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NPI 1467423517 · Dakota Dunes, SD · Ophthalmology Physician
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Beth Bruening is a ophthalmology physician provider located in Dakota Dunes, South Dakota. This profile covers 23 Medicare and 3 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 | Beth Bruening |
| Address | 101 Tower Rd Ste 300 |
| City | Dakota Dunes |
| State | SD |
| ZIP | 57049 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | January 27, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $704.9K |
| Medicaid | $2.2K |
This provider’s business is overwhelmingly Medicare-facing: total Medicare revenue is $704.9K compared with just $2.2K in Medicaid revenue, so the practice is effectively single-payer in scale with Medicare as the dominant revenue source. The Medicaid activity that does exist is small and largely limited to optical supplies rather than clinical procedures, indicating minimal participation in the state’s Medicaid clinical volume.
Revenue is highly concentrated in a small set of services: the precomputed top 3 Medicare codes account for 73.8% of Medicare revenue and the top 3 Medicaid codes account for 100.0% of Medicaid revenue. For Medicare the three revenue drivers are J0178, 99214, and 66984, which together dominate the payer dollars received and shape the practice’s operational focus.
J0178 (injection, aflibercept, 1 mg) is the single largest Medicare revenue driver at $370.4K (52.6% of Medicare revenue) with 536 claims, reflecting a practice that delivers a high volume of intravitreal anti-VEGF therapy consistent with retina-focused services; this code’s national standing is described as typical, unremarkable volume for this code (rank #1853 of 3204, 42th percentile).
99214 (established office visit, moderate MDM/≥30 minutes) is notable for being an extreme outlier: 1.1K claims producing $87.4K (12.4% of Medicare revenue), ranked in the 98th percentile nationally and labeled an "extreme outlier, far above typical national volume for this code." This suggests unusually high E/M intensity or high follow-up visit volume relative to peers, which has implications for staffing, scheduling, and chronic disease management workload.
66984 (cataract extraction with IOL) is a meaningful surgical component of the practice (161 claims, $62K, 8.8% of Medicare revenue) and is characterized as a typical, unremarkable volume for this code (rank #6203 of 15965, 61th percentile). The presence of cataract surgery revenue alongside J0178-driven retinal injections indicates a mixed procedure-based ophthalmology practice that spans both anterior- and posterior-segment services.
The provider shows heavy use of diagnostic imaging and testing that supports medical retina and glaucoma workflows: 92134 (retinal imaging) generated 899 claims and $25.2K (3.6% of Medicare revenue) and is characterized as typical, unremarkable volume for this code (91th percentile), while 92133 (optic nerve OCT) produced 356 claims and $8.5K and is labeled "notably above typical national volume for this code" (95th percentile). These imaging patterns reinforce a clinical emphasis on detailed retinal and optic nerve monitoring.
Medicaid activity is almost entirely retail optical codes: V2020 (frames) accounts for $1.9K and 85.6% of the provider’s Medicaid revenue, with V2103 and V2756 making up the remainder; the precomputed statement that the top 3 Medicaid codes account for 100.0% of Medicaid revenue underscores that Medicaid billing is concentrated in durable optical goods rather than advanced clinical procedures. In-state ranks for these codes are modest (for example V2020 ranks #89 of 110, 18th percentile), indicating the provider is not a major Medicaid supplier of optical services in the state.
The provider has an established practice history with an NPI enumerated on 2006-01-27 (~20 years ago), supporting a long-tenured presence in the local market. Overall competitive standing is mixed: while total Medicare revenue ($704.9K) and several procedure codes reflect a modest-to-moderate practice scale, the extreme outlier status on 99214 and notably above-typical volumes on select imaging codes point to specific service areas where this provider operates at well-above-average intensity relative to national peers.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
23 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 540 | $690 | $370.4K |
| 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… | 1,080 | $80 | $87.4K |
| 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… | 160 | $390 | $62K |
| 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… | 370 | $90 | $32.5K |
| 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. | 390 | $80 | $30K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 120 | $220 | $26.3K |
| 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. | 900 | $30 | $25.2K |
| 92083 | The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for an extended… | 310 | $40 | $12.8K |
| 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… | 120 | $100 | $11.3K |
| 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… | 190 | $60 | $11.2K |
Showing 1–10 of 23
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 23 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
23 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 9 | 10 | 690 | $690 | $788.7K |
| 67028 | 11 | 10 | 740 | $90 | $108.5K |
| 66984 | 24 | 130 | 40 | $410 | $67.7K |
| 66821 | 16 | 30 | 100 | $230 | $35.6K |
| 92014 | 30 | 200 | 170 | $80 | $17.1K |
| J9035 | 2 | 10 | 250 | $50 | $13.6K |
| 99214 | 12 | 1,660 | 90 | $70 | $11.4K |
| 92136 | 15 | 30 | 210 | $30 | $9.2K |
| 65855 | 11 | 10 | 40 | $150 | $8.6K |
| 99213 | 316 | 1,710 | 80 | $50 | $6.4K |
Showing 1–10 of 23
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
How this provider's Medicaid billing volume and revenue compare to other South Dakota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. South Dakota median
Other providers in the same ZIP code as Beth Bruening, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Cnos PC | SD | Orthopaedic Surgery Physician | $0 | $3.6M |
| Dunes Dental 4 Kids, LLP | SD | Pediatric Dentistry | $0 | $3.3M |
| Chad Laurich | SD | Vascular Surgery Physician | $3.2M | $0 |
| Liem Som Oei Md PC | SD | Nephrology Physician | $0 | $2.4M |
| Ear Nose And Throat Consultants And Hearing Services Plc | SD | Otolaryngology Physician | $0 | $2.2M |
| Oral Surgery Assocates, P.C. | SD | Oral and Maxillofacial Surgery (Dentist) | $0 | $2.1M |
| Dunes Anesthesia PC | SD | Pain Medicine (Anesthesiology) Physician | $0 | $1.1M |
| Midlands Clinic, P.C. | SD | Specialist | $0 | $822.9K |
| Dunes Medical Laboratories | SD | Clinical Medical Laboratory | $303K | $416.6K |
| Neal Khurana | SD | Vascular & Interventional Radiology Physician | $704.3K | $0 |
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