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    OpenPayerNPI Medicare & MedicaidMiguel Materin
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    Miguel Materin — Billing Profile & Reimbursement Data

    NPI 1528292679 · Durham, NC · Ophthalmology Physician

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    Miguel Materin is a ophthalmology physician provider located in Durham, North Carolina. This profile covers 16 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
    OrganizationMiguel Materin
    Address2351 Erwin Rd
    CityDurham
    StateNC
    ZIP27705
    TaxonomyOphthalmology Physician
    NPI EnumeratedMay 5, 2009

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

    Payer SourceTotal Paid
    Medicare$163.3K
    Medicaid$0

    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.

    16 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    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…680$90$57.7K
    76512The provider uses B–scan ultrasound imaging, with or without a non–qualitative A–scan superimposed, to examine the intraocular and orbital structures.660$30$21.8K
    67218In this procedure, the provider temporarily implants a radio therapeutic source within the eye to treat a cancerous lesion within the retina. After four to five days, he removes the source.20$1,040$19.7K
    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…130$110$14.5K
    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,…540$20$11.9K
    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.90$80$7.2K
    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…110$60$6.4K
    76513The provider uses immersion B–scan ultrasound or high resolution biomicroscopy imaging to examine the anterior segment of one or both eyes.110$50$5.7K
    67208The provider destroys a lesion of the retina using extreme cold or hot temperatures.10$300$3.9K
    J9035Injection, bevacizumab, 10 mg70$60$3.7K

    Showing 1–10 of 16

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    16 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    67028102120780$90$80K
    6721811020$1,040$19.7K
    9921481118,060110$80$15.1K
    J90356890140$50$13.4K
    92235447060$100$8.7K
    9213432579070$30$7.5K
    992135,63216,32070$50$7.1K
    992044418,43030$110$4.8K
    6720811010$300$3.9K
    7651311070$50$3.6K

    Showing 1–10 of 16

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    University Of North Carolina At Chapel HillNCAnesthesiology Physician$0$87.6M
    University Of North Carolina Hospitals At Chapel HillNCGeneral Acute Care Hospital$0$50.7M
    Private Diagnostic Clinic, PLLCNCGeneral Practice Physician$0$46.5M
    Duke University Health System, Inc.NCGeneral Acute Care Hospital$0$44.4M
    Duke Health Integrated Practice, Inc.NCGeneral Practice Physician$0$36.3M
    Balboa Nephrology Medical Group, Inc.CANephrology Physician$0$25.9M
    Duke University Health System, Inc.NCGeneral Acute Care Hospital$0$11.6M
    Duke University Affiliated Physicians, Inc.NCEmergency Medicine Physician$0$11.6M
    Duke University Health System, Inc.NCParenteral & Enteral Nutrition Supplies (DME)$0$8.3M
    Duke University Health System IncNCGeneral Acute Care Hospital$0$7.9M

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Majda HadziahmetovicNCOphthalmology Physician$2.3M$0
    Lejla VajzovicNCOphthalmology Physician$492.9K$0
    Vanessa JohnsonNCHematology & Oncology Physician$378.8K$0
    Tyler BlackNCGastroenterology Physician$351K$0
    John RobertsNCDiagnostic Radiology Physician$337.2K$0
    Ana MeekinsNCUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician$292.4K$0
    Garrett BresslerNCDermatology Physician$283.3K$0
    Robert AbbottNCDiagnostic Radiology Physician$273.5K$0
    Pratap ChallaNCOphthalmology Physician$253.1K$0
    Timothy DonahueNCClinical Cardiac Electrophysiology Physician$243.2K$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. North Carolina Distribution
    Miguel Materin — 4 of 16 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — North Carolina