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NPI 1891791844 · Brentwood, MO · Retina Specialist (Ophthalmology) Physician
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Nicholas Engelbrecht is a retina specialist (ophthalmology) physician provider located in Brentwood, Missouri. This profile covers 20 Medicare and 3 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 | Nicholas Engelbrecht |
| Address | 1600 S Brentwood Blvd Ste 700 |
| City | Brentwood |
| State | MO |
| ZIP | 63144 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | June 23, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.2M |
| Medicaid | $10K |
This provider’s billing is overwhelmingly Medicare-driven: total Medicare revenue is $3.2M versus total Medicaid revenue of $10K, indicating an effectively Medicare-dominant practice with minimal Medicaid activity. The scale difference suggests payer-specific strategies and financial sensitivity are likely to be concentrated on Medicare reimbursement policies.
Revenue concentration is high on a small set of codes. The top 3 Medicare codes account for 80.8% of Medicare revenue led by J0178 (46.4%), J2777 (28.0%), and 67028 (6.4%); on the Medicaid side the top 3 codes account for 100.0% of Medicaid revenue (92134 59.3%, 67028 33.1%, 99213 7.6%), showing that a very small number of services drive nearly all billed revenue for each payer.
The code mix indicates a medical retina practice centered on intravitreal anti-VEGF therapy and high-volume retinal imaging. High-revenue drug codes such as J0178 (2.1K claims, $1.5M revenue) and J2777 (30.5K claims, $885.7K revenue), together with procedure code 67028 for isolated intravitreal injection, point to routine, injection-based treatment workflows supported by extensive diagnostic imaging (92134).
Competitive standing for the principal drug and injection codes is solid but not dominant: J0178 ranks #474 of 3204 providers nationally (85th percentile; typical, unremarkable volume) and J2777 ranks #286 of 2039 providers nationally (86th percentile; typical, unremarkable volume), while 67028 ranks #237 of 4255 providers nationally (94th percentile; notably above typical national volume). These percentiles suggest above-average utilization relative to peers for injection procedures, with drug administration volumes that are high but within common practice patterns.
Retinal imaging and E/M activity are extreme outliers on Medicare, indicating unusual volume intensity in outpatient workup and follow-up. 92134 ranks #150 of 26868 providers nationally (99th percentile; extreme outlier) and 99213 ranks #2944 of 457151 providers nationally (99th percentile; extreme outlier), and Medicaid activity also shows meaningful imaging volume (92134: 651 claims, $5.9K revenue, 59.3% of Medicaid revenue), together implying a practice with very high per-provider imaging and routine E/M throughput.
Surgical retina procedures are present but represent a small share of revenue and appear at typical national volumes. Codes such as 67042 (25 claims, $22.2K revenue, 0.7% of Medicare revenue), 67113 (17 claims, $16.7K, 0.5%), and 67108 (14 claims, $12.7K, 0.4%) indicate some vitreoretinal surgical work but not a surgery-dominant business line.
Tenure and practice stability are evident: the NPI was enumerated on 2005-06-23 (~21 years ago), consistent with an established clinician likely running a mature retina-focused practice. Long enumeration paired with sustained Medicare revenue suggests continuity of referrals and patient volume over time.
Operational and reimbursement sensitivity should be noted given the heavy reliance on a few high-revenue codes. With the top 3 Medicare codes making up 80.8% of Medicare revenue and the top 3 Medicaid codes making up 100.0% of Medicaid revenue, shifts in drug prices, reimbursement for intravitreal injections, or imaging payment policies could materially affect revenue streams and warrant monitoring by payers and network managers.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
20 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2,140 | $690 | $1.5M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 30,540 | $30 | $885.7K |
| 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. | 2,340 | $90 | $201.6K |
| J2778 | Injection, ranibizumab, 0.1 mg | 750 | $180 | $133.4K |
| 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. | 3,890 | $30 | $116.6K |
| 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… | 1,180 | $90 | $104.9K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 1,350 | $60 | $83.6K |
| 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 | $100 | $40.3K |
| J9035 | Injection, bevacizumab, 10 mg | 610 | $50 | $32.2K |
| 67042 | In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina… | 30 | $890 | $22.2K |
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How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
20 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 7 | 60 | 820 | $690 | $683.3K |
| J2777 | 4 | 50 | 11,730 | $30 | $388.9K |
| J2778 | 10 | 20 | 540 | $180 | $203.8K |
| 67028 | 5 | 80 | 600 | $90 | $69.7K |
| 67042 | 10 | 30 | 20 | $1,070 | $26.8K |
| 67113 | 5 | 10 | 20 | $1,170 | $25.8K |
| J9035 | 8 | 40 | 170 | $60 | $21.8K |
| 67108 | 9 | 20 | 10 | $1,060 | $18K |
| 92014 | 10 | 730 | 120 | $80 | $18K |
| 99214 | 1,061 | 8,960 | 100 | $80 | $13.9K |
Showing 1–10 of 20
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
3 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. | 650 | $10 | $5.9K |
| 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. | 50 | $60 | $3.3K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 50 | $20 | $750 |
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
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 3,440 | 4,310 | 300 | $60 | $110.8K |
| 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. | 29 | 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. | 24 | 60 | 340 | $20 | $19.3K |
Other providers in the same ZIP code as Nicholas Engelbrecht, 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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