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NPI 1467510826 · Tacoma, WA · Ophthalmology Physician
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Hsushi Yeh is a ophthalmology physician provider located in Tacoma, Washington. This profile covers 13 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 | Hsushi Yeh |
| Address | 1311 South Union Avenue |
| City | Tacoma |
| State | WA |
| ZIP | 98405 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | December 5, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.5M |
| Medicaid | $953K |
This provider has a clear payer mix skew toward Medicare by scale: total Medicare revenue is $2.5M versus total Medicaid revenue of $953K, so the practice generates materially more revenue from Medicare than from Medicaid and is not effectively single-payer. Both payers are active in the billing profile, but Medicare drives the larger share of lifetime revenue.
Revenue is highly concentrated in a few codes on both payers. The top three Medicare codes by revenue account for 90.4% of the provider's Medicare revenue, and the top three Medicaid codes by revenue account for 78.6% of the provider's Medicaid revenue; in particular, J0178 alone represents 79.3% of Medicare revenue and 50.5% of Medicaid revenue, indicating heavy reliance on that single drug code.
The code mix (J0178, 67028, 92134 as leading Medicare codes and J0178, 67028, J9035 leading Medicaid codes) indicates a retina-focused practice model centered on intravitreal pharmacologic therapy and high-throughput retinal imaging. High-volume procedure codes for injections (J0178, 67028, J9035) together with large claim counts for retinal imaging (92134) are consistent with a practice operating as an anti-VEGF injection service with accompanying OCT diagnostics.
On Medicare the provider is a high-volume national participant for its top retina services: J0178 ranks #210 of 3204 providers nationally (93th percentile; notably above typical national volume for this code) and 92134 ranks #290 of 26868 providers nationally (99th percentile; extreme outlier, far above typical national volume for this code). These ranks indicate the provider is a major national outlier on retinal imaging volume and an above-typical national contributor for aflibercept administration.
State-level competitive standing is mixed across medications: for Medicaid J9035 (bevacizumab) the provider ranks #2 of 33 in-state (97th percentile; notably above typical state volume for this code), positioning it as a leading in-state user of bevacizumab, whereas for J0178 the Medicaid rank is #15 of 26 (44th percentile; typical, unremarkable volume for this code), so the provider is comparatively less dominant in-state for aflibercept. This suggests the practice uses both branded and compounded/cheaper anti-VEGF agents with different competitive roles across payers.
Payment and utilization patterns differ between payers for the same drugs, which has operational implications. For J0178 the average paid/claim is $685 on Medicare and $1101 on Medicaid as reported, and the provider submitted 2.8K Medicare claims and 436 Medicaid claims for J0178, indicating both payer-specific pricing and differential utilization that should be considered in contracting or cost-management reviews.
High imaging throughput is evident across payers and likely represents a significant operational capacity: the provider reported 3.3K Medicare claims for 92134 (rank #290 of 26868 nationally, 99th percentile; extreme outlier) and 6K Medicaid claims for 92134 in-state (rank #15 of 100, 86th percentile), underscoring sustained, heavy use of retinal OCT diagnostics that supports frequent intravitreal treatment visits. This pattern implies investment in imaging equipment and workflow optimized for retina disease management.
The provider has long tenure in the NPI file, enumerated on 2006-12-05 (~20 years ago), which, combined with concentrated high-volume billing in retina-related codes, suggests an established specialty practice with an operational focus on intravitreal injections and retinal imaging rather than a general ophthalmology mix. That longevity and focused revenue profile is relevant when assessing referral relationships, network value, and capacity for retina services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
13 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2,840 | $690 | $1.9M |
| 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. | 1,820 | $100 | $173.3K |
| 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. | 3,290 | $30 | $98.8K |
| 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… | 820 | $90 | $69.5K |
| 92012 | For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any… | 810 | $60 | $50.3K |
| J9035 | Injection, bevacizumab, 10 mg | 560 | $50 | $30.4K |
| 92004 | The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits. | 180 | $100 | $18.1K |
| 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… | 20 | $900 | $17K |
| 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 | $890 | $16.1K |
| 67108 | The provider repairs a detached retina using heat produced by a laser beam or by freezing the tissues. He may attach a scleral buckle to simplify the passage of fluid through and behind the retina or… | 20 | $930 | $13.9K |
Showing 1–10 of 13
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
13 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 3 | 90 | 470 | $680 | $597.2K |
| 67028 | 13 | 110 | 550 | $90 | $72.9K |
| 67042 | 24 | 40 | 30 | $1,190 | $39.2K |
| 67108 | 11 | 20 | 20 | $1,180 | $29.6K |
| 67041 | 1 | 10 | 20 | $1,150 | $19.5K |
| 92014 | 27 | 790 | 110 | $80 | $16.8K |
| 92012 | 12 | 220 | 70 | $70 | $12.9K |
| J9035 | 6 | 40 | 70 | $50 | $10.9K |
| 92235 | 23 | 50 | 50 | $110 | $8.3K |
| 92134 | 2 | 700 | 70 | $30 | $7.6K |
Showing 1–10 of 13
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 |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 440 | $1,100 | $480K |
| 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. | 3,570 | $40 | $135.8K |
| J9035 | Injection, bevacizumab, 10 mg | 2,630 | $50 | $131.3K |
| 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. | 5,990 | $10 | $83.9K |
| 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… | 940 | $40 | $39.4K |
| 92012 | For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any… | 1,060 | $30 | $33.9K |
| 92004 | The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits. | 510 | $60 | $32.8K |
| 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… | 750 | $10 | $6.8K |
| 92225 | N/A | 600 | $10 | $5.4K |
| 92202 | 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… | 170 | $10 | $860 |
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How this provider's Medicaid billing volume and revenue compare to other Washington providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Washington median
11 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 15 | 30 | 550 | $930 | $892.3K |
| J9035 | Injection, bevacizumab, 10 mg | 2 | 30 | 420 | $190 | $160.8K |
| 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. | 13 | 60 | 710 | $40 | $81.7K |
| 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… | 149 | 480 | 290 | $60 | $65.2K |
| 92004 | The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits. | 215 | 580 | 240 | $70 | $57.3K |
| 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. | 15 | 100 | 240 | $10 | $22.2K |
| 92012 | For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any… | 11 | 70 | 130 | $30 | $16.1K |
| 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,… | 168 | 180 | 140 | $20 | $10.6K |
| 92202 | 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… | 8 | 10 | 810 | $10 | $5.6K |
| 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… | 2 | 10 | 390 | $10 | $3.3K |
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Other providers in the same ZIP code as Hsushi Yeh, ranked by combined Medicare and Medicaid revenue.
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