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    OpenPayerNPI Medicare & MedicaidMark Reynolds
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    Mark Reynolds — Billing Profile & Reimbursement Data

    NPI 1497793632 · Fort Madison, IA · Ophthalmology Physician

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    Mark Reynolds is a ophthalmology physician provider located in Fort Madison, Iowa. This profile covers 21 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
    OrganizationMark Reynolds
    Address5409 Avenue O
    CityFort Madison
    StateIA
    ZIP52627
    TaxonomyOphthalmology Physician
    NPI EnumeratedJune 2, 2006

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

    Payer SourceTotal Paid
    Medicare$952.3K
    Medicaid$0

    Key Findings

    This provider’s Medicare activity is concentrated in intravitreal anti-VEGF injections: J0178, J2778 and J9035 together account for a large share of revenue and the platform notes the top 3 Medicare codes by revenue make up 70.1% of total Medicare revenue. The single largest revenue contributor is J0178 (aflibercept) at $500.3K and 52.6% of Medicare revenue, indicating that high-volume injection therapy for retinal disease is the core service line driving this practice’s Medicare business.

    Lifetime Medicare revenue for the provider is $952.3K and there is no Medicaid billing on file, so the practice is effectively single-payer with Medicare representing the entire public-payor footprint. The absence of Medicaid claims suggests the provider’s payer mix is heavily weighted toward Medicare-beneficiary ophthalmology services rather than dual Medicare/Medicaid coverage populations.

    Competitive standing on key retina injection codes is modest-to-typical: J0178 ranks #1596 of 3204 providers nationally (50th percentile) and J2778 ranks #662 of 1208 providers nationally (45th percentile), which the data labels as typical, unremarkable volume for these codes. These ranks imply the provider is not a national leader in anti-VEGF volume but operates at roughly average scale for peers delivering these injectables.

    The provider shows above-typical volume for general ophthalmology office and imaging codes: 92014 (comprehensive established exam) produced $68.6K (7.2% of Medicare revenue) and ranks in the 94th percentile nationally, and 92134 (retinal OCT) produced $32.7K (3.4%) and ranks in the 93rd percentile. These elevated ranks suggest a strong clinic-based outpatient practice that performs a high number of comprehensive eye exams and retinal imaging relative to national peers.

    Procedural mix includes cataract surgery and associated services but at modest scale: 66984 cataract with IOL accounts for $44.4K (4.7% of Medicare revenue) and ranks in the 59th percentile, while complex cataract (66982) and YAG capsulotomy (66821) also appear but with smaller revenue shares. This pattern indicates the practice provides a full-scope ophthalmology service line (medical retina plus cataract surgery) but derives the majority of its Medicare revenue from injection therapies rather than surgical volume.

    Visit-level E/M coding volumes show a pattern of frequent established-patient encounters: 99213 and 99214 together account for meaningful revenue ($31.4K and $16.6K respectively) and are described as notably above typical volume for 99213 (95th percentile) and typical for 99214 (69th percentile). Combined with the high counts for 92014, this suggests ongoing chronic disease management (likely retinal disease) with substantial follow-up visit volume.

    The provider has long tenure in the NPI registry, enumerated since 2006-06-02 (~20 years ago), which supports interpretation of an established local practice rather than a recent entrant. Longevity combined with the billing mix (high-volume injections and frequent established-patient exams) is consistent with an experienced ophthalmologist running an outpatient retinal-focused practice.

    While several service lines rank high relative to national peers, there are no extreme outliers flagged in the data; most high-volume codes are labeled “typical, unremarkable” or “notably above typical” rather than extreme. This indicates the provider’s utilization profile aligns with common practice patterns for an ophthalmologist concentrating on retinal injections and routine ophthalmic care rather than showing unusual procedural concentration beyond what peers report.

    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.

    21 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J0178Injection, aflibercept, 1 mg720$690$500.3K
    J2778Injection, ranibizumab, 0.1 mg570$170$98.6K
    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…860$80$68.6K
    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.770$80$64.5K
    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…150$300$44.4K
    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.1,170$30$32.7K
    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…540$60$31.4K
    66982The provider inserts an intraocular lens prosthesis after extracapsular cataract extraction using complex techniques and devices. He may perform this by means of an iris expansion device, providing…60$380$20.9K
    J9035Injection, bevacizumab, 10 mg340$50$18K
    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…210$80$16.6K

    Showing 1–10 of 21

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    21 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J01781940640$690$760.2K
    J27781320780$180$259.9K
    670282060420$80$80.6K
    669845734050$340$50.4K
    66982256040$450$39K
    9201414500200$70$19.8K
    992141,4374,690100$70$14.4K
    668216013040$210$14.4K
    J9035310200$50$14.2K
    992131804,740100$50$8K

    Showing 1–10 of 21

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Thomas BurokerIAMedical Oncology Physician$9.4M$0
    Kyle AllimanIAOphthalmology Physician$8.7M$0
    Alex KartvelishviliIAOphthalmology Physician$8.1M$0
    Paul BoekeIAOphthalmology Physician$7.1M$0
    Austin StrohbehnIARetina Specialist (Ophthalmology) Physician$5.8M$0
    Jeremy DeutschKSHematology & Oncology Physician$5.7M$0
    Robert BehrensIAMedical Oncology Physician$5.2M$0
    Matthew McknightIAFoot & Ankle Surgery Podiatrist$4.7M$23.5K
    James SingerIARetina Specialist (Ophthalmology) Physician$4.1M$0
    Christopher HaupertIARetina Specialist (Ophthalmology) Physician$3.9M$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Fort Madison C.s.d.IALocal Education Agency (LEA)$0$1.1M
    Lee County AuditorIAPublic Health or Welfare Agency$0$963.9K
    Hy-vee IncIACommunity/Retail Pharmacy$180.6K$32.3K
    Derek VogelpohlIAOptometrist$89.2K$49.5K
    Walgreen CoIAPharmacy$100K$5.8K
    Heather PerryIAFoot & Ankle Surgery Podiatrist$104.3K$0
    Nelson Pharmacy Consulting Services, PlcIACommunity/Retail Pharmacy$89.5K$1.3K
    Ruth BarosyIAFamily Medicine Physician$86.1K$0
    Mark SaathoffIAPodiatrist$73.3K$11.9K
    Kyle GibsonIAPhysician Assistant$62.1K$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.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Iowa Distribution
    Mark Reynolds — 3 of 21 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Iowa