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    OpenPayerNPI Medicare & MedicaidWest Eye Specialists, LLC
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    West Eye Specialists, LLC — Billing Profile & Reimbursement Data

    NPI 1477083459 · Mayaguez, PR · Retina Specialist (Ophthalmology) Physician

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    West Eye Specialists, LLC is a retina specialist (ophthalmology) physician provider located in Mayaguez, Puerto Rico. This profile covers 0 Medicare and 19 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationWest Eye Specialists, LLC
    Address#2625 Ave Hostos
    CityMayaguez
    StatePR
    ZIP00682
    TaxonomyRetina Specialist (Ophthalmology) Physician
    NPI EnumeratedJune 13, 2017

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$2.3M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    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

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    19 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    67028The 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.3,800$140$527.9K
    92014An 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…3,200$110$335.9K
    92012For 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…5,870$50$311.2K
    92134The 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.13,020$20$286.5K
    67228In retinopathy, tiny new vessels grow profusely and fibrous tissue proliferates in between the layers of the retina, which may extend into the optic nerve and vitreous, clear gel that fills the space…410$510$211.3K
    92202The 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…9,430$20$207.4K
    92002The provider performs an intermediate level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program.2,200$50$108K
    C9257Injection, bevacizumab, 0.25 mg3,490$30$97.6K
    92004The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.440$120$54K
    92226N/A5,860$10$46.9K

    Showing 1–10 of 19

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Puerto Rico providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Puerto Rico median

    19 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J9035Injection, bevacizumab, 10 mg2320370$2,820$2.3M
    67210The provider destroys a lesion of the retina using a laser beam that heats up the tissue.61090$370$235.2K
    67028The 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.5301,090$130$222.2K
    67228In retinopathy, tiny new vessels grow profusely and fibrous tissue proliferates in between the layers of the retina, which may extend into the optic nerve and vitreous, clear gel that fills the space…210110$510$153.3K
    92012For 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…24350540$50$96.4K
    92014An 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…7120180$80$62.9K
    C9257Injection, bevacizumab, 0.25 mg320350$50$61.8K
    92134The 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.280650$20$43.1K
    92002The provider performs an intermediate level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program.55440370$40$38.5K
    92015The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.304530630$20$32K

    Showing 1–10 of 19

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with West Eye Specialists, LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Alberto GuardiolaPROphthalmology Physician$22.6K$83.8K

    Nearby Providers

    Other providers in the same ZIP code as West Eye Specialists, LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Mayaguez Medical Center Dr Ramon Emeterio Betances IncPRGeneral Acute Care Hospital$0$7.1M
    West Cardio General Anesthesia CspPRAnesthesiology Physician$0$2.3M
    Adriana Mendez SanchezPRNeurology with Special Qualifications in Child Neurology Physician$0$835.7K
    Hgr Paramedic Transport IncPRAmbulance$20K$722.4K
    Jose A. Cancio Md, C.s.p.PRSpecialist$0$624.1K
    Juan AlmodovarPROphthalmology Physician$11.3K$509.5K
    Myrna E Montalvo CastilloPRClinical Medical Laboratory$12.4K$393.2K
    Walgreen CoPRPharmacy$106.7K$0
    Monica Egozcue-dionisiPRPulmonary Disease Physician$11.5K$26K
    Hildamari Justiniano GarciaPRMOHS-Micrographic Surgery Physician$25.7K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Puerto Rico Providers
    5 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Puerto Rico Distribution
    West Eye Specialists, LLC — 4 of 18 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Puerto Rico