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NPI 1912174897 · Providence, RI · Retina Specialist (Ophthalmology) Physician
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Altin Pani is a retina specialist (ophthalmology) physician provider located in Providence, Rhode Island. This profile covers 15 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 | Altin Pani |
| Address | 101 Plain St Ste 101 |
| City | Providence |
| State | RI |
| ZIP | 02903 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | May 10, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.7M |
| Medicaid | $17K |
ALTIN PANI is a retina specialist in PROVIDENCE, RI with an NPI enumerated 2008-05-10 (~18 years ago). The provider’s lifetime Medicare revenue is $1.7M compared with $17K in Medicaid revenue, indicating a practice that is effectively Medicare-dominant in scale and patient base.
Medicare revenue is highly concentrated: the precomputed top 3 Medicare codes account for 83.9% of this provider’s total Medicare revenue, with J0178 (aflibercept) alone representing 70.2% of Medicare receipts. This concentration indicates that a very small set of drug/procedure codes drive the majority of the practice’s federal revenue.
The code mix is consistent with a procedure-oriented retina practice focused on intravitreal biologic therapies and retina imaging. High-revenue codes include drug administration codes (J0178, J2777, J2778), the intravitreal injection procedure 67028, and diagnostic retinal imaging 92134, suggesting routine management of chronic retinal disease with frequent injections and imaging follow-up.
On competitive standing, J0178 ranks #688 of 3204 providers nationally (79th percentile) and is described as typical/unremarkable volume for that code, so the provider’s aflibercept use aligns with many peers rather than representing an outlier. By contrast, 92134 ranks #1049 of 26868 providers nationally (96th percentile) and is labeled notably above typical national volume, indicating comparatively high utilization of retinal imaging relative to national peers.
Other biologic and drug codes show mixed national footprints: J2777 appears with 3.8K claims, $29 avg paid/claim, $111.4K revenue (6.7% of Medicare revenue) but ranks #1703 of 2039 providers nationally (16th percentile; typical, unremarkable volume), while J2778 (436 claims, $78K revenue, 4.7% of Medicare revenue) ranks #806 of 1208 (33rd percentile). These patterns suggest diversified use of multiple intravitreal agents with variable national standing and payment profiles.
Medicaid billing is concentrated and modest in scale: the top 3 Medicaid codes account for 100.0% of Medicaid revenue and 92134 alone makes up 74.3% of the provider’s total Medicaid revenue. In-state rankings for those Medicaid codes are middle-to-low (92134 is #11 of 24, 57th percentile; 67028 is #12 of 14, 15th percentile), indicating the provider is a modest Medicaid participant for retinal imaging and injection services within Rhode Island.
The disparity between payers is striking for risk and revenue planning: $1.7M in Medicare vs $17K in Medicaid means the practice’s financial exposure is concentrated in Medicare reimbursement and utilization patterns. Any shifts in Medicare drug payment policy, utilization management for intravitreal agents, or reimbursement for 92134 could materially affect overall revenue given the observed concentration.
Operationally, the provider appears to generate more revenue from procedures and advanced imaging than from E/M visits: 92014 (731 claims, $65.8K, 4.0% of Medicare revenue) and 99214 (139 claims, $12.8K, 0.8% of Medicare revenue) are present but represent smaller revenue shares versus drug and imaging codes. This mix is typical of a retina-focused clinic that drives value through high-volume injections and diagnostic imaging rather than through routine office visit billing.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
15 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1,700 | $690 | $1.2M |
| 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. | 1,270 | $90 | $115.7K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 3,840 | $30 | $111.4K |
| J2778 | Injection, ranibizumab, 0.1 mg | 440 | $180 | $78K |
| 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… | 730 | $90 | $65.8K |
| 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. | 1,980 | $30 | $63.5K |
| J9035 | Injection, bevacizumab, 10 mg | 260 | $50 | $13.9K |
| 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… | 140 | $90 | $12.8K |
| 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… | 90 | $120 | $10.5K |
| 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… | 140 | $70 | $9.6K |
Showing 1–10 of 15
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
15 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 3 | 10 | 670 | $690 | $601.6K |
| J2777 | 6 | 10 | 5,790 | $30 | $158K |
| J2778 | 3 | 10 | 460 | $180 | $78.7K |
| 67028 | 2 | 20 | 610 | $90 | $58.9K |
| 92014 | 9 | 190 | 120 | $80 | $16.3K |
| 99214 | 720 | 1,950 | 100 | $80 | $11.7K |
| J9035 | 4 | 20 | 160 | $50 | $9.5K |
| 99213 | 531 | 1,950 | 70 | $60 | $7.4K |
| 92134 | 3 | 120 | 50 | $30 | $6.6K |
| 99204 | 51 | 740 | 30 | $110 | $4.6K |
Showing 1–10 of 15
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.
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. | 610 | $20 | $12.8K |
| 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. | 40 | $90 | $3.8K |
| 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… | 30 | $20 | $610 |
How this provider's Medicaid billing volume and revenue compare to other Rhode Island providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Rhode Island median
3 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. | 12 | 10 | 170 | $230 | $144.3K |
| 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. | 11 | 20 | 560 | $50 | $61.6K |
| 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… | 28 | 40 | 70 | $50 | $27.6K |
Other providers in the same ZIP code as Altin Pani, ranked by combined Medicare and Medicaid revenue.
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