Loading...
NPI 1356316855 · Des Plaines, IL · Retina Specialist (Ophthalmology) Physician
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Enrique Garcia-valenzuela is a retina specialist (ophthalmology) physician provider located in Des Plaines, Illinois. This profile covers 28 Medicare and 11 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 | Enrique Garcia-valenzuela |
| Address | 8901 W. Golf Road |
| City | Des Plaines |
| State | IL |
| ZIP | 60016 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | February 20, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.2M |
| Medicaid | $129.5K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
28 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1,170 | $690 | $806.3K |
| 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… | 3,040 | $100 | $291.6K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 9,660 | $30 | $280.1K |
| 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. | 1,350 | $110 | $144.4K |
| 67210 | The provider destroys a lesion of the retina using a laser beam that heats up the tissue. | 260 | $420 | $111.9K |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 680 | $160 | $107.3K |
| 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. | 2,900 | $30 | $90K |
| 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… | 540 | $110 | $59K |
| J9035 | Injection, bevacizumab, 10 mg | 890 | $50 | $47K |
| 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… | 140 | $270 | $36.9K |
Showing 1–10 of 28
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 28 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
28 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 46 | 140 | 700 | $690 | $688.4K |
| J2777 | 41 | 90 | 9,180 | $30 | $451K |
| 67028 | 38 | 190 | 400 | $90 | $64.4K |
| J7312 | 2 | 30 | 240 | $160 | $45.1K |
| 92014 | 5 | 1,420 | 130 | $80 | $24.7K |
| J9035 | 11 | 130 | 140 | $60 | $24.6K |
| 67210 | 1 | 20 | 30 | $410 | $22K |
| 67042 | 39 | 50 | 20 | $870 | $21.8K |
| 66821 | 323 | 370 | 50 | $70 | $16.4K |
| 67113 | 1 | 10 | 20 | $670 | $15.5K |
Showing 1–10 of 28
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.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | 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… | 2,310 | $20 | $44K |
| 92226 | N/A | 1,190 | $20 | $27.3K |
| 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. | 240 | $70 | $16.6K |
| 92201 | 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… | 1,640 | $10 | $14.8K |
| 92225 | N/A | 520 | $20 | $9.4K |
| 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. | 1,530 | $10 | $9.2K |
| 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,… | 200 | $10 | $2.8K |
| 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… | 130 | $20 | $2K |
| J9035 | Injection, bevacizumab, 10 mg | 80 | $20 | $1.8K |
| 67210 | The provider destroys a lesion of the retina using a laser beam that heats up the tissue. | 10 | $60 | $880 |
Showing 1–10 of 11
How this provider's Medicaid billing volume and revenue compare to other Illinois providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Illinois median
11 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. | 80 | 120 | 540 | $160 | $166.3K |
| 67210 | The provider destroys a lesion of the retina using a laser beam that heats up the tissue. | 7 | 10 | 100 | $310 | $83.8K |
| 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… | 217 | 1,230 | 450 | $40 | $54.1K |
| J9035 | Injection, bevacizumab, 10 mg | 59 | 80 | 290 | $60 | $43.4K |
| 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,… | 135 | 310 | 140 | $30 | $25.5K |
| 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. | 70 | 250 | 510 | $20 | $20.1K |
| 92226 | N/A | 15 | 50 | 430 | $20 | $19.5K |
| 92225 | N/A | 8 | 40 | 90 | $30 | $14.6K |
| 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 | 10 | 110 | $40 | $8.1K |
| 92201 | 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… | 5 | 50 | 110 | $10 | $5K |
Showing 1–10 of 11
Other providers in the same ZIP code as Enrique Garcia-valenzuela, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| City Of Desplaines | IL | Land Ambulance | $784.7K | $13.1M |
| Access Community Health Network | IL | Federally Qualified Health Center (FQHC) | $0 | $11.9M |
| Med Rush Clinical Lab Inc | IL | Clinical Medical Laboratory | $2.4M | $9.3M |
| Presence Home Care | IL | Home Health Agency | $0 | $7.3M |
| Alan Hirsch | IL | Neurology Physician | $50.8K | $3.8M |
| Srikanth Ravindran | IL | Family Medicine Physician | $198.8K | $3.4M |
| North Maine Fire Protection District | IL | Land Ambulance | $163.2K | $3.3M |
| George Wyhinny | IL | Retina Specialist (Ophthalmology) Physician | $2.9M | $33.9K |
| John Galasso | IL | Retina Specialist (Ophthalmology) Physician | $1.6M | $1.2M |
| Daniel Alter | IL | Retina Specialist (Ophthalmology) Physician | $2.7M | $9K |
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.