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    v1.0.28
    OpenPayerNPI Medicare & MedicaidMichael Richard
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    Michael Richard — Billing Profile & Reimbursement Data

    NPI 1669434197 · Durham, NC · Ophthalmology Physician

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    Michael Richard is a ophthalmology physician provider located in Durham, North Carolina. This profile covers 21 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
    OrganizationMichael Richard
    Address3802 Erwin Road
    CityDurham
    StateNC
    ZIP27710
    TaxonomyOphthalmology Physician
    NPI EnumeratedApril 2, 2006

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

    Payer SourceTotal Paid
    Medicare$230.7K
    Medicaid$0

    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.

    21 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J0585Injection, onabotulinumtoxina, 1 unit9,500$10$47.5K
    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…390$70$27.7K
    15823In this procedure, the provider surgically trims excessive skin that weighs down the upper eyelid, typically to improve the cosmetic appearance of the face and due to the interference of the tissue…30$690$20.7K
    67904The provider repairs a drooping eyelid by tightening the levator muscle that controls eyelid movement to improve cosmetic appearance or remove the obstruction to a patient’s vision. He accesses the…20$690$16.6K
    68840This procedure is the probing of the lacrimal canaliculi with or without irrigation.100$150$15.3K
    64612In this procedure, the provider injects a chemical on one side of the face to disable the facial nerve and relieve painful facial nerve disorders or abnormal involuntary movements of facial muscles.80$160$13.1K
    14060The provider replaces the lesions in the eyelids, nose, ears, or lips, with the healthy tissues from an adjacent site. This code represents a defect of 10 cm2 or less.30$410$11.1K
    92285Code 92285 describes photography of abnormalities using any of the methods described for documentation purposes and later comparison.550$20$11K
    67900The provider repairs a drooping eyebrow due to muscle weakness or paralysis, to improve cosmetic appearance or remove the obstruction to a patient’s vision. He makes an incision immediately above the…30$310$10K
    67911During this procedure, the provider corrects the retraction of the eyelid, in which the eyelid is moving away from the surface of the eye.20$390$9K

    Showing 1–10 of 21

    Medicare: Competitive Analysis & Benchmarks

    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 CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J0585391205,580$1$50.2K
    15823365050$520$40.3K
    67904234030$570$31.7K
    14060337030$560$19.5K
    9921412,34818,060110$80$15.1K
    6790092030$420$15K
    6790361020$480$11.5K
    6791141030$370$11.1K
    6461273060$130$8.4K
    6784093030$200$7.5K

    Showing 1–10 of 21

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Private Diagnostic Clinic, PLLCNCGeneral Practice Physician$0$46.5M
    Nj Eye And Ear LLCNJOphthalmology Physician$0$23.6M
    Robert BaroneNJOphthalmology Physician$4.8M$0
    Tamer MahmoudMIRetina Specialist (Ophthalmology) Physician$2.8M$0
    Francisco FolgarSCOphthalmology Physician$2.3M$0
    Ravi PatelNJRetina Specialist (Ophthalmology) Physician$1.7M$84.4K
    Michael AllinghamNCRetina Specialist (Ophthalmology) Physician$1.7M$0
    Jonathan CookNCDermatology Physician$1.6M$0
    Benjamin FreilichNJOphthalmology Physician$1.5M$111.3K
    Eleonora LadNCRetina Specialist (Ophthalmology) Physician$1.4M$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Duke University Health System, Inc.NCGeneral Acute Care Hospital$0$44.4M
    Duke Health Integrated Practice, Inc.NCGeneral Practice Physician$0$36.3M
    Tywana DonaldsonNCNurse Practitioner$1.4M$0
    Pretesh PatelNCRadiation Oncology Physician$668.8K$0
    Pedro VargasNCDiagnostic Radiology Physician$439.5K$0
    Michael RehornNCStudent in an Organized Health Care Education/Training Program$369.4K$0
    Christopher BrownNCOrthopaedic Surgery Physician$360.8K$0
    Sunit VekariaNCDiagnostic Radiology Physician$358.3K$0
    Priyatham MettuNCOphthalmology Physician$332.6K$0
    Christopher BoehlkeNCOphthalmology Physician$314.3K$0

    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. North Carolina Distribution
    Michael Richard — 2 of 21 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — North Carolina