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NPI 1356640726 · Neenah, WI · Retina Specialist (Ophthalmology) Physician
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Khalid Kahook is a retina specialist (ophthalmology) physician provider located in Neenah, Wisconsin. This profile covers 16 Medicare and 1 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 | Khalid Kahook |
| Address | 200 Theda Clark Plaza |
| City | Neenah |
| State | WI |
| ZIP | 54956 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | March 24, 2011 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.8M |
| Medicaid | $390 |
Medicare dominates this provider's pay mix: total Medicare revenue is $1.8M versus total Medicaid revenue of $387, so the practice is effectively Medicare‑driven with negligible Medicaid volume reported. The Medicaid total ($387) is immaterial relative to Medicare and consists almost entirely of a single code in-state.
Revenue is highly concentrated in a narrow set of retinal injection codes on Medicare: the precomputed top three Medicare codes account for 90.2% of Medicare revenue, led by J0178 ($1.3M, 69.7%), followed by J2777 ($247K, 13.4%) and 67028 ($131.1K, 7.1%). This concentration indicates the provider’s financial exposure and dependence on intravitreal injection therapies.
The code mix and volumes point to a procedural, retina-focused practice model: J0178 (1.9K claims, $682 avg paid/claim) and J2777 (8.8K claims, $28 avg paid/claim) are the primary revenue drivers and 67028 (1.5K claims, $90 avg paid/claim) is the principal procedure code, while typical E/M codes such as 99214 (176 claims, $15.7K) and 92014 (326 claims, $26.1K) contribute relatively small shares of revenue. Together, these patterns are consistent with a retina specialist whose patient encounters are centered on diagnostic imaging and repeated intravitreal injections rather than high volumes of office E/M care.
Competitive standing for the main drug and injection codes is modest nationally: J0178 ranks #591 of 3204 providers (82th percentile) and is characterized as a typical, unremarkable volume; J2777 ranks #1095 of 2039 (46th percentile; typical, unremarkable volume); and 67028 ranks #837 of 4255 (80th percentile; typical, unremarkable volume). In short, the provider is an active but not dominant national participant for the high‑revenue injection codes.
Diagnostic imaging (92134) is an outlier relative to peers: on Medicare 92134 has 2.1K claims, $29 avg paid/claim and $61.3K revenue (3.3% of Medicare revenue) and ranks #934 of 26868 providers (97th percentile), described as notably above typical national volume. By contrast, 92134 accounts for $384 (100.0% of this provider's Medicaid revenue) in Medicaid filings (12 claims, $32 avg paid/claim) and ranks #50 of 52 in-state (0th percentile; typical, unremarkable volume), highlighting a disparity between strong national imaging volume and minimal in‑state Medicaid participation.
Medicaid activity is essentially absent in practical terms: total Medicaid revenue is $387 with the precomputed statement that the top three Medicaid codes account for 100.0% of Medicaid revenue; the listed Medicaid activity is all 92134 (12 claims, $384). This suggests the provider either bills very few Medicaid patients or bills Medicaid for a very limited set of diagnostic services.
The provider has an established tenure: NPI enumerated on 2011-03-24 (~15 years ago), indicating a stable presence in the market long enough to develop a procedure‑centric retinal practice and the referral patterns that sustain recurrent anti‑VEGF injection volumes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
16 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1,880 | $680 | $1.3M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 8,820 | $30 | $247K |
| 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. | 1,460 | $90 | $131.1K |
| 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. | 2,120 | $30 | $61.3K |
| J9035 | Injection, bevacizumab, 10 mg | 620 | $50 | $32.6K |
| 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… | 330 | $80 | $26.1K |
| 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… | 180 | $90 | $15.7K |
| 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… | 10 | $790 | $11K |
| 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 | $9.7K |
| 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… | 140 | $60 | $8.4K |
Showing 1–10 of 16
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
16 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 3 | 60 | 440 | $690 | $488.1K |
| J2777 | 9 | 30 | 7,290 | $30 | $332K |
| 67028 | 8 | 110 | 310 | $80 | $43.7K |
| 67041 | 11 | 20 | 20 | $960 | $20.2K |
| J9035 | 8 | 70 | 110 | $50 | $14.5K |
| 92014 | 122 | 720 | 120 | $70 | $12.9K |
| 99214 | 2,249 | 9,800 | 80 | $70 | $9.2K |
| 67228 | 7 | 10 | 30 | $240 | $7.3K |
| 92012 | 120 | 160 | 50 | $60 | $5.1K |
| 92134 | 5 | 600 | 60 | $30 | $4.7K |
Showing 1–10 of 16
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.
1 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. | 10 | $30 | $380 |
How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Wisconsin median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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. | 50 | 50 | 410 | $10 | $20.9K |
Other providers in the same ZIP code as Khalid Kahook, ranked by combined Medicare and Medicaid revenue.
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