Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidRetina Specialists Of Michigan PC
    Ask Trek AI about this page

    Retina Specialists Of Michigan PC — Billing Profile & Reimbursement Data

    NPI 1801048699 · Grand Rapids, MI · Retina Specialist (Ophthalmology) Physician

    Customize your policy alerts

    Sign up for Retina Specialists Of Michigan PC — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Retina Specialists Of Michigan PC is a retina specialist (ophthalmology) physician provider located in Grand Rapids, Michigan. This profile covers 0 Medicare and 17 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationRetina Specialists Of Michigan PC
    Address5030 Cascade Rd Se
    CityGrand Rapids
    StateMI
    ZIP49546
    TaxonomyRetina Specialist (Ophthalmology) Physician
    NPI EnumeratedOctober 13, 2008

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

    Payer SourceTotal Paid
    Medicaid$5.5M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    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

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    17 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J0178Injection, aflibercept, 1 mg3,400$1,190$4M
    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.8,490$40$356.4K
    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…5,010$50$270.5K
    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.13,780$20$220.5K
    J3590Unclassified biologics2,420$80$186K
    99204The 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…1,200$80$90.3K
    J9035Injection, bevacizumab, 10 mg1,460$60$87.4K
    99214The 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…1,550$60$85.1K
    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,…3,940$20$78.7K
    92235The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken…890$50$45.5K

    Showing 1–10 of 17

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Michigan providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Michigan median

    17 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J0178Injection, aflibercept, 1 mg2201,170$1,140$2.1M
    99214The 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…1,8354,3801,000$70$289.9K
    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…4,6194,7701,060$50$247.8K
    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.3401,830$50$162.8K
    J9035Injection, bevacizumab, 10 mg930460$140$160.8K
    99215The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…1,0301,170170$90$107.9K
    99204The 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…3851,860220$90$96.9K
    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…38390310$60$91.6K
    67228In retinopathy, tiny new vessels grow profusely and fibrous tissue proliferates in between the layers of the retina, which may extend into the optic nerve and vitreous, clear gel that fills the space…1120240$190$91.3K
    92004The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.149340220$70$74.9K

    Showing 1–10 of 17

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Retina Specialists Of Michigan PC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Kathleen DehornMIOphthalmology Physician$1.7M$0
    Nathan PezdaMIRetina Specialist (Ophthalmology) Physician$1.1M$0
    Liliya SutherlandMIRetina Specialist (Ophthalmology) Physician$880.7K$0
    Scott WesthouseMIOphthalmology Physician$869.9K$0
    Joseph BossMIUveitis and Ocular Inflammatory Disease (Ophthalmology) Physician$761.2K$0
    Greg BeverMIRetina Specialist (Ophthalmology) Physician$749.5K$0
    Edward KorotMIRetina Specialist (Ophthalmology) Physician$407.1K$0

    Nearby Providers

    Other providers in the same ZIP code as Retina Specialists Of Michigan PC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Reliance Community Care PartnersMICase Management Agency$0$145.4M
    Dental Group Associates PCMIPediatric Dentistry$0$16.1M
    Pediatric Dental Specialists Of West MichiganMIPediatric Dentistry$0$11M
    Michigan Pain Consultants PCMIPain Medicine (Anesthesiology) Physician$0$9.9M
    Mitten Kids Dentistry Cascade PlcMIPediatric Dentistry$0$7.2M
    Carepoint Dental Anesthesia Group Of Michigan, PLLCMIDental Anesthesiology$0$6.4M
    Jeffrey ZheutlinMIOphthalmology Physician$1.5M$0
    East Paris Surgical Center, LLCMIAmbulatory Surgical Clinic/Center$968.8K$30.6K
    Louis GlazerMIOphthalmology Physician$896.2K$0
    Grand Rapids Surgical Suites LLCMIAmbulatory Surgical Clinic/Center$299.7K$112.2K

    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.

    Medicaid Revenue by Year vs. Michigan Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Michigan Distribution
    Retina Specialists Of Michigan PC — 1 of 16 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Michigan