NPI 1437574191 — Billing Profile & Reimbursement Data
NPI 1437574191 · XX · healthcare
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NPI 1437574191 is a healthcare provider located in Unspecified Location. This profile covers 12 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. Note: "XX" is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; claims coded under it are grouped and benchmarked here the same way a traditional state would be.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | NPI 1437574191 |
| Address | |
| City | |
| State | XX (Unspecified Location) |
| ZIP | |
| Taxonomy | N/A |
| NPI Enumerated | |
| NPI Deactivated | November 4, 2024 |
(source: CMS Medicare & Medicaid claims data)
Key Findings
Practice profile: The provider’s Medicare billing is concentrated in ophthalmic surgery consistent with an ambulatory cataract and eye-surgery practice — the top Medicare code is 66984 (cataract extraction with intraocular lens) and the code mix also includes glaucoma procedures (66174, 66180) and posterior-segment surgery (67036, 67042, 67113), indicating both anterior- and posterior-segment surgical services are performed.
Medicare revenue concentration: Medicare accounts for $1.4M of recorded lifetime revenue and the top 3 Medicare codes account for 86.9% of that Medicare revenue; specifically 66984 generates $1.1M (75.1%), generates $115.1K (8.2%), and generates $50.7K (3.6%).
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.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 66984 | The 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… | 1,400 | $760 | $1.1M |
| 66174 | The provider expands the aqueous outflow (drainage) canal of the eye to help relieve pressure in the eye. The procedure does not include leaving a device or stent in place. | 80 | $1,370 | $115.1K |
| 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. | 40 | $1,370 | $50.7K |
| 66180 | The provider implants a shunt in the anterior chamber of the eye to facilitate drainage of aqueous humor, or fluid, in order to reduce intraocular pressure. He uses a graft to reinforce the tissue… | 20 | $1,820 | $38.2K |
| 67042 | In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina… | 20 | $1,350 | $32.5K |
| 67113 | The provider repairs a complicated detached retina. He removes vitreous humor, the gelatinous material that gives shape to the eye, and peels the retinal membrane. He reattaches the retina with… | 20 | $1,370 | $21.9K |
| 66991 | The provider inserts an intraocular lens prosthesis during the same session as extracapsular cataract extraction. The provider also inserts one or more anterior segment aqueous drainage devices in… | 70 | $270 | $18.7K |
| 67900 | The provider repairs a drooping eyebrow due to muscle weakness or paralysis, to improve cosmetic appearance or remove the obstruction to a patient’s vision. He makes an incision immediately above the… | 50 | $410 | $18.3K |
| 15823 | In this procedure, the provider surgically trims excessive skin that weighs down the upper eyelid, typically to improve the cosmetic appearance of the face and due to the interference of the tissue… | 50 | $380 | $16.9K |
| 66710 | The provider destroys a portion of ciliary body using a laser beam. This procedure decreases the fluid production in the eye, thereby decreasing intraocular pressure. | 20 | $630 | $14.5K |
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Medicare: Competitive Analysis & Benchmarks
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes. Note: this provider's state, "XX," is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; the State panel below benchmarks against other providers coded under the same designation.
View: State1 / 2
Full comparison — all codes billed, vs. state median
Frequently Asked Questions
References
- 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
- 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.
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