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 Kentucky for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Kentucky 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. Kentucky (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 And Vitreous Associates Of Kentucky PLLC (NPI 1619949971)

Field	Value
Entity Type	Organization
Organization	Retina And Vitreous Associates Of Kentucky PLLC
Address	120 N Eagle Creek Dr
City	Lexington
State	KY
ZIP	40509
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	February 2, 2006

Payer Source	Total Paid
Medicaid	$13.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	14,800	$640	$9.5M
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.	32,010	$70	$2.3M
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.	34,800	$20	$591.6K
J2778	Injection, ranibizumab, 0.1 mg	670	$380	$252.7K
J9035	Injection, bevacizumab, 10 mg	4,700	$50	$225.8K
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…	9,740	$20	$194.7K
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…	3,380	$30	$97.9K
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,…	2,830	$30	$79.2K
J3590	Unclassified biologics	1,670	$10	$23.4K
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…	260	$60	$16.3K

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Retina And Vitreous Associates Of Kentucky PLLC — 6 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	Injection, aflibercept, 1 mg	1	10	210	$640	$1.4M
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…	561	3,340	1,020	$30	$296K
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…	547	2,460	580	$40	$245K
J2778	Injection, ranibizumab, 0.1 mg	1	10	380	$440	$166.8K
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	30	350	$70	$165.3K
J9035	Injection, bevacizumab, 10 mg	1	20	120	$130	$96.1K
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…	378	1,020	120	$70	$62K
99203	The provider sees a new 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 provider…	1,146	1,400	130	$50	$45.8K
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.	1	70	210	$20	$29.2K
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…	7	10	190	$40	$15.4K

Showing 1–10 of 12

Related Providers

Other providers that share a Tax Identification Number (TIN) with Retina And Vitreous Associates Of Kentucky PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nathan Steinle	CA	Retina Specialist (Ophthalmology) Physician	$9.5M	$0
Kyle Thompson	ID	Retina Specialist (Ophthalmology) Physician	$4.5M	$0
John Kitchens	KY	Retina Specialist (Ophthalmology) Physician	$3.5M	$514.7K
Todd Purkiss	KY	Retina Specialist (Ophthalmology) Physician	$3.9M	$4.8K
Matthew Cole	TN	Ophthalmology Physician	$3.3M	$0
Blake Isernhagen	KY	Retina Specialist (Ophthalmology) Physician	$3.2M	$120.3K
Gregory Lee	GA	Ophthalmology Physician	$2.9M	$6.3K
Aaron Ricca	KY	Retina Specialist (Ophthalmology) Physician	$2.5M	$307.6K
Belinda Shirkey	KY	Retina Specialist (Ophthalmology) Physician	$2.6M	$3.8K
Thomas Stone	KY	Retina Specialist (Ophthalmology) Physician	$2.5M	$520

Nearby Providers

Other providers in the same ZIP code as Retina And Vitreous Associates Of Kentucky PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Joseph Health System, Inc	KY	General Acute Care Hospital	$0	$67.4M
Scott-wilson, Inc.	KY	Home Infusion Therapy Pharmacy	$0	$24.5M
Labtox, LLC	KY	Clinical Medical Laboratory	$43.5K	$21.8M
Phi Health, LLC	KY	Air Ambulance	$2M	$13.2M
Key Assets Kentucky, Inc.	KY	Community/Behavioral Health Agency	$0	$10.8M
Grace Place Adult Day Center LLC	KY	Adult Day Care Clinic/Center	$0	$9.7M
Uhs Of Ridge LLC	KY	Psychiatric Hospital	$0	$9.1M
United Seating And Mobility LLC	KY	Durable Medical Equipment & Medical Supplies	$0	$8.6M
Ridge Outpatient Counseling, LLC	KY	Psychiatric Hospital Unit	$0	$5.2M
Baptist Health Surgery Center LLC	KY	Ambulatory Surgical Clinic/Center	$1.8M	$2.9M

Retina And Vitreous Associates Of Kentucky PLLC — Billing Profile & Reimbursement Data

Sign up for Retina And Vitreous Associates Of Kentucky PLLC — Billing Profile & Reimbursement Data policy alerts

Retina And Vitreous Associates Of Kentucky PLLC — Billing Profile & Reimbursement Data

Sign up for Retina And Vitreous Associates Of Kentucky PLLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References