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    OpenPayerNPI Medicare & MedicaidSharon Richens
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    Sharon Richens — Billing Profile & Reimbursement Data

    NPI 1497769368 · St George, UT · Ophthalmology Physician

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    Sharon Richens is a ophthalmology physician provider located in St George, Utah. This profile covers 29 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.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationSharon Richens
    Address161 W 200 N
    CitySt George
    StateUT
    ZIP84770
    TaxonomyOphthalmology Physician
    NPI EnumeratedJuly 28, 2006

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

    Payer SourceTotal Paid
    Medicare$838.5K
    Medicaid$0

    Key Findings

    This provider’s Medicare footprint is the sole payer presence in the file: total Medicare revenue is $838.5K and there is no Medicaid billing on file. That payer concentration makes this effectively a single‑payer Medicare practice in the available data and means Medicaid-driven service lines or cross‑payer mix effects are not observable for this NPI.

    Revenue is highly concentrated in a few codes: the precomputed top 3 Medicare codes (J0178, J2777, and 66984) account for 65.0% of this provider’s total Medicare revenue. Individually those codes report $227K (27.2%) for J0178, $191.4K (22.9%) for J2777, and $125.2K (15.0%) for 66984, signaling that high-cost intravitreal medications and cataract surgery drive the majority of dollars.

    The code mix points to a retina-focused ophthalmology practice that also performs cataract surgery: high-revenue medical retina drugs (J0178 and J2777) sit alongside a substantial cataract procedure (66984) and retinal imaging (92134). Specific activity levels include 328 claims for J0178, 6.6K claims for J2777, 304 claims for 66984, and 547 claims for 92134, which together suggest routine intravitreal injection clinics supported by diagnostic imaging and surgical cataract volume.

    Despite the material revenue from anti‑VEGF and related intravitreal agents, the provider’s national ranking on these drug codes is modest: J0178 ranks #2247 of 3204 (30th percentile) and J2777 ranks #1325 of 2039 (35th percentile), both described as "typical, unremarkable volume" for these codes. In plain terms, the provider participates meaningfully in anti‑VEGF/faricimab administration locally but is not a national high‑volume outlier for these drugs.

    By contrast, procedural and diagnostic services show stronger competitive standing: 66984 (cataract/IOL insertion) ranks #3996 of 15965 (75th percentile) and 92134 (retinal imaging) ranks #3297 of 26868 (88th percentile), both labeled "typical, unremarkable volume" but positioned well above median peers. High E/M office visit volume (99214: 624 claims, $53K, rank #32987 of 479517, 93rd percentile) further supports that this provider delivers substantial face‑to‑face and ancillary diagnostic services beyond injections.

    The practice appears to adopt newer retina therapies and a range of intravitreal agents: in addition to J0178 and J2777, the file shows J2781 (pegcetacoplan, 510 claims, $61.2K, 7.3%) and smaller use of J9035 (bevacizumab, 52 claims, $2.9K). These entries indicate clinical adoption of multiple intravitreal treatment options rather than exclusive reliance on a single agent.

    Non-procedure chronic care and staffing codes are present at measurable but not dominant levels: 99426 appears with 71 claims ($3.3K) and 99427 with 17 claims ($629), and both ranks sit near mid/low percentiles (99426 rank #574 of 1130, 49th percentile; 99427 rank #363 of 408, 9th percentile). This suggests some integration of clinical staff–directed chronic care management alongside procedural workflows, but it is a secondary revenue stream compared with injections and surgery.

    The provider’s NPI was enumerated on 2006-07-28 (~20 years ago), indicating a long-tenured practice. Combined with the procedure, imaging, and injection profile, the tenure supports an established ophthalmology operation that balances outpatient retina injections, diagnostic imaging, and cataract surgery rather than a newly established or purely ambulatory injection clinic.

    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.

    29 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J0178Injection, aflibercept, 1 mg330$690$227K
    J2777Injection, faricimab‑svoa, 0.1 mg6,600$30$191.4K
    66984The 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…300$410$125.2K
    J2781Injection, pegcetacoplan, intravitreal, 1 mg510$120$61.2K
    99214The 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…620$90$53K
    66821The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.130$240$30.2K
    99213The 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…460$60$28.6K
    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.300$100$28.6K
    68761The provider places a plug to close off the lacrimal punctum and block excessive drainage of tears. He performs this procedure to treat dry eye syndrome.190$80$15.9K
    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…190$80$15.8K

    Showing 1–10 of 29

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 29 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    29 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J01782740620$690$683.2K
    J2777182013,140$30$523.9K
    J27811320960$120$126.6K
    669841915090$520$80.3K
    670283460440$90$61.7K
    9942721020$40$43.6K
    9942621040$40$33.6K
    6617461020$660$27.5K
    J90351010110$50$17.5K
    92014128330140$70$16.6K

    Showing 1–10 of 29

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Sharon Richens, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Ihc Health Services, Inc.UTChildren's Hospital$0$129.5M
    Ihc Health Services, Inc.UTGeneral Acute Care Hospital$0$68.7M
    Ihc Health Services, Inc.UTGeneral Acute Care Hospital$0$65.8M
    Ihc Health Services IncUTGeneral Acute Care Hospital$0$54.1M
    Ihc Health Services, Inc.UTGeneral Acute Care Hospital$0$44.3M
    Ihc Health Services IncUTHome Infusion Therapy Pharmacy$0$38.1M
    Ihc Health Services IncUTDurable Medical Equipment & Medical Supplies$0$26.9M
    Ihc Health Services IncUTGeneral Acute Care Hospital$0$25.3M
    Ihc Health Services, Inc.UTClinical Medical Laboratory$2.7M$17.9M
    Ihc Health Services, Inc.UTGeneral Acute Care Hospital$0$20.4M

    Nearby Providers

    Other providers in the same ZIP code as Sharon Richens, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    American Logistics, LLC.UTTransportation Broker$0$299.6M
    Southwest CenterUTMental Health Clinic/Center (Including Community Mental Health Center)$0$58.3M
    Red Rock Healthcare, Inc.UTHome Health Agency$0$27.3M
    Virgin River Healthcare, Inc.UTIn Home Supportive Care Agency$0$13.3M
    Crimson Heights LLCUTCommunity/Behavioral Health Agency$0$7.8M
    Southwest CenterUTSubstance Use Disorder Rehabilitation Clinic/Center$0$7.7M
    Crimson Heights LLCUTBehavior Analyst$0$6.8M
    Washington County School DistrictUTLocal Education Agency (LEA)$0$6.8M
    Red Mesa Home CareUTHome Health Agency$0$4M
    The Learning Center For FamiliesUTDevelopmentally Disabled Services Day Training Agency$0$3.9M

    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.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Utah Distribution
    Sharon Richens — 3 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Utah