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NPI 1902880313 · Columbia, MO · Ophthalmology Physician
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Mari Keithahn is a ophthalmology physician provider located in Columbia, Missouri. This profile covers 16 Medicare and 5 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 | Mari Keithahn |
| Address | 105 N Keene St Ste 102 |
| City | Columbia |
| State | MO |
| ZIP | 65201 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | November 30, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $4.3M |
| Medicaid | $231.7K |
This provider’s revenue is heavily concentrated in intravitreal injection and retina-focused services: the Medicare top codes are J0178, J2777 and 67028, and those three codes account for 91.2% of total Medicare revenue. The prominence of J0178 (aflibercept) with $2.6M in Medicare revenue and J2777 (faricimab) with $1M suggests the practice functions primarily as a medical-retina/injection center delivering high-volume anti-VEGF therapy, with 92134 and imaging codes supporting treatment decision-making.
Medicare is by far the dominant payer for this clinician: lifetime Medicare revenue is $4.3M versus $231.7K in Medicaid. This gap indicates the provider’s operations and revenue base are primarily Medicare-facing, with Medicaid representing a much smaller portion of overall volume and proceeds.
Revenue concentration poses business sensitivity to changes in ophthalmic drug reimbursement: the precomputed top-3 Medicare codes drive 91.2% of Medicare revenue and the precomputed top-3 Medicaid codes drive 95.2% of Medicaid revenue. Such concentration—led by J0178 and J2777 on Medicare and J0178 and 67028 on Medicaid—creates exposure to payment, utilization, or formulary shifts affecting these specific drugs and associated injection procedures.
J0178 is a national strength for this provider: 3.8K Medicare claims produced $2.6M in revenue and the provider ranks #82 of 3204 nationally (97th percentile) with a labeled standing of notably above typical volume. The same code is also the largest Medicaid driver (517 claims, $154.1K, ranking #2 of 4 in-state), confirming that aflibercept administration is a core, high-volume service across both payers.
The provider shows exceptionally high relative volume on several non-drug codes, signaling large procedural and office-visit throughput. For Medicare, 99213 (2.5K claims, $144.6K) ranks #427 of 457151 providers (100th percentile; extreme outlier) and 92134 (3.3K claims, $85.9K) ranks #288 of 26868 providers (99th percentile; extreme outlier), indicating unusually high E/M and retinal imaging volumes compared with national peers and a busy ambulatory practice flow.
Medicaid volumes mirror the Medicare-focused service mix but at a much smaller scale: J0178 accounts for 66.5% of the provider’s Medicaid revenue and 67028 accounts for 22.8%, and the three largest Medicaid codes together account for 95.2% of the provider’s Medicaid receipts. In-state rankings for these Medicaid codes are modest-to-strong (J0178 ranks #2 of 4, 67028 ranks #6 of 34), showing the provider is a meaningful contributor to anti-VEGF and injection activity in Missouri but not a statewide outlier.
Competitive standing is mixed by code: the provider is a strong national performer on J0178 and 67028 (97th percentiles on Medicare for both codes, described as notably above typical volume), while activity on J2777, though large in absolute claims (37.3K Medicare claims), is characterized as typical/unremarkable versus peers (91th percentile). This profile suggests national-level strength in aflibercept and vitreous injection services, with more typical participation for some newer biologic agents.
The NPI has been enumerated since 2005-11-30 (~21 years ago), indicating an established practice history. Combined with the concentration in high-volume injection codes and extreme outlier status on key E/M and imaging codes, the tenure and coding pattern are consistent with a long-standing, procedure-focused ophthalmology practice specializing in retinal disease management.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
16 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 3,840 | $690 | $2.6M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 37,260 | $30 | $1M |
| 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. | 2,720 | $80 | $207K |
| 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… | 2,450 | $60 | $144.6K |
| 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. | 3,300 | $30 | $85.9K |
| J3590 | Unclassified biologics | 60 | $800 | $48.5K |
| 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… | 470 | $80 | $35K |
| 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… | 230 | $100 | $22.5K |
| 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… | 20 | $820 | $15.6K |
| 92235 | The 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… | 60 | $90 | $5.4K |
Showing 1–10 of 16
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
16 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 1 | 60 | 820 | $690 | $683.3K |
| J2777 | 2 | 50 | 11,730 | $30 | $388.9K |
| 67028 | 3 | 80 | 600 | $90 | $69.7K |
| 67042 | 17 | 30 | 20 | $1,070 | $26.8K |
| J3590 | 19 | 30 | 80 | $160 | $19K |
| 92014 | 566 | 730 | 120 | $80 | $18K |
| 99214 | 796 | 8,960 | 100 | $80 | $13.9K |
| 99213 | 5 | 8,730 | 70 | $50 | $7K |
| 92134 | 5 | 570 | 60 | $30 | $6.8K |
| 92235 | 15 | 40 | 50 | $100 | $6.6K |
Showing 1–10 of 16
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.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 520 | $300 | $154.1K |
| 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. | 1,700 | $30 | $52.8K |
| 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… | 550 | $30 | $13.7K |
| 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. | 940 | $10 | $9.4K |
| 92012 | For 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… | 110 | $20 | $1.8K |
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
5 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… | 1,609 | 4,310 | 300 | $60 | $110.8K |
| J0178 | Injection, aflibercept, 1 mg | 2 | 10 | 280 | $290 | $106.9K |
| 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. | 6 | 30 | 290 | $90 | $75.9K |
| 92012 | For 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… | 64 | 120 | 120 | $40 | $23.9K |
| 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. | 19 | 60 | 340 | $20 | $19.3K |
Other providers in the same ZIP code as Mari Keithahn, ranked by combined Medicare and Medicaid revenue.
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