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NPI 1649279456 · Bellevue, WA · Ophthalmology Physician
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Robert Nash is a ophthalmology physician provider located in Bellevue, Washington. This profile covers 18 Medicare and 3 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 | Robert Nash |
| Address | 1750 112th Ave Ne |
| City | Bellevue |
| State | WA |
| ZIP | 98004 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | July 14, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.9M |
| Medicaid | $20 |
This provider’s Medicare revenue is highly concentrated in a small set of intravitreal drug and procedure codes: the precomputed top 3 Medicare codes by revenue account for 69.6% of total Medicare revenue, with J0178 generating $986.5K (51.5% of Medicare revenue), J2777 generating $221.8K (11.6%), and 67028 generating $124.9K (6.5%). That concentration indicates the practice derives the majority of its Medicare dollars from anti‑VEGF/retina pharmacologic therapy and isolated intravitreal injection procedures rather than a broad mix of other ophthalmology services.
The code mix and descriptions point to an interventional retina focus: J0178 (aflibercept) and J2777 (faricimab) are the top revenue drivers, supported by procedure 67028 (intravitreal injection) and diagnostic imaging code 92134 (retinal imaging). 92134 brought $68.3K (3.6% of Medicare revenue) and is described as "notably above typical national volume," which supports a workflow that couples frequent imaging-based monitoring with high-volume injections.
Medicare dominates the payer mix: Total Medicare revenue is $1.9M while Total Medicaid revenue is $24, so the provider is effectively single‑payer with Medicare making up virtually all billed revenue. Given the negligible Medicaid take ($24), analyses of commercial/Medicaid risk, access, or network strategy should treat this entity as Medicare-centric.
Competitive standing across top drug and procedure codes is generally modest to typical rather than dominant. J0178 ranks #870 of 3204 providers nationally (73th percentile; typical, unremarkable volume for this code), J2777 ranks #1181 of 2039 (42th percentile; typical, unremarkable volume), and 67028 ranks #1111 of 4255 (74th percentile; typical, unremarkable volume), indicating solid but not market-leading volume for the main revenue drivers.
Office visit and follow‑up E/M volume is relatively high for a specialist practice, consistent with frequent post‑injection management: 99213 generated $45K (2.3% of Medicare revenue) with 652 claims and ranks #16503 of 457151 (96th percentile; notably above typical national volume), while 99214 added $25.5K (1.3%) and ranks in the 75th percentile. This pattern suggests routine follow-up visits are an important operational component alongside injections and imaging.
The practice shows notable use of non‑specific and compounded drug billing: J3490 (unclassified drugs) produced $71.7K (3.7% of Medicare revenue) and ranks #1960 of 2838 providers nationally (30th percentile; typical, unremarkable volume), while J7999 (compounded drug) produced $23.9K (1.2%) and ranks #287 of 1333 (78th percentile). These entries could reflect occasional billing for non‑standard drug products or billing for compounded preparations used in niche cases rather than primary revenue sources.
The provider has a long-established Medicare presence, with the NPI enumerated on 2005-07-14 (~21 years ago), indicating an established practice history that aligns with sustained, injection‑centric Medicare billing over time. This tenure combined with concentrated drug/procedure revenue suggests an experienced interventional retina practice rather than a newly entered service line.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
18 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1,440 | $690 | $986.5K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 7,920 | $30 | $221.8K |
| 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. | 1,210 | $100 | $124.9K |
| J2778 | Injection, ranibizumab, 0.1 mg | 620 | $180 | $112.8K |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 740 | $120 | $88.2K |
| J3490 | Unclassified drugs | 40 | $1,890 | $71.7K |
| 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. | 2,130 | $30 | $68.3K |
| 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… | 670 | $100 | $64.6K |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 280 | $210 | $59.3K |
| 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… | 650 | $70 | $45K |
Showing 1–10 of 18
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
18 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J2777 | 35 | 50 | 12,780 | $30 | $599.7K |
| J0178 | 24 | 90 | 470 | $680 | $597.2K |
| Q5128 | 10 | 10 | 520 | $220 | $136.6K |
| J2778 | 10 | 30 | 510 | $180 | $117.1K |
| J2781 | 7 | 10 | 650 | $120 | $88.6K |
| 67028 | 29 | 110 | 550 | $90 | $72.9K |
| J3490 | 43 | 70 | 70 | $50 | $51.2K |
| 92014 | 51 | 790 | 110 | $80 | $16.8K |
| J7999 | 12 | 70 | 150 | $70 | $15.9K |
| 99214 | 2,069 | 10,860 | 100 | $80 | $13.6K |
Showing 1–10 of 18
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
3 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. | 40 | $0 | $0 |
| 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. | 90 | $0 | $0 |
| 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 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Washington providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Washington median
3 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… | 1,745 | 1,860 | 610 | $40 | $295.5K |
| 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. | 49 | 60 | 710 | $40 | $81.7K |
| 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. | 62 | 100 | 240 | $10 | $22.2K |
Other providers in the same ZIP code as Robert Nash, ranked by combined Medicare and Medicaid revenue.
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