Loading...
NPI 1528026838 · Lafayette, LA · Ophthalmology Physician
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Robert Blem is a ophthalmology physician provider located in Lafayette, Louisiana. This profile covers 24 Medicare and 7 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 | Robert Blem |
| Address | 1000 W Pinhook Rd |
| City | Lafayette |
| State | LA |
| ZIP | 70503 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | May 3, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.2M |
| Medicaid | $93.6K |
This profile is heavily Medicare-weighted: the provider reported Total Medicare revenue of $1.2M versus Total Medicaid revenue of $93.6K, so Medicare dominates the revenue picture. The NPI was enumerated 2006-05-03 (~20 years ago), indicating long-standing Medicare/Medicaid participation and an established practice presence in Lafayette, LA.
Medicare revenue is highly concentrated in a small set of services: the precomputed top 3 Medicare codes account for 76.4% of this provider's total Medicare revenue, led by J0178 (57.5%), 92014 (13.6%), and 92134 (5.3%). This mix points to a practice model focused on intravitreal pharmacologic therapy combined with high-volume comprehensive office exams and retinal imaging rather than a broad, equal distribution across many service lines.
J0178 (1K claims, $682 avg paid/claim, $682K revenue) is the single largest Medicare revenue driver at 57.5% of Medicare revenue, but the provider ranks #1286 of 3204 nationally (60th percentile; typical, unremarkable volume for this code). In other words, aflibercept administration generates the majority of Medicare dollars for this clinician even though their national volume for this drug is not an extreme outlier.
92014 shows unusually high Medicare clinic throughput: the code has 1.9K claims, $86 avg paid/claim, and $161.1K revenue (13.6% of Medicare revenue) and ranks #313 of 35415 nationally (99th percentile; extreme outlier, far above typical national volume for this code). This signals that the provider performs an exceptionally large number of comprehensive established-patient eye exams on Medicare compared with national peers, consistent with a high-volume office practice.
92134 is another Medicare outlier in imaging activity, with 2.3K claims, $27 avg paid/claim, and $63.3K revenue (5.3% of Medicare revenue) and a national rank of #757 of 26868 (97th percentile; extreme outlier, far above typical national volume for this code). The combination of high 92014 and 92134 volumes underscores a retina-focused outpatient workflow emphasizing diagnostic imaging plus frequent follow-up visits.
Medicaid billing is likewise concentrated but at a much smaller scale: the precomputed top 3 Medicaid codes account for 88.8% of the provider's total Medicaid revenue, with 92014 (57.2%), 92250 (25.0%), and 92134 (6.6%) as the leaders. For Medicaid the pattern emphasizes comprehensive established-patient exams and fundus photography; 92250 (1.2K claims, $19 avg paid/claim, $23.5K revenue) ranks #40 of 211 in-state (81th percentile; typical, unremarkable volume for this code), indicating above-typical in-state imaging volume relative to peers.
Competitive standing is mixed by payer and service: on Medicare the provider is an extreme outlier for outpatient exam and retinal imaging codes (92014 and 92134), signaling a nationally high volume for those services, while their leading drug code J0178 is only at the 60th percentile nationally. On Medicaid the provider posts typical-to-above-typical imaging and exam volumes in-state but overall Medicaid revenue ($93.6K) remains small relative to Medicare ($1.2M), so this clinician is effectively a Medicare-focused operator rather than a Medicaid-dominant practice.
Procedure-level data show occasional surgical retina work but at low volumes relative to clinic services: for example 67036 appears with 38 claims, $630 avg paid/claim, $23.9K revenue and ranks #125 of 832 (84th percentile; typical, unremarkable volume for this code). The presence of some surgical entries alongside dominant injection and imaging codes supports a practice that primarily delivers outpatient injections and diagnostic services with intermittent surgical interventions.
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 |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1,000 | $680 | $682K |
| 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… | 1,870 | $90 | $161.1K |
| 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. | 2,340 | $30 | $63.3K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 1,860 | $30 | $53.9K |
| 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. | 590 | $90 | $50.5K |
| 92004 | The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits. | 250 | $100 | $24.8K |
| 67036 | The provider removes vitreous fluid from the eye to access the posterior segment of the eye and introduce surgical instruments through incisions in the pars plana. | 40 | $630 | $23.9K |
| 99205 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider… | 100 | $160 | $16K |
| 67210 | The provider destroys a lesion of the retina using a laser beam that heats up the tissue. | 40 | $380 | $15K |
| 67113 | The provider repairs a complicated detached retina. He removes vitreous humor, the gelatinous material that gives shape to the eye, and peels the retinal membrane. He reattaches the retina with… | 20 | $940 | $14.2K |
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 |
|---|---|---|---|---|---|
| J0178 | 10 | 50 | 300 | $680 | $371.5K |
| J2777 | 27 | 30 | 6,660 | $30 | $309.4K |
| 67028 | 19 | 70 | 410 | $80 | $44.3K |
| 67042 | 15 | 20 | 20 | $1,110 | $26.6K |
| 92014 | 6 | 470 | 170 | $80 | $23.9K |
| 67036 | 2 | 10 | 20 | $950 | $23.7K |
| 67113 | 4 | 10 | 20 | $1,180 | $18.8K |
| 92242 | 10 | 10 | 90 | $180 | $18.5K |
| 67210 | 6 | 10 | 40 | $380 | $16.5K |
| 92012 | 281 | 350 | 100 | $60 | $11.7K |
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.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 1,680 | $30 | $53.7K |
| 92250 | Code 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,… | 1,240 | $20 | $23.5K |
| 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. | 880 | $10 | $6.2K |
| 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. | 150 | $40 | $5.7K |
| 92004 | The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits. | 80 | $30 | $2.4K |
| J9035 | Injection, bevacizumab, 10 mg | 90 | $20 | $2.1K |
| 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… | 20 | $20 | $350 |
How this provider's Medicaid billing volume and revenue compare to other Louisiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Louisiana median
7 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 253 | 660 | 1,070 | $60 | $129.3K |
| 92004 | The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits. | 474 | 580 | 610 | $80 | $103.9K |
| 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. | 38 | 50 | 470 | $60 | $95.8K |
| J9035 | Injection, bevacizumab, 10 mg | 28 | 40 | 240 | $30 | $34.1K |
| 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… | 17 | 20 | 200 | $30 | $21K |
| 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. | 51 | 130 | 490 | $10 | $19.4K |
| 92250 | Code 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,… | 40 | 210 | 200 | $20 | $17.5K |
Other providers in the same ZIP code as Robert Blem, ranked by combined Medicare and Medicaid revenue.
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.