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    OpenPayerNPI Medicare & MedicaidRetina Associates Of Cleveland, Inc.
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    Retina Associates Of Cleveland, Inc. — Billing Profile & Reimbursement Data

    NPI 1912991225 · Beachwood, OH · Retina Specialist (Ophthalmology) Physician

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    Retina Associates Of Cleveland, Inc. is a retina specialist (ophthalmology) physician provider located in Beachwood, Ohio. This profile covers 0 Medicare and 18 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 TypeOrganization
    OrganizationRetina Associates Of Cleveland, Inc.
    Address24075 Commerce Park
    CityBeachwood
    StateOH
    ZIP44122
    TaxonomyRetina Specialist (Ophthalmology) Physician
    NPI EnumeratedSeptember 1, 2005

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

    Payer SourceTotal Paid
    Medicaid$11.2M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    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

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    18 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J0178Injection, aflibercept, 1 mg7,970$1,080$8.6M
    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.28,120$50$1.4M
    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.44,480$10$355.8K
    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…5,890$40$212K
    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…9,150$20$155.6K
    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…4,540$20$109.1K
    99213The 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…3,840$30$95.9K
    J3590Unclassified biologics1,370$40$53.5K
    99204The 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…880$60$48.2K
    92250Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…2,330$20$44.2K

    Showing 1–10 of 18

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Ohio providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Ohio median

    18 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J0178Injection, aflibercept, 1 mg120310$1,070$1.4M
    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…7034,510500$60$377.8K
    99213The 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…1,2045,080560$40$323.9K
    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.150310$70$202.5K
    J3590Unclassified biologics22070$190$75.4K
    J9035Injection, bevacizumab, 10 mg520170$180$73.9K
    99204The 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…2441,410120$70$65.7K
    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.3100420$20$55.8K
    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…541,070390$40$46.9K
    92004The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.8091,020290$40$34.2K

    Showing 1–10 of 18

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Retina Associates Of Cleveland, Inc., ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Scott PendergastOHRetina Specialist (Ophthalmology) Physician$6M$0
    David MillerOHRetina Specialist (Ophthalmology) Physician$4.8M$0
    Llewelyn RaoOHRetina Specialist (Ophthalmology) Physician$3.7M$0
    Joseph ConeyOHRetina Specialist (Ophthalmology) Physician$3.2M$140
    Arnold NothnagelOHRetina Specialist (Ophthalmology) Physician$2.9M$0
    Shawn LewisOHRetina Specialist (Ophthalmology) Physician$2.8M$0
    Thomas HullOHRetina Specialist (Ophthalmology) Physician$2.6M$0
    Hang PhamOHOphthalmology Physician$2.6M$0
    Michael NovakOHRetina Specialist (Ophthalmology) Physician$2.5M$0
    Jerome SchartmanOHRetina Specialist (Ophthalmology) Physician$2.4M$0

    Nearby Providers

    Other providers in the same ZIP code as Retina Associates Of Cleveland, Inc., ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    University Primary Care Practices IncOHInternal Medicine Physician$0$78.7M
    Pearl's Hope, LLCOHHome Health Agency$0$47.8M
    Health Care Bridge, IncOHHome Health Agency$0$32.3M
    Cleveland Clinic Health System - East RegionOHGeneral Acute Care Hospital$0$31.5M
    Altimate Care LLCOHHome Health Agency$0$24M
    Signature Health, IncOHFederally Qualified Health Center (FQHC)$0$23M
    University Hospitals Ahuja Medical Center, IncOHGeneral Acute Care Hospital$0$21.1M
    Shaker Clinic, LLCOHMental Health Clinic/Center (Including Community Mental Health Center)$0$15.5M
    Psychological & Behavioral Consultants, LLCOHPsychiatry Physician$0$14.9M
    Northeast Home Health ServicesOHHome Health Agency$0$11.9M

    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.

    Medicaid Revenue by Year vs. Ohio Providers
    3 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Ohio Distribution
    Retina Associates Of Cleveland, Inc. — 7 of 18 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Ohio