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NPI 1679570675 · Lexington, KY · Retina Specialist (Ophthalmology) Physician
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Jack Hollins is a retina specialist (ophthalmology) physician provider located in Lexington, Kentucky. This profile covers 14 Medicare and 5 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 | Jack Hollins |
| Address | 120 N Eagle Creek Dr Ste 500 |
| City | Lexington |
| State | KY |
| ZIP | 40509 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | July 5, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.2M |
| Medicaid | $112.8K |
Medicare dominates this provider's payer mix by scale: total Medicare revenue is $2.2M compared with total Medicaid revenue of $112.8K, so the practice is effectively Medicare-driven in dollars. The disparity in scale indicates that Medicare reimbursement and referral patterns will be the primary drivers of the practice's financial performance and utilization profile.
Medicare revenue is highly concentrated in intravitreal anti-VEGF dispensing: the top 3 Medicare codes account for 85.0% of this provider's total Medicare revenue, led by J0178 at $1.5M (70.8%). The second- and third-largest Medicare contributors are J2777 ($203.6K, 9.3%) and 67028 ($105.2K, 4.8%), which together indicate a revenue base built on repeated in-office injections and related procedural billing.
Medicaid activity shows an even tighter concentration around injections and retinal imaging: the top 3 Medicaid codes account for 90.0% of this provider's total Medicaid revenue, with 67028 at $65.8K (58.5%), 92134 at $28.4K (25.2%), and J9035 at $7K (6.2%). This pattern suggests the provider bills Medicaid largely for procedural retinal care (intravitreal injections) and diagnostic retinal imaging rather than broad primary eye-care services.
The code mix and descriptions align with a retina-focused procedural practice: frequent use of J0178, J2777, J2778, and 67028 point to regular intravitreal injections for retinal disease, while high-volume 92134 claims reflect substantial posterior-segment imaging (OCT) throughput. Combined with E/M codes like 99213 and 99214 on the Medicare side, the data indicate a workflow centered on injection clinics supported by retinal imaging and follow-up office visits.
On Medicare national competitive standing, the provider is a strong local operator for core retinal therapies but not an outlier for the leading drug: J0178 ranks #419 of 3204 providers nationally (87th percentile; typical, unremarkable volume for this code), so aflibercept use is high in revenue but described as typical relative to national peers. In contrast, two supporting Medicare codes are labeled extreme outliers: 99213 (1.5K claims, ranks #2311 of 457151 providers nationally, 99th percentile; extreme outlier, far above typical national volume for this code) and 92134 (2.5K claims, ranks #677 of 26868 providers nationally, 97th percentile; extreme outlier, far above typical national volume for this code), indicating particularly high E/M and OCT throughput versus national peers.
Within the state Medicaid population the provider is a modest in-market participant rather than a dominant statewide provider: 67028 ranks #15 of 31 providers in-state (53th percentile; typical, unremarkable volume for this code) and 92134 ranks #15 of 74 providers in-state (81th percentile; typical, unremarkable volume for this code). Those ranks suggest routine Medicaid-level procedure and imaging volumes without clear statewide dominance.
The provider has long-tenured enrollment (NPI enumerated 2005-07-05 (~21 years ago)), consistent with an established retinal practice. This longevity, paired with concentrated injection and imaging revenue, suggests an experienced operator whose business model centers on recurring, procedure-based care and follow-up visits rather than episodic or broad general ophthalmology services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
14 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2,240 | $690 | $1.5M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 7,020 | $30 | $203.6K |
| 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 | $90 | $105.2K |
| 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… | 1,470 | $60 | $87.9K |
| J2778 | Injection, ranibizumab, 0.1 mg | 460 | $180 | $83.9K |
| 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. | 2,480 | $30 | $66.9K |
| 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… | 550 | $90 | $51K |
| 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… | 130 | $110 | $14.1K |
| J3590 | Unclassified biologics | 120 | $90 | $10.9K |
| 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… | 100 | $70 | $7.5K |
Showing 1–10 of 14
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
14 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 12 | 40 | 870 | $690 | $858.5K |
| J2777 | 21 | 30 | 11,040 | $30 | $399.1K |
| J2778 | 14 | 20 | 700 | $180 | $148.3K |
| 67028 | 18 | 50 | 650 | $90 | $72.9K |
| J3590 | 24 | 40 | 160 | $60 | $17K |
| 99214 | 489 | 7,230 | 110 | $70 | $14.1K |
| 99213 | 19 | 7,250 | 80 | $50 | $7.7K |
| 92134 | 8 | 410 | 50 | $30 | $6.3K |
| 92235 | 10 | 20 | 30 | $90 | $5.3K |
| 99204 | 163 | 3,200 | 30 | $100 | $4.8K |
Showing 1–10 of 14
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.
5 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. | 450 | $150 | $65.8K |
| 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. | 1,010 | $30 | $28.4K |
| J9035 | Injection, bevacizumab, 10 mg | 120 | $60 | $7K |
| 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… | 400 | $10 | $5.6K |
| 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… | 180 | $30 | $5.6K |
How this provider's Medicaid billing volume and revenue compare to other Kentucky providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Kentucky median
5 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… | 2,480 | 3,340 | 1,020 | $30 | $296K |
| 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. | 15 | 30 | 350 | $70 | $165.3K |
| 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… | 456 | 710 | 790 | $60 | $98.4K |
| J9035 | Injection, bevacizumab, 10 mg | 9 | 20 | 120 | $130 | $96.1K |
| 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. | 15 | 70 | 210 | $20 | $29.2K |
Other providers in the same ZIP code as Jack Hollins, ranked by combined Medicare and Medicaid revenue.
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