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NPI 1669476560 · Brentwood, MO · Retina Specialist (Ophthalmology) Physician
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Kevin Blinder is a retina specialist (ophthalmology) physician provider located in Brentwood, Missouri. This profile covers 22 Medicare and 7 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 | Kevin Blinder |
| Address | 1600 S Brentwood Blvd Ste 700 |
| City | Brentwood |
| State | MO |
| ZIP | 63144 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | June 8, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.6M |
| Medicaid | $39.4K |
Provider is a retina-focused specialist whose Medicare revenue is overwhelmingly driven by intravitreal pharmacotherapy: J0178 ($1.5M, 55.1% of Medicare revenue), J2777 ($529K, 20.0%), and 67028 ($143.9K, 5.4%) together account for 80.6% of Medicare revenue. The code mix (two high-revenue biologic injection codes plus a separate vitreous injection procedure) is consistent with a practice model centered on frequent in-office injections and associated procedural visits rather than primarily surgical retina work.
Medicare revenue concentration is high: the precomputed top-three share of 80.6% indicates material dependence on a small set of injection and procedure codes. J0178 alone supplies $1.5M of the $2.6M total Medicare revenue, which signals financial exposure to utilization or reimbursement changes for those specific intravitreal agents and related injection procedures.
Although injections drive most Medicare dollars, the provider shows exceptional posterior-segment imaging and diagnostic volume: 92134 is listed as an "extreme outlier, far above typical national volume" (rank #252 of 26868) and 92201 is also an "extreme outlier, far above typical national volume" (rank #23 of 2619). Those nationally elevated imaging ranks, together with high-volume comprehensive new patient evaluations (92004 ranked in the 99th percentile), point to substantial in-office imaging capacity and a referral stream that generates both new-patient consults and repeated retinal imaging.
Office evaluation-and-management activity is also notable: 99214 and 99213 are both described as "notably above typical national volume" (99214 at 98th percentile). This pattern—high E/M throughput alongside frequent injections and heavy imaging—indicates routine management of chronic retinal conditions with repeated visits and monitoring rather than sparse episodic care.
Medicaid is a very small component of this provider's lifetime billing profile: total Medicaid revenue is $39.4K versus total Medicare revenue of $2.6M, so the practice is effectively Medicare-dominant. Medicaid billing is concentrated as well: the top three Medicaid codes account for 89.2% of Medicaid revenue and consist of 92134 ($13.9K, 34.7%), 67028 ($11.3K, 28.3%), and 92226 ($10.5K, 26.2%), reflecting the same service mix (imaging plus intravitreal procedures) but at much lower volume and dollar scale.
Within the state Medicaid market the provider’s presence is modest to mixed: 92134 ranks #16 of 62 providers in-state (75th percentile; characterized as typical), while 67028 ranks #24 of 34 (30th percentile) and 92226 ranks #11 of 23 (55th percentile). These in-state ranks suggest the provider is not a dominant Medicaid retinal provider locally, despite high national standing on certain Medicare imaging codes.
Tenure data show the NPI was enumerated on 2005-06-08 (~21 years ago), indicating an established practice and likely a stable referral base. Combined with concentrated Medicare revenue and very high national imaging ranks, the long active period strengthens the interpretation that this is an experienced retina specialist with mature clinical workflows focused on injections and posterior-segment diagnostics.
From a payer/contracting perspective, the operational footprint implied by the claims mix—high-value intravitreal agents (J0178 and J2777) plus extreme-outlier imaging (92134/92201)—suggests payers should treat this provider as a high-utilization retina imaging and injection site for Medicare populations. For Medicaid, low overall dollars and middling in-state ranks mean network or utilization management actions would be guided more by Medicare patterns and clinical volume than by Medicaid spend alone.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
22 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2,120 | $690 | $1.5M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 18,240 | $30 | $529K |
| 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. | 1,560 | $90 | $143.9K |
| 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. | 3,370 | $30 | $97.8K |
| 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… | 1,060 | $90 | $95.5K |
| 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… | 770 | $100 | $74.3K |
| 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… | 860 | $70 | $58.4K |
| 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. | 380 | $110 | $42K |
| J2778 | Injection, ranibizumab, 0.1 mg | 220 | $180 | $39.5K |
| 92201 | The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece… | 2,080 | $20 | $39.5K |
Showing 1–10 of 22
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
22 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 8 | 60 | 820 | $690 | $683.3K |
| J2777 | 11 | 50 | 11,730 | $30 | $388.9K |
| J2778 | 23 | 20 | 540 | $180 | $203.8K |
| 67028 | 10 | 80 | 600 | $90 | $69.7K |
| 67042 | 12 | 30 | 20 | $1,070 | $26.8K |
| J9035 | 13 | 40 | 170 | $60 | $21.8K |
| 67108 | 9 | 20 | 10 | $1,060 | $18K |
| 92014 | 47 | 730 | 120 | $80 | $18K |
| 99214 | 102 | 8,960 | 100 | $80 | $13.9K |
| 99213 | 107 | 8,730 | 70 | $50 | $7K |
Showing 1–10 of 22
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.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 1,070 | $10 | $13.9K |
| 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. | 110 | $100 | $11.3K |
| 92226 | N/A | 440 | $20 | $10.5K |
| 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… | 90 | $20 | $2K |
| 92012 | For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any… | 110 | $10 | $1.1K |
| 92201 | The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece… | 130 | $10 | $800 |
| 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… | 20 | $30 | $390 |
How this provider's Medicaid billing volume and revenue compare to other Missouri providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Missouri median
7 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 2,857 | 3,170 | 230 | $70 | $128.1K |
| 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. | 24 | 30 | 290 | $90 | $75.9K |
| 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… | 375 | 560 | 190 | $60 | $36K |
| 92012 | For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any… | 60 | 120 | 120 | $40 | $23.9K |
| 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. | 16 | 60 | 340 | $20 | $19.3K |
| 92226 | N/A | 11 | 20 | 430 | $20 | $7.9K |
| 92201 | The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece… | 10 | 20 | 130 | $10 | $6.2K |
Other providers in the same ZIP code as Kevin Blinder, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Pyramid Homemaker Services, Inc. | MO | In Home Supportive Care Agency | $0 | $15.7M |
| Heeral Shah | MO | Retina Specialist (Ophthalmology) Physician | $1.6M | $0 |
| Sam Martin | MO | Interventional Pain Medicine Physician | $34.1K | $1.3M |
| Thomas Krummenacher | MO | Retina Specialist (Ophthalmology) Physician | $737.7K | $280 |
| Empowerme Diagnostics LLC | MO | Clinical Medical Laboratory | $271.9K | $0 |
| Rachel Darken | MO | Neurology Physician | $221.4K | $0 |
| Luqi Chi | MO | Neurology Physician | $137.3K | $0 |
| Craig Sorce | MO | Optometrist | $101.8K | $0 |
| Kelsey Melsheimer | MO | Occupational Therapist | $83.1K | $0 |
| Samir Cardona | MO | Physical Therapist | $79.7K | $0 |
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