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    OpenPayerNPI Medicare & MedicaidJames Macdonald
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    James Macdonald — Billing Profile & Reimbursement Data

    NPI 1851408835 · San Antonio, TX · Ophthalmology Physician

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    James Macdonald is a ophthalmology physician provider located in San Antonio, Texas. This profile covers 13 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
    OrganizationJames Macdonald
    Address7940 Floyd Curl Dr
    CitySan Antonio
    StateTX
    ZIP78229
    TaxonomyOphthalmology Physician
    NPI EnumeratedAugust 24, 2006

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

    Payer SourceTotal Paid
    Medicare$1M
    Medicaid$0

    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.

    13 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J0178Injection, aflibercept, 1 mg1,110$690$766.7K
    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.1,070$90$99.9K
    J7999Compounded drug, not otherwise classified870$60$55.7K
    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…510$90$44.4K
    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.930$30$26.1K
    92004The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.130$110$13.3K
    67036The provider removes vitreous fluid from the eye to access the posterior segment of the eye and introduce surgical instruments through incisions in the pars plana.20$640$10.8K
    92012For 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…130$60$7.7K
    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…50$100$4.8K
    67145The provider prevents the detachment of the retina in the presence of small tears or thinning of the edges (lattice degeneration) by applying an intense light (such as a laser) to create scar tissue…20$160$2.8K

    Showing 1–10 of 13

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    13 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J017868210610$690$694.9K
    6702883290510$90$73K
    67036367020$1,000$29.1K
    922358816060$100$21.3K
    920144072,700100$80$21K
    J7999514090$80$14.4K
    920126391,69080$60$10.9K
    921341351,69070$30$8.3K
    920042822,07040$90$6.1K
    9220240100130$10$4.4K

    Showing 1–10 of 13

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Samuel JurcaIDFamily Medicine Physician$24M$0
    Richard LaneTXRetina Specialist (Ophthalmology) Physician$4.8M$0
    Thomas OeiTXRetina Specialist (Ophthalmology) Physician$4.3M$0
    Ronald DrenglerTXMedical Oncology Physician$3.8M$0
    Jose MartinezTXOphthalmology Physician$3.8M$0
    Jeremiah BrownTXRetina Specialist (Ophthalmology) Physician$3.7M$0
    Sarah HolyTXRetina Specialist (Ophthalmology) Physician$3.5M$0
    Richard KinseyTNAnatomic Pathology & Clinical Pathology Physician$3.3M$147.3K
    Robert ZajacTXInfectious Disease Physician$3.1M$0
    Howard MartinTXDermatopathology (Pathology) Physician$3M$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Bexar County Hospital DistrictTXGeneral Acute Care Hospital$0$91.4M
    A Plus Family Care LLCTXHome Health Agency$0$72.7M
    Methodist Healthcare System Of San Antonio, Ltd., L.L.P.TXGeneral Acute Care Hospital$0$68M
    Casa Linda Homecare, Inc.TXHome Health Agency$0$39.7M
    Axiom Home Health LLCTXHome Health Agency$0$39.2M
    University Of Texas Health Science Center At San AntonioTXInternal Medicine Physician$0$35.5M
    Easter Seal Rehabilitation CenterTXRegistered Dietitian$0$24.2M
    Access Quality Therapy Services, LLCTXHome Health Agency$0$23.4M
    Emergency Medicine Services Of Tx, PLLCTXEmergency Medicine Physician$0$15M
    San Rafael Healthcare, IncTXHome Health Agency$0$13.6M

    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. Texas Distribution
    James Macdonald — 1 of 13 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Texas