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    OpenPayerNPI Medicare & MedicaidScott Barb
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    Scott Barb — Billing Profile & Reimbursement Data

    NPI 1609137595 · Knoxville, TN · Ophthalmology Physician

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    Scott Barb is a ophthalmology physician provider located in Knoxville, Tennessee. This profile covers 15 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
    OrganizationScott Barb
    Address1342 Old Weisgarber Rd
    CityKnoxville
    StateTN
    ZIP37909
    TaxonomyOphthalmology Physician
    NPI EnumeratedJune 6, 2012

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

    Payer SourceTotal Paid
    Medicare$2.8M
    Medicaid$0

    Key Findings

    Practice profile and service line: SCOTT BARB’s billing pattern is dominated by intravitreal anti‑VEGF therapy and retina-focused care, driven by high volumes of injection codes J0178 (1.2K claims, $686 avg paid/claim, $847.9K revenue, 30.7% of this provider's total Medicare revenue), J2778 (4.7K claims, $178 avg paid/claim, $829.7K revenue, 30.0%), and J2777 (22.8K claims, $29 avg paid/claim, $661.2K revenue, 23.9%). The presence of substantial imaging (92134) and separate vitreous injection procedure coding (67028) supports a workflow centered on repeated intravitreal injections with diagnostic follow‑up rather than a broad general ophthalmology mix.

    Revenue concentration: the top three Medicare codes are highly dominant — the precomputed figure shows that the top 3 Medicare codes by revenue account for 84.7% of this provider's total Medicare revenue. Those three codes (J0178, J2778, J2777) individually contribute 30.7%, 30.0%, and 23.9% respectively, indicating that most Medicare dollars are tied to anti‑VEGF medication administration rather than routine office visits or surgical procedures.

    Competitive standing on key therapeutics: for ranibizumab (J2778) the provider ranks #51 of 1208 nationally (96th percentile; notably above typical national volume for this code), indicating a strong position in administering this agent compared with peers. By contrast, J0178 ranks #1057 of 3204 (67th percentile; typical, unremarkable volume) and J2777 ranks #445 of 2039 (78th percentile; typical, unremarkable volume), so the provider’s ranibizumab volume is the clearest national outlier among its drug mix.

    Imaging intensity and workflow implication: 92134 (computerized retinal imaging) is billed at 3.2K claims for $85.9K revenue (3.1% of this provider's total Medicare revenue) and ranks #332 of 26868 providers nationally (99th percentile; extreme outlier, far above typical national volume for this code). This extreme outlier status for OCT imaging indicates a retina‑centered practice pattern with heavy diagnostic imaging per treated patient, consistent with frequent intravitreal therapy.

    Procedure mix beyond injections: the provider also reports significant separate vitreous injections (67028: 2K claims, $86 avg paid/claim, $173.9K revenue, 6.3% of this provider's total Medicare revenue) and angiography (92235: 135 claims, $98 avg paid/claim, $13.2K revenue, 0.5%). 67028’s national rank (#388 of 4255; 91th percentile; typical, unremarkable volume) suggests above‑average utilization of the isolated injection procedure relative to peers, consistent with a high‑throughput injection practice.

    Payer mix and financial concentration risk: lifetime Medicare revenue is $2.8M while there is no Medicaid billing on file (none below), making this effectively a single‑payer provider in the dataset. This absence of Medicaid activity concentrates payer exposure in Medicare and may influence contracting and reimbursement sensitivity analyses.

    Office visit and E/M footprint: evaluation & management and comprehensive eye exam codes appear but represent a small share of revenue (e.g., 99214: 447 claims, $90 avg paid/claim, $40.2K revenue, 1.5%; 92014: 480 claims, $81 avg paid/claim, $38.9K revenue, 1.4%). These figures indicate that routine office visits support the injection practice but are not the primary revenue driver, reinforcing an operational model centered on drug administration and retinal imaging.

    Tenure and scale: NPI enumerated (registered) 2012-06-06 (~14 years ago), and the provider’s lifetime Medicare revenue of $2.8M positions them as an established, mid‑scale Medicare earner focused on retina therapeutics. The combination of long tenure and concentrated anti‑VEGF billing suggests an experienced clinician operating a specialized injection/imaging workflow rather than a generalist or predominantly surgical practice.

    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.

    15 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J0178Injection, aflibercept, 1 mg1,240$690$847.9K
    J2778Injection, ranibizumab, 0.1 mg4,660$180$829.7K
    J2777Injection, faricimab‑svoa, 0.1 mg22,800$30$661.2K
    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.2,020$90$173.9K
    92134The 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.3,180$30$85.9K
    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…450$90$40.2K
    92014An 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…480$80$38.9K
    J9035Injection, bevacizumab, 10 mg460$50$23.7K
    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…360$60$21.8K
    92235The 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…140$100$13.2K

    Showing 1–10 of 15

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    15 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J01783080790$680$769.8K
    J277775015,060$30$592.1K
    J27782401,340$180$370.2K
    6702811801,130$90$98.5K
    92014242810120$80$19.2K
    J90351970140$50$17.1K
    992141,48111,370120$80$16.6K
    921341460060$30$8.2K
    992131,30511,03080$50$8K
    9223534050$100$5.7K

    Showing 1–10 of 15

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    James MillerTNRetina Specialist (Ophthalmology) Physician$3.9M$0
    Devon GhodasraTNRetina Specialist (Ophthalmology) Physician$3.6M$0
    Nicholas AndersonTNRetina Specialist (Ophthalmology) Physician$3M$0
    Rohan ShahTNRetina Specialist (Ophthalmology) Physician$2.9M$0
    Robert ShulerTNRetina Specialist (Ophthalmology) Physician$2.6M$0
    Tod McmillanTNRetina Specialist (Ophthalmology) Physician$2.5M$0
    Ailee LahamTNRetina Specialist (Ophthalmology) Physician$2.5M$0
    Stephen PerkinsTNRetina Specialist (Ophthalmology) Physician$2.3M$0
    Francis DecroosTNRetina Specialist (Ophthalmology) Physician$2.3M$0
    Cristoforo LarzoTNRetina Specialist (Ophthalmology) Physician$2.2M$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Omni Community Health, Inc.TNCommunity/Behavioral Health Agency$0$77.7M
    Summit Medical Group, PLLCTNInternal Medicine Physician$0$44.5M
    Allergy Associates, P.A.TNSpecialist$0$26.5M
    Knoxville Pediatric Dentistry, PLLCTNGeneral Practice Dentistry$0$11.2M
    The Florence Crittenton Agency IncTNCommunity/Behavioral Health Agency$0$10.7M
    Bsp Enterprises, LLCTNIn Home Supportive Care Agency$0$8M
    Associated Pain Specialists, PCTNPain Medicine Physician$0$6.8M
    Jeremiah BivinsTNAllergy & Immunology Physician$419.4K$4.6M
    Westbrook Medical Center, PLLCTNFamily Medicine Physician$0$4M
    Pcet Surgery Center LLCTNAmbulatory Surgical Clinic/Center$1.7M$60K

    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. Tennessee Distribution
    Scott Barb — 2 of 15 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Tennessee