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NPI 1538587936 · Salisbury, NC · Ophthalmology Physician
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Alexander Barnes is a ophthalmology physician provider located in Salisbury, North Carolina. This profile covers 21 Medicare and 6 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 | Alexander Barnes |
| Address | 530 Corporate Cir |
| City | Salisbury |
| State | NC |
| ZIP | 28147 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | April 2, 2014 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.2M |
| Medicaid | $22.5K |
This provider’s business is overwhelmingly Medicare-facing: reported lifetime Medicare revenue is $2.2M compared with $22.5K in Medicaid, indicating Medicare drives the practice’s scale and cash flow while Medicaid is a very small share of overall revenue. The NPI has been enumerated since 2014-04-02 (~12 years ago), so this is an established practice with roughly a decade of billing history to Medicare and Medicaid.
Revenue concentration on Medicare is heavily driven by intravitreal biologic therapy: the precomputed top-3 Medicare codes account for 74.3% of Medicare revenue, led by J0178 (56.4% of Medicare revenue), followed by J2777 (10.5%) and Q5128 (7.3%). That mix — two anti-VEGF therapeutics and a ranibizumab biosimilar — identifies the practice as medically retina-focused, with anti-VEGF injections as the core revenue-generating service.
Medicaid revenue is even more concentrated: the precomputed top-3 Medicaid codes account for 96.0% of Medicaid revenue, with 67028 (56.2%) and 92250 (32.0%) together making up the bulk of the small $22.5K Medicaid total. In practical terms Medicaid billing here is concentrated on intravitreal injections (67028) and fundus photography (92250), but the absolute Medicaid dollar volume is very limited compared with Medicare.
The provider’s competitive standing is mixed across services. For the largest Medicare revenue code J0178 the provider ranks #625 of 3204 nationally and is described as "typical, unremarkable volume" (80th percentile), while J2777 and Q5128 also show typical volumes against national peers; by contrast, retinal imaging and fundus photography show unusually high relative activity — 92134 is at the 95th percentile and 92250 is an "extreme outlier" (100th percentile), indicating the provider performs retinal imaging and fundus photography at a substantially higher rate than most peers.
Office visit mix shows higher-than-typical new-patient and some established-visit activity relative to national peers. Medicare 99204 is flagged as a "extreme outlier" (100th percentile) and 99213 is at the 97th percentile, which together suggest this practice records an elevated volume of new-patient consultations and routine follow-up visits in addition to procedure-based care.
Procedure breadth is primarily non-surgical, with a dominant procedural footprint in intravitreal injections and diagnostic imaging but occasional surgical retina work. Medicare shows 1.3K claims for 67028 (intravitreal injection as an isolated procedure) generating $123.6K (5.6% of Medicare revenue), while surgical vitrectomy code 67042 appears at low volume (11 claims, $9.9K), indicating surgery is infrequent compared with injection-based outpatient care.
The drug and device mix indicates adoption of multiple anti-VEGF agents and biosimilars: Medicare top codes include J0178 (aflibercept), J2777 (faricimab), and Q5128 (ranibizumab biosimilar). That product diversity suggests the practice actively administers newer agents and biosimilars, making clinical and revenue exposure sensitive to changes in drug utilization, payer coverage, or average paid per claim for these codes.
State-level competitive posture for Medicaid is modest despite the provider’s high imaging volume on Medicare. For Medicaid, 67028 ranks #34 of 43 in-state (21th percentile) and 92250 ranks #37 of 143 in-state (75th percentile), so relative to other North Carolina providers this clinician is not a dominant injector for Medicaid patients, even though fundus photography is a meaningful component of the small Medicaid revenue base.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
21 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1,820 | $680 | $1.2M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 7,980 | $30 | $231.4K |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 740 | $220 | $160.6K |
| J2778 | Injection, ranibizumab, 0.1 mg | 840 | $180 | $149.5K |
| 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. | 1,290 | $100 | $123.6K |
| 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. | 1,710 | $30 | $51.3K |
| 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… | 540 | $90 | $47.4K |
| 99213 | The 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… | 690 | $70 | $45.8K |
| 99204 | The 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… | 330 | $120 | $39.2K |
| 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,… | 1,420 | $30 | $36.9K |
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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 Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 29 | 100 | 950 | $690 | $881K |
| J2777 | 42 | 70 | 12,990 | $30 | $503.7K |
| J2778 | 19 | 50 | 620 | $180 | $202.2K |
| Q5128 | 1 | 10 | 370 | $220 | $83.6K |
| 67028 | 38 | 120 | 780 | $90 | $80K |
| J3490 | 53 | 80 | 50 | $450 | $24.1K |
| 67042 | 31 | 30 | 20 | $990 | $23.8K |
| J7999 | 1 | 10 | 50 | $390 | $19.3K |
| 92014 | 93 | 880 | 110 | $80 | $17.7K |
| 99214 | 5,224 | 18,060 | 110 | $80 | $15.1K |
Showing 1–10 of 21
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
6 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. | 90 | $140 | $12.5K |
| 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,… | 590 | $10 | $7.1K |
| 99204 | The 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… | 20 | $120 | $1.8K |
| 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. | 540 | $1 | $540 |
| J9035 | Injection, bevacizumab, 10 mg | 50 | $10 | $290 |
| 99213 | The 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… | 20 | $1 | $40 |
How this provider's Medicaid billing volume and revenue compare to other North Carolina providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. North Carolina median
6 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99213 | The 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… | 3,789 | 4,130 | 670 | $50 | $219.9K |
| 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. | 34 | 40 | 990 | $40 | $97.9K |
| 99204 | The 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… | 1,157 | 1,310 | 80 | $90 | $59.7K |
| 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. | 40 | 80 | 770 | $10 | $21.5K |
| J9035 | Injection, bevacizumab, 10 mg | 19 | 20 | 360 | $20 | $13.6K |
| 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,… | 37 | 140 | 130 | $10 | $8.4K |
Other providers in the same ZIP code as Alexander Barnes, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Bayada Home Health Care, Inc. | NC | Home Health Agency | $0 | $9.4M |
| Robert Wilson | NC | Interventional Pain Medicine Physician | $252.6K | $0 |
| Jeffrey Zeckser | NC | Physical Medicine & Rehabilitation Physician | $199.4K | $0 |
| Natalie Errante | NC | Psychiatric/Mental Health Nurse Practitioner | $31.1K | $158.2K |
| Megan Way | NC | Physician Assistant | $177.6K | $0 |
| Hernan Gatuslao | NC | Neurology Physician | $77.5K | $0 |
| Eugene Eline | NC | Orthopaedic Surgery Physician | $30.2K | $0 |
| Lorin Oden | NC | Audiologist | $11.4K | $0 |
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