Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or New Mexico for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to New Mexico only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. New Mexico (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Retina Consultants Of New Mexico, LLC (NPI 1558960799)

Field	Value
Entity Type	Organization
Organization	Retina Consultants Of New Mexico, LLC
Address	6401 Holly Ave Ne
City	Albuquerque
State	NM
ZIP	87113
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	October 20, 2020

Payer Source	Total Paid
Medicaid	$1.5M
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	460	$900	$409.5K
J2778	Injection, ranibizumab, 0.1 mg	540	$730	$394.5K
J2777	Injection, faricimab‑svoa, 0.1 mg	200	$1,330	$261.2K
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.	2,780	$70	$202.6K
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…	1,080	$70	$73.3K
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.	2,460	$30	$61.6K
J9035	Injection, bevacizumab, 10 mg	380	$80	$28.7K
99214	The 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…	290	$60	$17.2K
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.	150	$100	$14.5K
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…	90	$100	$9K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Mexico Distribution

Retina Consultants Of New Mexico, LLC — 0 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. New Mexico median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	Injection, aflibercept, 1 mg	5	10	480	$1,280	$3.2M
99214	The 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…	660	960	1,010	$90	$490K
J2778	Injection, ranibizumab, 0.1 mg	2	10	380	$900	$408.7K
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.	3	10	1,470	$70	$340.1K
J2777	Injection, faricimab‑svoa, 0.1 mg	2	10	200	$1,080	$292.6K
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…	48	140	630	$80	$236.9K
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.	101	140	510	$100	$218.8K
J9035	Injection, bevacizumab, 10 mg	3	10	380	$70	$203.4K
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…	220	380	150	$130	$132.8K
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.	6	20	880	$30	$132.3K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Retina Consultants Of New Mexico, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Christopher Roybal	NM	Ophthalmology Physician	$3.8M	$0
Jamie Odden	NM	Retina Specialist (Ophthalmology) Physician	$605.1K	$0

Nearby Providers

Other providers in the same ZIP code as Retina Consultants Of New Mexico, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
New Mexico Consumer Direct Personal Care, LLC	NM	Home Health Agency	$0	$149.8M
Ambercare Hospice, Inc.	NM	Community Based Hospice Care Agency	$0	$28.7M
Advantage Home Care, Inc.	NM	Primary Care Nurse Practitioner	$0	$13.7M
Home Modification Solutions, LLC	NM	In Home Supportive Care Agency	$0	$9.9M
A Childs Voice	NM	Community/Behavioral Health Agency	$0	$5.3M
Allergy Partners, PLLC	NM	Allergy & Immunology Physician	$0	$5M
Armada Skilled Homecare Of New Mexico LLC	NM	Home Health Agency	$0	$3.2M
Anne K. Hempstead D.d.s., P.C.	NM	Pediatric Dentistry	$0	$3M
Autism Specialists LLC	NM	Speech-Language Pathologist	$0	$2.1M
Dr Puneet Rastogi & Associates LLC	NM	Optometrist	$0	$2M

Retina Consultants Of New Mexico, LLC — Billing Profile & Reimbursement Data

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Retina Consultants Of New Mexico, LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References