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NPI 1750545455 · Bettendorf, IA · Ophthalmology Physician
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Martin O'malley is a ophthalmology physician provider located in Bettendorf, Iowa. This profile covers 22 Medicare and 2 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 | Martin O'malley |
| Address | 777 Tanglefoot Ln |
| City | Bettendorf |
| State | IA |
| ZIP | 52722 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | July 11, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.9M |
| Medicaid | $2.7K |
This provider is effectively Medicare‑driven: lifetime Medicare revenue is $1.9M versus $2.7K in Medicaid, so Medicaid represents a vanishingly small share of reported public‑payer receipts. The NPI was enumerated on 2008-07-11 (~18 years ago), indicating long-standing participation in public programs but a business footprint concentrated on Medicare billing.
Medicare revenue is highly concentrated in intravitreal drug administrations: the precomputed top‑3 Medicare codes account for 81.5% of Medicare revenue, led by J0178 (41.1% of Medicare revenue, $777.8K), followed by J2777 (30.3%, $572.5K) and J2778 (10.1%, $190.3K). These three anti‑VEGF/anti‑angiogenic drug codes dominate the practice’s Medicare inflows and define its core procedural service line.
The CPT/HCPCS mix points to a retina/injection‑focused ophthalmology practice rather than a high‑volume primary ophthalmic clinic: the leading codes J0178, J2777 and J2778 are injections (aflibercept, faricimab, ranibizumab) into the vitreous, and procedural codes such as 66984 (cataract/IOL, $99.6K, 5.3% of Medicare revenue) are present but secondary. Imaging and diagnostic codes (e.g., 92134 at $27.4K) appear to support the injection workflow rather than drive overall revenue.
National competitive standing on the top Medicare injection codes is modest-to-typical rather than dominant: J0178 ranks #1161 of 3204 (64th percentile; typical, unremarkable volume for this code), J2777 ranks #541 of 2039 (73th percentile; typical, unremarkable volume for this code), and J2778 ranks #418 of 1208 (65th percentile; typical, unremarkable volume for this code). In short, the provider is a regular regional participant in anti‑VEGF delivery but not an outlier at the national level.
Medicaid billing is negligible in scale and concentrated: the precomputed top‑3 Medicaid codes account for 100.0% of Medicaid revenue, with 67028 representing $2.3K (84.0% of Medicaid revenue) and 92015 $432 (16.0%). Both Medicaid rank positions are low in‑state (67028 ranks #15 of 15, 0th percentile; 92015 ranks #382 of 421, 9th percentile), indicating minimal Medicaid market presence and limited statewide competitive standing.
Operationally, the practice’s visit/E&M revenue is small relative to procedural income — Medicare 99214 produced $27.1K (1.4% of Medicare revenue) and 99213 produced $24.4K (1.3% of Medicare revenue) — which suggests encounters are largely centered on procedure scheduling and injection visits rather than high‑revenue longitudinal office management. This pattern is consistent with a procedure‑centric retina service line where injections and associated imaging drive throughput.
Imaging and diagnostics are used at above‑typical levels for certain modalities: 92134 (retinal imaging) accounts for $27.4K and ranks #1896 of 26868 (93th percentile; typical, unremarkable volume for this code), and 92136 and 92133 appear as additional supportive imaging codes. These metrics imply the practice deploys retinal imaging at scale to support intravitreal therapy decision‑making and follow‑up.
The presence of cataract surgery billing (66984 at $99.6K, 5.3% of Medicare revenue) indicates the provider performs some operative work in addition to injections, but surgical revenue is clearly secondary to anti‑VEGF drug administration. Given the concentration of drug codes and the revenue split, the practice’s strategic and contracting value to payers will be driven primarily by its injection volume and drug reimbursement profile rather than broad primary 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.
22 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1,120 | $690 | $777.8K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 19,740 | $30 | $572.5K |
| J2778 | Injection, ranibizumab, 0.1 mg | 1,060 | $180 | $190.3K |
| 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. | 1,270 | $90 | $110.5K |
| 66984 | The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to… | 250 | $400 | $99.6K |
| 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. | 1,190 | $20 | $27.4K |
| 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… | 310 | $90 | $27.1K |
| 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… | 410 | $60 | $24.4K |
| J9035 | Injection, bevacizumab, 10 mg | 430 | $50 | $22.6K |
| 92136 | The provider uses a noninvasive method to measure the patient’s eye or eyes to get information that the provider then uses to calculate the appropriate power for an intraocular lens (IOL). Selecting… | 260 | $30 | $7.5K |
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 |
|---|---|---|---|---|---|
| J2777 | 17 | 20 | 43,140 | $30 | $1.7M |
| J0178 | 15 | 40 | 640 | $690 | $760.2K |
| J2778 | 9 | 20 | 780 | $180 | $259.9K |
| 67028 | 16 | 60 | 420 | $80 | $80.6K |
| 66984 | 35 | 340 | 50 | $340 | $50.4K |
| 92014 | 407 | 500 | 200 | $70 | $19.8K |
| 99214 | 959 | 4,690 | 100 | $70 | $14.4K |
| 66821 | 70 | 130 | 40 | $210 | $14.4K |
| J9035 | 2 | 10 | 200 | $50 | $14.2K |
| 99213 | 335 | 4,740 | 100 | $50 | $8K |
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.
2 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. | 10 | $170 | $2.3K |
| 92015 | The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced. | 20 | $20 | $430 |
How this provider's Medicaid billing volume and revenue compare to other Iowa providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Iowa median
2 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. | 15 | 20 | 460 | $140 | $410.5K |
| 92015 | The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced. | 382 | 420 | 310 | $10 | $5.8K |
Other providers in the same ZIP code as Martin O'malley, ranked by combined Medicare and Medicaid revenue.
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