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    OpenPayerNPI Medicare & MedicaidMatthew Reed
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    Matthew Reed — Billing Profile & Reimbursement Data

    NPI 1790753564 · Newport News, VA · Ophthalmology Physician

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    Matthew Reed is a ophthalmology physician provider located in Newport News, Virginia. This profile covers 15 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
    OrganizationMatthew Reed
    Address11800 Rock Landing Dr
    CityNewport News
    StateVA
    ZIP23606
    TaxonomyOphthalmology Physician
    NPI EnumeratedMarch 9, 2006

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

    Payer SourceTotal Paid
    Medicare$4.6M
    Medicaid$0

    Key Findings

    This provider’s Medicare activity is dominated by intravitreal drug administration and retina-focused diagnostic services, with the top three drug-related codes J0178, J2777, and J2778 accounting for the bulk of clinical work. J0178 shows 3.2K claims with $684 avg paid/claim and $2.2M revenue, J2777 shows 50.3K claims with $29 avg paid/claim and $1.5M revenue, and J2778 shows 2.4K claims with $178 avg paid/claim and $421.1K revenue; additional high-volume retina procedures include 67028 (2.6K claims, $244.8K) and diagnostic imaging codes 92134 (3.6K claims, $112.6K) and 92014 (1.4K claims, $125.4K).

    Revenue concentration on Medicare is very high: the precomputed top 3 Medicare codes by revenue account for 87.9% of this provider’s total Medicare revenue. Those three codes alone represent $2.2M + $1.5M + $421.1K in reported revenue, making the practice financially reliant on a small set of high-value ocular drug administrations.

    Payer mix is effectively single-payer for payor-facing analysis: total Medicare revenue is $4.6M while total Medicaid revenue is none (no Medicaid billing on file). This absence of Medicaid billing indicates a Medicare-dominant billing profile and limited exposure to state Medicaid revenue streams in the data.

    On competitive standing, the provider ranks as a high-volume national participant for key retina/drug administration codes. J0178 ranks #157 of 3204 providers nationally (95th percentile) and J2777 ranks #104 of 2039 providers nationally (95th percentile), both described as "notably above typical national volume"; in contrast J2778 ranks #172 of 1208 providers nationally (86th percentile), a more typical participation level for that drug code.

    The provider is an extreme outlier on several diagnostic and exam codes, indicating sustained patient management volume beyond drug administration alone. 92014 ranks #682 of 35415 providers nationally (98th percentile; extreme outlier) and 92134 ranks #198 of 26868 providers nationally (99th percentile; extreme outlier), supporting a pattern of frequent comprehensive exams and retinal imaging accompanying injection-based therapy.

    Operational and revenue-cycle implications follow from the code-level reimbursement mix: J0178’s $684 avg paid/claim and J2778’s $178 avg paid/claim contrast sharply with J2777’s $29 avg paid/claim, suggesting that reimbursement units or dosing/billing structure differ materially across the principal anti-VEGF/related therapies used. High volumes of injectable drug codes and associated procedure codes (67028) imply on-site drug handling, inventory and administration workflows are central to the practice’s operations and revenue.

    There is potential payer-concentration and access risk stemming from the lack of Medicaid billing on file; with Medicare-only reported revenue, the practice’s negotiated rates and patient access will be closely tied to Medicare reimbursement trends for high-cost ocular drugs. This single-payer concentration may limit leverage in state Medicaid networks and affect patient demographics seen in the claims data.

    The provider has an established tenure in the NPI registry (enumerated 2006-03-09, ~20 years ago), which combined with consistently high national ranks on injection and imaging codes suggests a long-standing, high-volume retina/ophthalmology practice in Newport News, VA. Long enumeration plus the concentration in advanced retinal therapies supports the interpretation of an established specialty practice rather than a low-volume general ophthalmology provider.

    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.

    15 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J0178Injection, aflibercept, 1 mg3,170$680$2.2M
    J2777Injection, faricimab‑svoa, 0.1 mg50,280$30$1.5M
    J2778Injection, ranibizumab, 0.1 mg2,370$180$421.1K
    67028The 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.2,580$100$244.8K
    92014An 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…1,440$90$125.4K
    92134The 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.3,630$30$112.6K
    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…360$60$22.5K
    67108The provider repairs a detached retina using heat produced by a laser beam or by freezing the tissues. He may attach a scleral buckle to simplify the passage of fluid through and behind the retina or…20$920$14.8K
    92250Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…540$30$14.5K
    67041In this procedure, the provider removes scar tissue from the retinal membrane that obscures vision. He removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical…10$830$10.8K

    Showing 1–10 of 15

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    15 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J01788801,400$690$1.1M
    J277736013,200$30$517.1K
    J2778440560$180$171.5K
    670287901,000$90$107.1K
    9201450870170$80$32.8K
    6710882020$1,180$23.5K
    67041112020$1,110$23.3K
    J90353460170$50$19.9K
    992131,49412,44090$60$10K
    92134868070$30$9.7K

    Showing 1–10 of 15

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Riverside Hospital IncVAGeneral Acute Care Hospital$0$136.7M
    Riverside Physician Services, Inc.VAFamily Medicine Physician$0$44.7M
    Shore Health Services Inc.VARural Acute Care Hospital$0$24.7M
    Vcu Health Tappahannock HospitalVAGeneral Acute Care Hospital$0$20.6M
    Riverside Middle Peninsula Hospital IncVAGeneral Acute Care Hospital$0$19M
    Riverside Physician Services IncVAEmergency Medicine Physician$0$17.3M
    Michumi PLLCVAEmergency Medicine Physician$0$12.4M
    Doctors' Hospital Of WilliamsburgVAGeneral Acute Care Hospital$0$12M
    Riverside Hospital Inc.VAFamily Medicine Physician$0$7.7M
    Brian KeelVAOphthalmology Physician$2.7M$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    National Counseling Group, IncVAMental Health Counselor$0$25.9M
    Maxim Healthcare Services, Inc.VAHome Health Agency$0$20M
    Care Advantage, IncVAHome Health Agency$0$17.4M
    Behavior Health & Wellness Center, LLCVABehavior Analyst$0$15.8M
    Personal Touch Home Care Of Va, IncVAHome Health Agency$0$14.6M
    Odyssey Community Services IncVACommunity/Behavioral Health Agency$0$14.4M
    Hope In-home Care LLCVAHome Health Agency$0$10.2M
    1life1love, Inc.VACommunity/Behavioral Health Agency$0$9.2M
    Beyond Disabilities, LLCVADevelopmentally Disabled Services Day Training Agency$0$7.9M
    Childrens Medical Group IncVAPediatrics Physician$0$7.1M

    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. Virginia Distribution
    Matthew Reed — 3 of 15 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Virginia