Loading...
NPI 1497953871 · Bloomington, IL · Retina Specialist (Ophthalmology) Physician
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Sreenivasa Basavanthappa is a retina specialist (ophthalmology) physician provider located in Bloomington, Illinois. This profile covers 19 Medicare and 2 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 | Sreenivasa Basavanthappa |
| Address | 2501 E College Ave Ste B |
| City | Bloomington |
| State | IL |
| ZIP | 61704 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | July 6, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.2M |
| Medicaid | $14.2K |
This provider operates as a retina-focused ophthalmology practice where intravitreal drug therapy is the primary revenue engine: J0178 (aflibercept) generated 2.3K claims and $1.6M in Medicare revenue (49.5% of the provider's Medicare total) and J2777 (faricimab) produced 34.3K claims and $993.6K (31.4% of Medicare revenue). The presence of high-volume therapeutic injections alongside diagnostic imaging codes such as 92134 indicates an office-based injection clinic workflow treating retinal vascular disease and macular degeneration.
Medicare revenue is highly concentrated: the top three Medicare codes (J0178, J2777, 67028) account for 87.1% of the provider's total Medicare revenue. That level of concentration signals heavy dependence on a small set of high-value injection and related procedure codes, which makes overall revenue sensitive to reimbursement or utilization shifts for those specific therapies.
On Medicaid the provider’s billing is almost entirely limited to injections and retinal imaging—the top three Medicaid codes account for 100.0% of Medicaid revenue, with 67028 representing $9.9K (70.5%) and 92134 $4.1K (29.5%) of the $14.2K Medicaid total. This pattern shows the provider is not broadly engaged with Medicaid for other service lines and that Medicaid activity mirrors the Medicare service mix but at a very small scale.
The payer mix is effectively Medicare-dominant: lifetime Medicare revenue is $3.2M versus $14.2K in Medicaid, so the provider’s financial footprint is overwhelmingly supported by Medicare. From a contracting or network strategy perspective, this makes Medicare policy and pricing the primary driver of practice economics while Medicaid participation has minimal revenue impact.
Competitive standing on key Medicare codes is mixed: J0178 ranks in approximately the 87th percentile nationally and J2777 in the 89th percentile (both labeled as typical, unremarkable volume relative to peers), whereas 92134 is an extreme outlier at the 98th percentile, reflecting exceptionally high retinal imaging volume for this provider. Additionally, 67028 is noted as notably above typical national volume (around the 93rd percentile), which together with the imaging outlier result suggests clinical throughput for retinal procedures and diagnostics is substantially higher than most peers despite medication volumes being described as typical.
Within the state Medicaid market the provider is not a leading participant: for Medicaid 67028 ranks #104 of 120 in-state (13th percentile) and 92134 ranks #153 of 250 (39th percentile), indicating modest to low relative Medicaid volume compared with in-state peers. This suggests limited Medicaid market penetration despite higher national standing on several Medicare measures.
The provider’s billing mix includes ancillary retinal services beyond anti-VEGF therapy—J7312 (dexamethasone implant) generated $66.8K (2.1% of Medicare revenue) and J3490 (unclassified drugs) produced $46.2K (1.5% of Medicare revenue), while evaluation and management/eye exam codes such as 92014 accounted for $87.1K (2.8%). These additional lines indicate the practice manages both procedure-based and diagnostic continuity of care (implants, drug administration, and follow-up exams) rather than exclusively one-off injections.
The NPI tenure shows long-standing presence in the market: the provider was enumerated (registered) 2007-07-06 (~19 years ago). That longevity, combined with the concentrated high-volume retinal procedure and imaging profile, is consistent with an established retina specialist maintaining a focused service line over time.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
19 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2,270 | $690 | $1.6M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 34,260 | $30 | $993.6K |
| 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. | 2,210 | $90 | $194.3K |
| 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… | 970 | $90 | $87.1K |
| 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. | 2,860 | $30 | $83K |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 430 | $150 | $66.8K |
| J3490 | Unclassified drugs | 30 | $1,710 | $46.2K |
| J9035 | Injection, bevacizumab, 10 mg | 590 | $60 | $33.4K |
| J2778 | Injection, ranibizumab, 0.1 mg | 180 | $180 | $31.7K |
| 92235 | The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken… | 210 | $100 | $21.1K |
Showing 1–10 of 19
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
19 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 19 | 140 | 700 | $690 | $688.4K |
| J2777 | 12 | 90 | 9,180 | $30 | $451K |
| J2778 | 23 | 20 | 540 | $180 | $214.9K |
| 67028 | 10 | 190 | 400 | $90 | $64.4K |
| J7312 | 5 | 30 | 240 | $160 | $45.1K |
| 92014 | 102 | 1,420 | 130 | $80 | $24.7K |
| J9035 | 22 | 130 | 140 | $60 | $24.6K |
| J3490 | 112 | 140 | 50 | $210 | $19.4K |
| 99214 | 12,142 | 18,540 | 110 | $80 | $17.1K |
| 92012 | 263 | 670 | 100 | $60 | $12.4K |
Showing 1–10 of 19
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.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 60 | $160 | $9.9K |
| 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. | 240 | $20 | $4.1K |
How this provider's Medicaid billing volume and revenue compare to other Illinois providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Illinois median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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. | 104 | 120 | 540 | $160 | $166.3K |
| 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. | 153 | 250 | 510 | $20 | $20.1K |
Other providers in the same ZIP code as Sreenivasa Basavanthappa, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Sandeep Thota | IL | Dentist | $0 | $5.5M |
| St Joseph Medical Center | IL | Home Health Agency | $0 | $4.8M |
| Adrienne Schupbach | IL | Dermatology Physician | $1.4M | $3K |
| Renuka Bhaskar | IL | Clinical Pathology/Laboratory Medicine Physician | $783.2K | $530.9K |
| Wynn Kao | IL | Dermatology Physician | $425K | $116.2K |
| Gustavo Galue | IL | Family Medicine Physician | $136.9K | $343.6K |
| Benjamin Taimoorazy | IL | Interventional Pain Medicine Physician | $105.4K | $193.7K |
| Chad Osborne | IL | Family Medicine Physician | $126.8K | $149.5K |
| Wilbert Leonard | IL | Podiatrist | $76.5K | $189.7K |
| The Center For Orthopedic Medicine, LLC | IL | Ambulatory Surgical Clinic/Center | $194.4K | $0 |
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.