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NPI 1669665105 · Nashville, TN · Retina Specialist (Ophthalmology) Physician
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David Reichstein is a retina specialist (ophthalmology) physician provider located in Nashville, Tennessee. This profile covers 24 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 | David Reichstein |
| Address | 345 23rd Ave N |
| City | Nashville |
| State | TN |
| ZIP | 37203 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | August 18, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $4.9M |
| Medicaid | $141.7K |
Practice scale and payer mix are heavily Medicare‑driven: the provider reported $4.9M in total Medicare revenue versus $141.7K in Medicaid, indicating Medicare dominates this clinician’s revenue base and Medicaid is a very small portion of overall billing. This gap suggests the provider operates primarily in fee-for-service Medicare markets rather than relying on state Medicaid volume.
Medicare revenue is highly concentrated in intravitreal drug administration: the top three Medicare codes (J0178, J2777, Q5128) account for 74.0% of total Medicare revenue, with J0178 at $2M (42.1%), J2777 at $897.8K (18.4%), and Q5128 at $659.2K (13.5%). This concentration signals that anti‑VEGF and related biologic injections are the core revenue drivers for Medicare payers.
The service mix reflects a retina‑specialist procedural model centered on injections and retinal imaging: high‑revenue injection codes (J0178, J2777, Q5128) appear alongside high volumes of injection procedure code 67028 and retinal imaging codes 92134 and 92014. Billing patterns are consistent with an ophthalmology retina practice that performs frequent in‑office intravitreal injections and diagnostic imaging as routine parts of care.
National competitive standing is strong for several high‑impact services: J0178 ranks 186 of 3204 providers nationally (94th percentile) and Q5128 ranks 34 of 373 (91th percentile), while 67028 ranks in the 95th percentile and 92134 is an extreme outlier at the 98th percentile. These rank/percentile positions indicate above‑typical to exceptional national volume for key injection and imaging services versus peers.
Medicaid billing is tightly concentrated and modest in scale: the top three Medicaid codes (67028, 92134, J9035) account for 100.0% of this provider’s Medicaid revenue, with 67028 contributing $98.6K (69.3%), 92134 $25K (17.6%), and J9035 $18.7K (13.2%). In‑state ranks for those codes are middling (e.g., 67028 is 22 of 37, 42th percentile), indicating the provider is not a dominant Medicaid volume leader statewide despite procedural focus.
Clinical interpretation for Medicaid suggests the practice bills primarily for procedures and imaging under state programs rather than high‑priced biologics: Medicaid revenue is driven by 67028 (intravitreal injection) and 92134 (retinal imaging), while the injectable listed is J9035 (bevacizumab) at a comparatively low dollar contribution. This pattern aligns with a regimen where lower‑cost drug choices and procedure reimbursement drive Medicaid collections.
Distinct utilization outliers point to operational emphases: 92134 is labeled an "extreme outlier, far above typical national volume" and 92014 ranks in the 97th percentile, indicating unusually high imaging and established‑patient office visit volumes relative to national peers. Those outlier labels, combined with high injection code ranks, suggest a high‑throughput clinic workflow focused on monitoring and treating retinal disease.
Long NPI tenure supports an established referral footprint: the provider’s NPI was enumerated on 2007-08-18 (~19 years ago), which is consistent with sustained, long‑term operation and may underlie the steady high volumes observed for injections and imaging services. Sustained presence in the market is a plausible contributor to the provider’s high national percentiles on several retina procedures.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
24 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2,980 | $690 | $2M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 30,960 | $30 | $897.8K |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 3,070 | $220 | $659.2K |
| J3490 | Unclassified drugs | 200 | $1,350 | $267.3K |
| J2778 | Injection, ranibizumab, 0.1 mg | 1,280 | $180 | $229.5K |
| 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. | 2,360 | $100 | $226.8K |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 1,010 | $120 | $120.6K |
| 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… | 1,230 | $80 | $102.3K |
| Q5124 | Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg | 530 | $180 | $94.5K |
| 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. | 2,620 | $30 | $73.3K |
Showing 1–10 of 24
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 24 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
24 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 4 | 80 | 790 | $680 | $769.8K |
| J2777 | 10 | 50 | 15,060 | $30 | $592.1K |
| Q5128 | 3 | 20 | 1,190 | $210 | $394K |
| J2778 | 22 | 40 | 1,340 | $180 | $370.2K |
| Q5124 | 8 | 10 | 690 | $180 | $137.8K |
| 67028 | 8 | 80 | 1,130 | $90 | $98.5K |
| J2781 | 5 | 20 | 560 | $120 | $82.5K |
| J7312 | 12 | 10 | 210 | $150 | $45.8K |
| J3490 | 8 | 60 | 70 | $400 | $41.9K |
| 67042 | 32 | 40 | 20 | $1,020 | $34.5K |
Showing 1–10 of 24
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. | 640 | $150 | $98.6K |
| 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. | 890 | $30 | $25K |
| J9035 | Injection, bevacizumab, 10 mg | 370 | $50 | $18.7K |
How this provider's Medicaid billing volume and revenue compare to other Tennessee providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Tennessee median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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. | 22 | 40 | 760 | $50 | $193K |
| J9035 | Injection, bevacizumab, 10 mg | 21 | 30 | 780 | $20 | $65.7K |
| 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. | 34 | 80 | 440 | $10 | $29.6K |
Other providers in the same ZIP code as David Reichstein, ranked by combined Medicare and Medicaid revenue.
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