NPI 1467409383 — Billing Profile & Reimbursement Data
NPI 1467409383 · XX · healthcare
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NPI 1467409383 is a healthcare provider located in Unspecified Location. 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. 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 1467409383 |
| Address | |
| City | |
| State | XX (Unspecified Location) |
| ZIP | |
| Taxonomy | N/A |
| NPI Enumerated | |
| NPI Deactivated | August 7, 2024 |
(source: CMS Medicare & Medicaid claims data)
Key Findings
This provider’s billing is effectively single‑payer Medicare: total Medicare revenue is $4.4M and there is no Medicaid billing on file. The top three Medicare codes account for 89.3% of the provider’s Medicare revenue, indicating heavy dependence on a narrow set of services for revenue generation.
The code mix points to a retina/ophthalmology practice built around intravitreal biologic injections and retinal diagnostics. The highest‑revenue codes are J2777, J0178, and J2778 (all intravitreal biologics) alongside procedure and imaging codes such as 67028 (intravitreal injection procedure) and 92134 (retinal imaging), which supports an operational model centered on in‑office drug administration and retinal disease management.
Revenue is highly concentrated: generated $2.9M (66.2% of Medicare revenue), generated $724.9K (16.7%), and generated $280.4K (6.4%); together the top three codes represent 89.3% of Medicare revenue. That concentration suggests material exposure to changes in utilization, reimbursement, or drug mix for these specific biologics.
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 Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 99,420 | $30 | $2.9M |
| J0178 | Injection, aflibercept, 1 mg | 1,050 | $690 | $724.9K |
| J2778 | Injection, ranibizumab, 0.1 mg | 1,520 | $180 | $280.4K |
| 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. | 2,180 | $80 | $178.8K |
| 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. | 2,600 | $30 | $70.2K |
| J3590 | Unclassified biologics | 170 | $280 | $49.4K |
| 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… | 590 | $80 | $44.7K |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 270 | $160 | $42.9K |
| 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… | 280 | $80 | $22.3K |
| 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… | 380 | $60 | $21.2K |
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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 17 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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