmology Physician$2.7M$0
    Brandywine Pediatrics, P.A.DEPediatrics Physician$0$1.6M
    Harry LebowitzDEOphthalmology Physician$1.1M$0
    Rehabilitation Associates, P.A.DEPhysical Medicine & Rehabilitation Physician$0$852.8K
    David CozzolinoDEUrology Physician$786.9K$0
    Chloe PayneDEDermatology Physician$541.5K$11.7K
    James FierroDEFamily Medicine Physician$530.7K$0
    Clifford L. Anzilotti, D.m.d., P.A.DEOrthodontics and Dentofacial Orthopedics Dentistry$0$510.8K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    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.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Delaware Distribution
    Andrew Barrett — 3 of 17 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Delaware