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NPI 1336469444 · Lexington, KY · Retina Specialist (Ophthalmology) Physician
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Blake Isernhagen is a retina specialist (ophthalmology) physician provider located in Lexington, Kentucky. This profile covers 19 Medicare and 5 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 | Blake Isernhagen |
| Address | 120 N Eagle Creek Dr |
| City | Lexington |
| State | KY |
| ZIP | 40509 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | June 11, 2010 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.2M |
| Medicaid | $120.3K |
This NPI has been enumerated since 2010-06-11 (~16 years ago), indicating an established retinal specialty practice in Lexington, KY; the code mix (high-volume intravitreal injections and retinal imaging) aligns with a clinic-based retina subspecialty rather than a primarily surgical practice. Top injectable and diagnostic codes dominate the profile rather than high-volume inpatient or hospital-based surgery codes.
Medicare revenue is concentrated in a small set of injection and retina procedure codes: the top three Medicare codes account for 87.7% of the provider's $3.2M Medicare revenue, with J0178 alone representing $2.1M (66.1% of Medicare revenue). This concentration indicates that aflibercept administration is the primary Medicare revenue driver for this provider.
On Medicaid this provider is even more concentrated: the top three Medicaid codes account for 97.3% of $120.3K total Medicaid revenue, led by J0178 at $50.4K (41.9%), 67028 at $46.9K (39.0%), and 92134 at $19.7K (16.4%). The Medicaid portfolio mirrors the Medicare pattern with injections and retinal imaging comprising nearly all billed Medicaid activity.
Payer mix is heavily Medicare-weighted: lifetime Medicare revenue is $3.2M versus Medicaid revenue of $120.3K, showing Medicare is the dominant payer in scale for this clinician. From a contracting and utilization-management perspective, Medicare trends will drive overall revenue and utilization patterns far more than Medicaid.
Competitive standing for the provider's highest-volume Medicare injection, J0178, is strong: J0178 is $2.1M of revenue and ranks #178 of 3204 providers nationally (94th percentile), described in the source as "notably above typical" national volume. Similarly, retinal imaging 92134 shows unusually high Medicare activity (2.1K claims, $58K, ranks #903 of 26868, 97th percentile and described as "notably above typical"), indicating regional prominence in diagnostic imaging and aflibercept administration on Medicare. Conversely, Medicaid rankings for J0178 (#8/9 in-state, 13th percentile) show this provider is not a leading in-state Medicaid supplier of that drug despite high Medicaid dollar share.
E/M and clinic visit codes are present at meaningful volume relative to peers: 99213 has 650 Medicare claims ($39K, 96th percentile, described as "notably above typical"), and 99214 has 422 Medicare claims ($38K, 87th percentile). This pattern suggests substantial follow-up and management of chronic retinal conditions in-office in addition to procedural throughput.
Surgical retina procedures are present but represent a small share of Medicare revenue and volume: example surgical codes include 67108 ($21.7K, 25 claims), 67036 ($17.6K, 29 claims), and 67042 ($11.2K, 14 claims), each accounting for under 1% of Medicare revenue. The low claim counts and revenue share imply the practice focuses primarily on outpatient injections and diagnostic imaging rather than frequent complex retinal surgery.
Across both payers the provider shows a business model centered on intravitreal biologic administration and retinal imaging: high-dollar biologic J0178 and imaging code 92134 together drive a large portion of billed services, consistent with a clinic that manages exudative retinal disease (e.g., AMD/diabetic macular edema) through repeat intravitreal therapy and diagnostic follow-up. Contracting, utilization review, and network placement strategies should prioritize injection capacity, biologic procurement/pricing, and outpatient imaging access given these concentration signals.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
19 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 3,050 | $690 | $2.1M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 18,300 | $30 | $530.7K |
| 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 | $90 | $155K |
| J2778 | Injection, ranibizumab, 0.1 mg | 520 | $190 | $95.6K |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 510 | $160 | $80.7K |
| 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. | 2,150 | $30 | $58K |
| 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… | 650 | $60 | $39K |
| 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… | 420 | $90 | $38K |
| 67108 | The provider repairs a detached retina using heat produced by a laser beam or by freezing the tissues. He may attach a scleral buckle to simplify the passage of fluid through and behind the retina or… | 30 | $870 | $21.6K |
| 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. | 30 | $610 | $17.6K |
Showing 1–10 of 19
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
19 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 5 | 40 | 870 | $690 | $858.5K |
| J2777 | 7 | 30 | 11,040 | $30 | $399.1K |
| J2778 | 11 | 20 | 700 | $180 | $148.3K |
| 67028 | 9 | 50 | 650 | $90 | $72.9K |
| J7312 | 2 | 10 | 190 | $160 | $43.9K |
| 67036 | 7 | 20 | 20 | $910 | $28.1K |
| 67042 | 9 | 10 | 20 | $1,170 | $23.4K |
| 67108 | 5 | 10 | 20 | $1,010 | $23.2K |
| J3590 | 27 | 40 | 160 | $60 | $17K |
| 99214 | 841 | 7,230 | 110 | $70 | $14.1K |
Showing 1–10 of 19
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.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 40 | $1,200 | $50.4K |
| 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. | 330 | $140 | $46.9K |
| 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. | 660 | $30 | $19.7K |
| 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… | 50 | $30 | $1.8K |
| J9035 | Injection, bevacizumab, 10 mg | 20 | $60 | $1.4K |
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
5 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 8 | 10 | 210 | $640 | $1.4M |
| 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… | 2,879 | 3,340 | 1,020 | $30 | $296K |
| 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. | 17 | 30 | 350 | $70 | $165.3K |
| J9035 | Injection, bevacizumab, 10 mg | 15 | 20 | 120 | $130 | $96.1K |
| 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. | 22 | 70 | 210 | $20 | $29.2K |
Other providers in the same ZIP code as Blake Isernhagen, ranked by combined Medicare and Medicaid revenue.
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