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    OpenPayerNPI Medicare & MedicaidWendell Danforth
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    Wendell Danforth — Billing Profile & Reimbursement Data

    NPI 1821043803 · Kapolei, HI · Ophthalmology Physician

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    Wendell Danforth is a ophthalmology physician provider located in Kapolei, Hawaii. This profile covers 24 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
    OrganizationWendell Danforth
    Address1001 Kamokila Blvd
    CityKapolei
    StateHI
    ZIP96707
    TaxonomyOphthalmology Physician
    NPI EnumeratedMay 24, 2006

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

    Payer SourceTotal Paid
    Medicare$974.5K
    Medicaid$0

    Key Findings

    This provider’s Medicare footprint dominates their payer mix: total Medicare revenue is $974.5K and there is no Medicaid billing on file, indicating an effectively single‑payer (Medicare) practice profile rather than a mixed Medicare–Medicaid operation. Analysts should treat Medicaid impact as nil for this entity when modeling payer diversification or access to state‑program populations.

    Revenue is highly concentrated in a small set of services: the top three Medicare codes (J0178, 92014, J2777) are precomputed to account for 67.2% of the provider’s total Medicare revenue. Those top codes include $307.8K from J0178 (31.6% of total) and $239K from 92014 (24.5% of total), showing most billing dollars flow from a narrow procedural mix.

    The code mix points to a medical retina and high‑throughput outpatient ophthalmology operation: J0178 (aflibercept injection), J2777 (faricimab), and intravitreal procedure code 67028 appear among top earners alongside high volumes of retinal imaging (92134, 92250) and visual field testing (92082, 92083). This combination is consistent with a clinic that pairs frequent office‑based injections for retinal disease with in‑house diagnostic imaging and visual field monitoring.

    Competitive standing is mixed across services: for office comprehensive exams 92014 the provider ranks #112 of 35415 (100th percentile; extreme outlier), and for fundus photography 92250 they rank #380 of 25087 (98th percentile; extreme outlier), indicating nationally unusually high throughput for E/M and retinal imaging. By contrast, the largest revenue drug code J0178 ranks #2010 of 3204 (37th percentile; typical, unremarkable volume), so the practice’s exam and imaging volumes outpace its relative standing for some intravitreal drug codes.

    Several diagnostic and testing codes are clear outliers compared with national peers: 92082 ranks #19 of 1475 (99th percentile; extreme outlier) and 92134 ranks #1164 of 26868 (96th percentile; notably above typical national volume), showing the provider performs visual field and retinal OCT services at well above typical rates. These elevated percentiles suggest unusually high instrument‑driven patient throughput and may reflect a referral base or clinic workflow optimized for frequent monitoring.

    Injection/drug billing shows a different pattern: J0178 ($307.8K, 31.6% of revenue) and J2777 ($107.6K, 11.0% of revenue) are both classified as typical, unremarkable volume by their percentiles (37th and 18th, respectively), and 67028 is also typical. In plain terms, while intravitreal injections are a major revenue source dollar‑wise, their per‑code national rank does not indicate the provider is a dominant injector relative to peers.

    The provider has long tenure in the Medicare program with NPI enumeration dated 2006-05-24 (~20 years ago), which supports interpretation of these patterns as established practice behavior rather than a transient billing profile. Analysts evaluating referral networks or practice stability can treat the provider as a long‑standing ophthalmology practice.

    Operationally, the combination of extreme outlier volumes for office exams and several diagnostic services together with concentrated revenue in three codes implies the practice relies on high clinic throughput and a narrow set of services for most revenue. For contracting or utilization management purposes this pattern signals that reimbursement changes or shifts in utilization for those top codes (J0178, 92014, J2777) would have an outsized effect on overall Medicare revenue given the 67.2% concentration in the top three codes.

    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.

    24 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J0178Injection, aflibercept, 1 mg450$680$307.8K
    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…2,600$90$239K
    J2777Injection, faricimab‑svoa, 0.1 mg4,140$30$107.6K
    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.680$90$63.4K
    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.1,860$30$57.8K
    J7999Compounded drug, not otherwise classified360$70$26.5K
    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,…860$30$22.5K
    66821The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.80$270$22.1K
    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…180$110$20.8K
    92242The provider injects two different special dyes into one or both eyes that cause the blood vessels to stand out in photographic images timed so that multiple frames are taken in rapid succession. He…90$210$19.4K

    Showing 1–10 of 24

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 24 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    24 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J0178720330$680$350.4K
    J27777104,140$30$173.8K
    67028520390$90$44.1K
    9227372070$110$22.9K
    920142220120$90$22.5K
    9224211080$210$14.4K
    9201257150110$60$13.1K
    J7999310100$70$12.8K
    68761222070$80$11.9K
    6682165030$260$11.6K

    Showing 1–10 of 24

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Farhad SafiFLOphthalmology Physician$2.9M$0
    Kellen KashiwaHIOptometrist$784.8K$0
    Peter Hurlbut-millerHIRetina Specialist (Ophthalmology) Physician$509.4K$0
    John DickHIOphthalmology Physician$391.9K$0
    Center For Sight - West Oahu LLCHIOphthalmology Physician$0$365.6K
    Retina Institute Of Hawaii LLCHIOphthalmology Physician$0$346.7K
    Center For Sight LLCHIOphthalmology Physician$0$157.7K
    Thomas RedensLAOphthalmology Physician$83.4K$13K

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Usrc Kapolei, LLCHIEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center$0$3.5M
    Waianae District Comprehensive Health And Hospital Board, IncorporatedHIFederally Qualified Health Center (FQHC)$0$3.3M
    Responsive Caregivers Of HawaiiHIDevelopmentally Disabled Services Day Training Agency$0$3.1M
    Dialysis Newco LLCHIEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center$0$2.9M
    Usrc West Oahu, LLCHIEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center$0$2.3M
    Family Tree Project, LLPHICommunity/Behavioral Health Agency$0$1.5M
    Kidshine Kapolei LLCHIDental Clinic/Center$0$1.5M
    Dean T. Sueda D.d.s., M.s. IncHIPediatric Dentistry$0$1.4M
    Workstar Occupational Health Systems IncHIOccupational Medicine Physician$0$911.7K
    Rainbow Dental Center Kapolei IncHIDentist$0$854.3K

    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. Hawaii Distribution
    Wendell Danforth — 6 of 24 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Hawaii