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NPI 1841558822 · Brentwood, MO · Retina Specialist (Ophthalmology) Physician
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Alia Durrani is a retina specialist (ophthalmology) physician provider located in Brentwood, Missouri. This profile covers 12 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 | Alia Durrani |
| Address | 1600 S Brentwood Blvd Ste 700 |
| City | Brentwood |
| State | MO |
| ZIP | 63144 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | April 27, 2012 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.5M |
| Medicaid | $4.6K |
ALIA DURRANI is operating as a retina-focused ophthalmology practice that is heavily weighted toward intravitreal pharmacologic therapy and retina diagnostics; the Medicare top codes driving revenue are J0178, J2777 and 67028, and the provider also reports substantial volume in retinal imaging (92134). The code mix (large volumes of aflibercept and faricimab injections alongside diagnostic imaging) is consistent with a medical-retina practice that manages retinal vascular disease primarily with office-based injections and imaging follow-up.
Medicare revenue is highly concentrated in a small set of high-cost drug and injection codes: the provider's top 3 Medicare codes (J0178, J2777, 67028) together account for 82.3% of total Medicare revenue, with J0178 alone representing 53.7% and J2777 22.7% of Medicare revenue. This concentration indicates material dependence on aflibercept and faricimab administration for Medicare reimbursement.
On Medicaid the provider’s billing is narrowly concentrated: the top Medicaid codes account for 100.0% of Medicaid revenue, with 92134 representing 73.7% and 67028 representing 26.3% of the $4.6K in total Medicaid revenue. Given the absolute scale ($4.6K) this means Medicaid is a very small contributor to the practice’s overall payer revenue.
Payer mix is effectively Medicare-dominant: the provider reports $1.5M in lifetime Medicare revenue versus $4.6K in Medicaid revenue, indicating the practice’s commercial and government-facing activity is overwhelmingly centered on Medicare beneficiaries. This public-payer concentration has implications for contracting and reimbursement risk exposure, with Medicare policy and drug reimbursement trends likely to drive revenue variance.
Competitive standing on key injection drugs is modestly above median but not dominant: J0178 ranks #1095 of 3204 providers nationally at the 66th percentile and J2777 ranks #880 of 2039 providers nationally at the 57th percentile, both described as typical, unremarkable volume for those codes. By contrast, the provider is an outlier on retinal imaging—92134 ranks #1001 of 26868 providers nationally in the 96th percentile and is labeled notably above typical national volume—suggesting above-average diagnostic throughput relative to peers.
Operational profile shows a treatment-centered clinic with supporting diagnostics and occasional surgery: the practice reports 2K Medicare claims for 92134 ($61.2K) and 1.2K claims for J0178 ($823K), while surgical retina work (67113) is present but minimal at 13 claims and $12.8K (0.8% of Medicare revenue). This mix implies routine, office-based injection workflows are the core service line with infrequent operative retina procedures.
The provider has an established NPI tenure, enumerated on 2012-04-27 (~14 years ago), indicating sustained participation in Medicare and Medicaid billing over more than a decade; combined with the concentrated drug-injection revenue and high 92134 imaging rank, this suggests a stable, mature retina practice focused on medical management of retinal disease.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1,200 | $690 | $823K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 12,000 | $30 | $348K |
| 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. | 960 | $90 | $90K |
| J2778 | Injection, ranibizumab, 0.1 mg | 380 | $180 | $67.9K |
| 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. | 2,040 | $30 | $61.2K |
| 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… | 610 | $90 | $54.5K |
| 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… | 400 | $90 | $37.1K |
| 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… | 120 | $110 | $13.7K |
| 67113 | The provider repairs a complicated detached retina. He removes vitreous humor, the gelatinous material that gives shape to the eye, and peels the retinal membrane. He reattaches the retina with… | 10 | $980 | $12.8K |
| J9035 | Injection, bevacizumab, 10 mg | 220 | $50 | $11.9K |
Showing 1–10 of 12
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
12 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 19 | 60 | 820 | $690 | $683.3K |
| J2777 | 23 | 50 | 11,730 | $30 | $388.9K |
| J2778 | 17 | 20 | 540 | $180 | $203.8K |
| 67028 | 24 | 80 | 600 | $90 | $69.7K |
| 67113 | 8 | 10 | 20 | $1,170 | $25.8K |
| J9035 | 17 | 40 | 170 | $60 | $21.8K |
| 92014 | 70 | 730 | 120 | $80 | $18K |
| 99214 | 1,079 | 8,960 | 100 | $80 | $13.9K |
| 99213 | 1,706 | 8,730 | 70 | $50 | $7K |
| 92134 | 18 | 570 | 60 | $30 | $6.8K |
Showing 1–10 of 12
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 |
|---|---|---|---|---|
| 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. | 310 | $10 | $3.4K |
| 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 | $100 | $1.2K |
How this provider's Medicaid billing volume and revenue compare to other Missouri providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Missouri 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. | 34 | 30 | 290 | $90 | $75.9K |
| 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. | 32 | 60 | 340 | $20 | $19.3K |
Other providers in the same ZIP code as Alia Durrani, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Pyramid Homemaker Services, Inc. | MO | In Home Supportive Care Agency | $0 | $15.7M |
| Heeral Shah | MO | Retina Specialist (Ophthalmology) Physician | $1.6M | $0 |
| Sam Martin | MO | Interventional Pain Medicine Physician | $34.1K | $1.3M |
| Thomas Krummenacher | MO | Retina Specialist (Ophthalmology) Physician | $737.7K | $280 |
| Empowerme Diagnostics LLC | MO | Clinical Medical Laboratory | $271.9K | $0 |
| Rachel Darken | MO | Neurology Physician | $221.4K | $0 |
| Luqi Chi | MO | Neurology Physician | $137.3K | $0 |
| Craig Sorce | MO | Optometrist | $101.8K | $0 |
| Kelsey Melsheimer | MO | Occupational Therapist | $83.1K | $0 |
| Samir Cardona | MO | Physical Therapist | $79.7K | $0 |
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