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NPI 1497075642 · Waterloo, IA · Ophthalmology Physician
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Thomas Petrie is a ophthalmology physician provider located in Waterloo, Iowa. This profile covers 24 Medicare and 1 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 | Thomas Petrie |
| Address | 909 E San Marnan Dr |
| City | Waterloo |
| State | IA |
| ZIP | 50702 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | June 9, 2010 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.2M |
| Medicaid | $330 |
This provider’s business is overwhelmingly Medicare-facing: lifetime Medicare revenue is $1.2M versus just $326 in Medicaid revenue, so the practice is effectively single‑payer with Medicare as the dominant source of reimbursed services. The Medicaid activity that does exist is entirely V2020 frames purchases (100.0% of Medicaid revenue), which indicates no substantive Medicaid clinical billing on file beyond eyewear transactions.
Revenue concentration on Medicare is high and dominated by intravitreal biologics: the precomputed top‑3 Medicare codes account for 65.0% of Medicare revenue, led by J2777 (faricimab) at $469.8K and 40.6% of Medicare revenue, followed by J0178 (aflibercept) at $161.9K and J2778 (ranibizumab) at $120K. This concentration shows the practice’s revenue is driven primarily by high‑cost retinal drug injections rather than broad primary eyecare or surgical volume.
The top revenue codes signal a retina‑focused medical practice model: J2777, J0178, J2778, and biosimilar Q5124 are all intravitreal injection products used to treat retinal disease, and the presence of high counts for 67028 (609 claims) and diagnostic imaging codes such as 92134 (918 claims) reinforce a workflow centered on injections, retinal imaging, and follow‑up management. Cataract procedure codes (66984, 66982) and E/M codes (92014, 99214/99213) appear at lower revenue levels, suggesting the provider performs some surgical and general ophthalmology work but that these are not the primary revenue drivers.
Competitive standing for the lead biologic is modest: J2777 generates $469.8K (40.6% of Medicare revenue) but ranks #661 of 2039 providers nationally (68th percentile; typical, unremarkable volume for this code), indicating above‑median use but not a dominant national position. By contrast, J0178 ranks #2485 of 3204 (22th percentile; typical, unremarkable volume for this code), signaling relatively low national volume for aflibercept in this provider’s mix despite its role among the top three Medicare revenue drivers.
Biosimilar adoption is visible but occurs in a smaller national cohort: Q5124 (ranibizumab‑nuna, biosimilar) produced $117.1K (10.1% of Medicare revenue) and ranks #50 of 122 providers nationally (60th percentile; typical, unremarkable volume for this code), which suggests the provider uses biosimilar ranibizumab at a rate above many peers within the limited set of clinicians billing that specific code. That pattern may reflect formulary choices or local payer coverage that make biosimilar use practical for a portion of retinal injections.
Imaging and office visit volumes are comparatively high versus many peers: 92134 (retinal imaging) has 918 claims and $24.8K revenue, ranking #2300 of 26868 providers nationally (91th percentile; typical, unremarkable volume for this code), and established‑patient E/M 99213 ranks #36348 of 457151 (92th percentile; typical, unremarkable volume for this code). Those percentiles, paired with the injection volume, point to a clinic workflow that pairs frequent imaging and routine follow‑up visits with intravitreal therapy management.
Medicaid activity is vanishingly small and concentrated in eyewear sales: the single Medicaid code on file, V2020 (frames, purchases), accounts for 100.0% of Medicaid revenue with $325 and 13 claims, and ranks #407 of 417 in‑state (1th percentile; typical, unremarkable volume for this code). For payers evaluating network adequacy or Medicaid access, this provider should be considered essentially absent from Medicaid clinical billing and service delivery.
The provider has an established practice history by NPI enumeration: NPI enumerated (registered) 2010-06-09 (~16 years ago), indicating long tenure in the Medicare program. This length of enrollment combined with a concentrated retinal injection profile suggests a stable, specialty‑oriented practice rather than a new or broad primary‑care ophthalmology entrant.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
24 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 16,200 | $30 | $469.8K |
| J0178 | Injection, aflibercept, 1 mg | 230 | $690 | $161.9K |
| J2778 | Injection, ranibizumab, 0.1 mg | 660 | $180 | $120K |
| Q5124 | Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg | 690 | $170 | $117.1K |
| 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… | 170 | $380 | $62.4K |
| 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. | 610 | $90 | $52.4K |
| 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… | 470 | $80 | $36.9K |
| 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. | 920 | $30 | $24.8K |
| 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… | 300 | $80 | $24.4K |
| 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… | 420 | $60 | $24.3K |
Showing 1–10 of 24
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 24 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
24 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J2777 | 18 | 20 | 43,140 | $30 | $1.7M |
| J0178 | 31 | 40 | 640 | $690 | $760.2K |
| J2778 | 11 | 20 | 780 | $180 | $259.9K |
| Q5124 | 3 | 10 | 740 | $170 | $130.5K |
| 67028 | 23 | 60 | 420 | $80 | $80.6K |
| 66984 | 55 | 340 | 50 | $340 | $50.4K |
| 66982 | 50 | 60 | 40 | $450 | $39K |
| 15823 | 17 | 20 | 30 | $520 | $29.4K |
| 92014 | 89 | 500 | 200 | $70 | $19.8K |
| 99214 | 1,012 | 4,690 | 100 | $70 | $14.4K |
Showing 1–10 of 24
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.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| V2020 | Frames, purchases | 10 | $30 | $330 |
How this provider's Medicaid billing volume and revenue compare to other Iowa providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Iowa median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| V2020 | Frames, purchases | 407 | 420 | 420 | $20 | $22.3K |
Other providers in the same ZIP code as Thomas Petrie, ranked by combined Medicare and Medicaid revenue.
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