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NPI 1801856232 · Alexandria, LA · Ophthalmology Physician
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Thomas Norton is a ophthalmology physician provider located in Alexandria, Louisiana. This profile covers 35 Medicare and 7 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 | Thomas Norton |
| Address | 231 Windermere Blvd |
| City | Alexandria |
| State | LA |
| ZIP | 71303 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | March 28, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.2M |
| Medicaid | $21.6K |
THOMAS NORTON’s billing profile is strongly ophthalmology-focused, with procedure and diagnostic codes consistent with a cataract and retina practice mix. High-volume surgical codes like 66984 and post-operative/laser codes such as 66821 and 65820 appear alongside imaging codes 92134 and 92250 and frequent intravitreal injections (J0178, J9035, J2777), indicating an operation that performs cataract surgery, retinal imaging, and medical retina injections as core services.
Medicare revenue is dominant relative to Medicaid: lifetime Medicare revenue is $1.2M versus total Medicaid revenue of $21.6K, indicating the provider is effectively Medicare-driven with minimal Medicaid participation. This payer mix implies the practice’s financial reliance on Medicare beneficiaries and procedures reimbursed at Medicare rates.
Revenue concentration on Medicare is meaningfully concentrated: the precomputed top 3 Medicare codes account for 38.5% of the provider’s total Medicare revenue, signaling that a subset of high-revenue procedures (including 65778, J0178, and 92014) drive a large share of Medicare payments. For Medicaid the concentration is extreme: the top 3 Medicaid codes account for 92.9% of the provider’s total Medicaid revenue, with 92014 alone representing $16.1K (74.0% of Medicaid revenue), showing Medicaid activity is narrowly concentrated in a few office and imaging services.
The provider’s national competitive standing varies by code: for routine comprehensive eye exams 92014 the provider is an extreme outlier (ranks #505 of 35415, 99th percentile) and similarly high-volume for retinal imaging 92134 (95th percentile). Those high percentiles reflect unusually large visit and imaging volumes relative to national peers, consistent with a busy outpatient clinic. Conversely, high-revenue drug administration J0178 ranks much lower nationally (22th percentile), indicating intravitreal aflibercept billing is not large compared with national injectors.
Several codes show above-typical or notable volume relative to peers, highlighting practice strengths: 92012 and 92250 both rank in the 96–97th percentiles and 92134 ranks at the 95th percentile, meaning intermediate/established exam visits and fundus photography are delivered at volumes well above typical national providers. Other procedure codes such as 65778 (92nd percentile) and 66821 (94th percentile) are also relatively elevated, suggesting the practice provides a broader set of ocular surface and post‑cataract services at higher-than-typical rates.
There are modest or limited presences in some specialized interventions: codes like J2777 (faricimab) and J9035 (bevacizumab) rank in the low national percentiles (3rd and 64th respectively for their cohorts), indicating the provider’s use of certain newer or alternative intravitreal agents is not a leading part of its national activity. This may reflect local prescribing mix or patient population differences rather than overall injection volume, given J0178 has higher absolute Medicare revenue.
The provider’s tenure is long-standing: NPI enumerated ~20 years ago (2006-03-28), which supports interpretation of high visit volumes and an established referral footprint. Long enumeration combined with the high percentiles on office and imaging codes is consistent with a mature outpatient ophthalmology practice serving a stable patient base.
From a payer-strategy perspective, the practice appears to generate most of its clinical volume and revenue from office-based ophthalmology services and cataract care on Medicare patients, while Medicaid encounters are limited and concentrated primarily in comprehensive exams (92014) and retinal imaging (92134). For payers and network planners, this pattern suggests the provider is an important local source for high-volume exams and retinal diagnostics in the Medicare population but not a major Medicaid service node.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
35 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 65778 | The provider places amniotic membrane on the ocular surface, similar to the placement of a contact lens. | 180 | $920 | $167.1K |
| J0178 | Injection, aflibercept, 1 mg | 240 | $700 | $164.3K |
| 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… | 1,600 | $70 | $118.5K |
| 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… | 320 | $360 | $115.3K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 1,980 | $30 | $57.4K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 250 | $220 | $55K |
| 93890 | N/A | 280 | $190 | $53.5K |
| 92012 | For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any… | 890 | $60 | $53.5K |
| 93886 | The provider performs an ultrasound of the arteries inside the head using Doppler technique to study the flow and speed of blood through the arteries. He performs the procedure to assess blood flow… | 280 | $190 | $53.2K |
| 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. | 1,590 | $30 | $42.9K |
Showing 1–10 of 35
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 35 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
35 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 29 | 50 | 300 | $680 | $371.5K |
| J2777 | 26 | 30 | 6,660 | $30 | $309.4K |
| 66984 | 33 | 210 | 80 | $500 | $91.3K |
| 65778 | 1 | 10 | 40 | $910 | $50.8K |
| 67028 | 40 | 70 | 410 | $80 | $44.3K |
| 66991 | 20 | 20 | 40 | $960 | $42.3K |
| 93890 | 2 | 10 | 180 | $190 | $37.2K |
| 66174 | 12 | 10 | 30 | $630 | $27K |
| 65820 | 1 | 10 | 20 | $920 | $25.8K |
| 15823 | 6 | 20 | 30 | $510 | $24.5K |
Showing 1–10 of 35
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.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 240 | $70 | $16.1K |
| 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. | 110 | $20 | $2.1K |
| 92004 | The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits. | 30 | $80 | $2K |
| 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… | 10 | $100 | $1.2K |
| V2020 | Frames, purchases | 10 | $30 | $370 |
| 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. | 130 | $0 | $0 |
| 99072 | The provider uses items, supplies materials, or requires clinical staff time in excess of what is normally used or provided for an office visit or other nonfacility encounter. These additional items… | 60 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Louisiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Louisiana median
7 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 482 | 660 | 1,070 | $60 | $129.3K |
| 92004 | The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits. | 533 | 580 | 610 | $80 | $103.9K |
| 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… | 1,151 | 1,170 | 160 | $80 | $102.7K |
| V2020 | Frames, purchases | 546 | 550 | 1,570 | $20 | $50.6K |
| 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. | 97 | 130 | 490 | $10 | $19.4K |
| 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. | 408 | 520 | 940 | $1 | $9.8K |
| 99072 | The provider uses items, supplies materials, or requires clinical staff time in excess of what is normally used or provided for an office visit or other nonfacility encounter. These additional items… | 75 | 90 | 240 | $0 | $0 |
Other providers in the same ZIP code as Thomas Norton, ranked by combined Medicare and Medicaid revenue.
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