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    OpenPayerNPI Medicare & MedicaidTennessee Retina PC
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    Tennessee Retina PC — Billing Profile & Reimbursement Data

    NPI 1497828321 · Nashville, TN · Retina Specialist (Ophthalmology) Physician

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    Tennessee Retina PC is a retina specialist (ophthalmology) physician provider located in Nashville, Tennessee. This profile covers 0 Medicare and 14 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
    OrganizationTennessee Retina PC
    Address345 23rd Ave N
    CityNashville
    StateTN
    ZIP37203
    TaxonomyRetina Specialist (Ophthalmology) Physician
    NPI EnumeratedNovember 16, 2006

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

    Payer SourceTotal Paid
    Medicaid$6M
    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.

    14 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.39,410$60$2.4M
    J0178Injection, aflibercept, 1 mg2,490$490$1.2M
    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…32,560$20$716.3K
    J9035Injection, bevacizumab, 10 mg29,520$20$620K
    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.49,210$10$492.1K
    Q5128Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg1,290$170$220.6K
    92250Code 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,…8,780$20$184.5K
    99204The provider sees a new 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 provider…2,060$50$109.3K
    Q5124Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg40$150$6.2K
    99223The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…40$130$5.4K

    Showing 1–10 of 14

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Tennessee median

    14 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J0178Injection, aflibercept, 1 mg11040$570$363.4K
    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.140760$50$193K
    Q5128Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg110900$130$120.6K
    99204The provider sees a new 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 provider…851,080120$80$90.7K
    99233The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…476550290$30$77K
    J9035Injection, bevacizumab, 10 mg130780$20$65.7K
    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…1710340$50$60K
    99223The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…350480160$50$46.3K
    92250Code 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,…4220330$30$30.7K
    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.180440$10$29.6K

    Showing 1–10 of 14

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Roy WallaceTNRetina Specialist (Ophthalmology) Physician$5.4M$0
    David ReichsteinTNRetina Specialist (Ophthalmology) Physician$4.9M$141.7K
    Carl AwhTNRetina Specialist (Ophthalmology) Physician$4.7M$0
    Brandon BusbeeTNRetina Specialist (Ophthalmology) Physician$4.3M$0
    Eric SchneiderTNRetina Specialist (Ophthalmology) Physician$4.1M$0
    Franco RecchiaTNRetina Specialist (Ophthalmology) Physician$3.6M$2.6K
    Akshay ThomasTNRetina Specialist (Ophthalmology) Physician$3.2M$52K
    Everton ArrindellTNRetina Specialist (Ophthalmology) Physician$3M$0
    Jay GloverTNRetina Specialist (Ophthalmology) Physician$2.9M$0
    Peter SonkinTNRetina Specialist (Ophthalmology) Physician$2.2M$0

    Nearby Providers

    Other providers in the same ZIP code as Tennessee Retina PC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Hca Health Services Of Tennessee, Inc.TNGeneral Acute Care Hospital$0$45.9M
    Pediatrix Medical Group Of Tennessee, P.C.TNNeonatal-Perinatal Medicine Physician$0$32.3M
    Saint Thomas Medical PartnersTNInternal Medicine Physician$0$21.9M
    Radiology Alliance PCTNDiagnostic Radiology Physician$0$13.2M
    Emergency Medicine Services Of Tn, PCTNEmergency Medicine Physician$0$12.9M
    Tennessee Maternal-fetal Medicine LLCTNSpecialist$0$12.5M
    The Next Door, Inc.TNSubstance Abuse Rehabilitation Facility$0$8.6M
    Tennessee Oncology PLLCTNHematology & Oncology Physician$0$8.5M
    Vcphcs Ix, LLCTNSubstance Use Disorder Rehabilitation Clinic/Center$257.7K$6.6M
    Pediatric Associates Of Davidson County, P.C.TNPediatrics Physician$0$5.8M

    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. Tennessee Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Tennessee Distribution
    Tennessee Retina PC — 8 of 14 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Tennessee