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    v1.0.28
    OpenPayerNPI Medicare & MedicaidMichael Mcclintock
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    Michael Mcclintock — Billing Profile & Reimbursement Data

    NPI 1871737239 · Roanoke, VA · Retina Specialist (Ophthalmology) Physician

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    Michael Mcclintock is a retina specialist (ophthalmology) physician provider located in Roanoke, Virginia. This profile covers 19 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
    OrganizationMichael Mcclintock
    Address6125 Airport Rd
    CityRoanoke
    StateVA
    ZIP24019
    TaxonomyRetina Specialist (Ophthalmology) Physician
    NPI EnumeratedApril 28, 2009

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

    Payer SourceTotal Paid
    Medicare$5.4M
    Medicaid$0

    Key Findings

    Practice profile and service mix: This provider is a retina specialist (Ophthalmology) physician whose Medicare billing is dominated by intravitreal medication administration and retina diagnostic imaging, consistent with a retina-focused outpatient treatment practice. High-volume drug codes J2777 (faricimab), J0178 (aflibercept), and J2778 (ranibizumab) appear alongside procedure codes such as 67028 (intravitreal injection), 92134 (retinal imaging), and 92235 (fluorescein angiography), indicating a clinical model centered on recurring intravitreal injections plus routine retinal imaging and diagnostic procedures.

    Revenue concentration: Revenue is highly concentrated in a small set of drugs — the precomputed top 3 Medicare codes account for 88.3% of this provider's total Medicare revenue, with J2777 generating $2.2M (41.8% of Medicare revenue), J0178 generating $2.2M (41.3% of Medicare revenue), and J2778 contributing $279K (5.2% of Medicare revenue). This concentration signals that the practice’s top-line Medicare performance is largely dependent on high-volume anti-VEGF and related intravitreal biologic therapy.

    Payer mix / single‑payer exposure: Lifetime Medicare revenue is $5.4M while there is no Medicaid billing on file, so the provider is effectively single‑payer with respect to public programs and is highly reliant on Medicare for all reported government reimbursement. The absence of Medicaid claims suggests limited participation in or billing to Medicaid programs and implies that payer-network negotiations or changes to Medicare drug coverage could materially affect revenue.

    National competitive standing for top drugs: For the two revenue-leading drug codes the provider ranks well above typical national volumes — J2777 ranks #36 of 2039 providers (98th percentile; labeled an "extreme outlier") and J0178 ranks #140 of 3204 providers (96th percentile; labeled "notably above typical"). These ranks indicate the provider is a major national-scale user of faricimab and a high-volume aflibercept reporter relative to peers.

    Broader Medicare procedure footprint and outlier signals: Beyond drugs, several diagnostic and procedural CPTs also show elevated national positioning: 92134 (3.3K claims) ranks #266 of 26868 (99th percentile; "extreme outlier") and 92014 (1.6K claims) ranks #545 of 35415 (98th percentile; "extreme outlier"). Procedure 67028 (2.4K claims) ranks #223 of 4255 (95th percentile; "notably above typical"), supporting that the practice manages a large established Medicare patient panel receiving retina injections and routine follow-up imaging.

    Code-level variability and typical volumes: Some codes in the top 25 reflect typical or unremarkable volumes — for example, J2778 (ranibizumab) at the 76th percentile is described as "typical, unremarkable," and common E/M codes 99214 and 99213 also fall into typical percentile ranges. This mix suggests a specialist whose revenue mix is dominated by a few high-volume biologic drug codes while general E/M work remains consistent with specialty norms.

    Operational implications: The extremely high claim count for J2777 (77.6K claims, $29 avg paid/claim) together with large J0178 volume (3.2K claims, $690 avg paid/claim) implies operational capacity for frequent intravitreal administration and substantial drug handling/administration workflows. Payers and network analysts should expect this provider to require drug acquisition and infusion/injection logistics, strong appointment throughput for recurring injections, and robust ophthalmic imaging support.

    Tenure and stability signal: The provider’s NPI was enumerated on 2009-04-28 (~17 years ago), indicating long-tenured participation in Medicare billing; combined with concentrated, high-volume drug and imaging activity, this tenure supports a stable, established retina treatment practice rather than a short-term or sporadic reporter.

    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.

    19 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J2777Injection, faricimab‑svoa, 0.1 mg77,580$30$2.2M
    J0178Injection, aflibercept, 1 mg3,230$690$2.2M
    J2778Injection, ranibizumab, 0.1 mg1,500$190$279K
    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.2,380$100$240.5K
    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…1,570$90$141.4K
    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.3,340$30$96.9K
    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…460$100$47.3K
    J7312Injection, dexamethasone, intravitreal implant, 0.1 mg220$160$35.6K
    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…310$90$27.8K
    67041In this procedure, the provider removes scar tissue from the retinal membrane that obscures vision. He removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical…20$870$15.6K

    Showing 1–10 of 19

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    19 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J01784801,400$690$1.1M
    J277726013,200$30$517.1K
    J2778540560$180$171.5K
    670286901,000$90$107.1K
    J73121620240$160$42.5K
    9201436870170$80$32.8K
    6704182020$1,110$23.3K
    992143,77812,890140$80$21K
    67210171020$370$14.5K
    9201259343080$60$11.9K

    Showing 1–10 of 19

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Vistar Eye Center, IncVASpecialist$0$11.4M
    Timothy ByrnesVARetina Specialist (Ophthalmology) Physician$4.7M$0
    Vishak JohnNCOphthalmology Physician$4.3M$0
    Romulo AlbuquerqueKYRetina Specialist (Ophthalmology) Physician$3.8M$0
    Anna MackinVARetina Specialist (Ophthalmology) Physician$3.1M$0
    Craig HartranftVAOphthalmology Physician$2.8M$0
    Frank CotterVAOphthalmology Physician$683.7K$0
    Chad AlbrightVAOphthalmology Physician$560.3K$0
    Will GriffethVAOphthalmology Physician$484.5K$0
    Tad SchoedelVAOphthalmology Physician$478.6K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Depaul Community ResourcesVAFoster Care Agency$0$86.6M
    Family Preservation Services LLCVACommunity/Behavioral Health Agency$0$58.8M
    Pinnacle Treatment Services Of Roanoke, LLCVASubstance Use Disorder Rehabilitation Clinic/Center$0$14.2M
    Roanoke County Board Of SupervisorsVALand Ambulance$1.3M$1.7M
    Bradley GoadVAInternal Medicine Physician$444.3K$0
    Quasir RazaVAInternal Medicine Physician$409K$0
    Donald ScothornVAOptometrist$304.1K$0
    Natasha HartVAPsychiatric/Mental Health Nurse Practitioner$233.6K$0
    Sharee BirkettVAFamily Nurse Practitioner$200.9K$0
    Branda HodgesVAPsychiatric/Mental Health Nurse Practitioner$153.8K$0

    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. Virginia Distribution
    Michael Mcclintock — 4 of 19 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Virginia