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NPI 1932467198 · Ogden, UT · Ophthalmology Physician
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Lisa Leishman is a ophthalmology physician provider located in Ogden, Utah. This profile covers 18 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 | Lisa Leishman |
| Address | 4360 Washington Blvd |
| City | Ogden |
| State | UT |
| ZIP | 84403 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | April 25, 2012 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.6M |
| Medicaid | $419.9K |
Practice is heavily oriented toward medical retina care: the provider’s largest Medicare revenue source is J0178 (injection, aflibercept) at $1.1M, which represents 69.1% of Medicare revenue, and other high-volume items are intravitreal injection codes (J2777, 67028) and retinal imaging (92134). This mix — dominated by anti-VEGF/anti-complement intravitreal drugs and OCT imaging — is consistent with a clinic that treats chronic retinal diseases (e.g., AMD, diabetic macular edema) and delivers repeated in-office injections and diagnostic follow-up rather than a surgery-heavy practice.
Medicare revenue is highly concentrated: the top three Medicare codes by revenue (J0178, J2777, 67028) account for 86.3% of this provider’s total Medicare revenue. That concentration indicates the provider’s Medicare business depends primarily on a small set of high-revenue drug and injection codes rather than a broad array of office or procedural billing.
Medicaid revenue is even more concentrated on the same service line: the top three Medicaid codes by revenue (J0178, 67028, 92134) account for 98.0% of Medicaid revenue, with J0178 alone making up 70.5% of Medicaid revenue ($296.6K). This near-total concentration in a few injection and imaging codes implies Medicaid exposure is tightly coupled to intravitreal drug administration and related diagnostics.
Payer mix skews toward Medicare in absolute scale: reported Medicare revenue is $1.6M compared with Medicaid revenue of $419.9K, so Medicare is the materially larger payer for this provider. The presence of both payers means the practice is not single‑payer, but revenues are driven primarily by Medicare-funded encounters and drug reimbursements.
Competitive standing is mixed across payers and codes: for Medicare J0178 the provider ranks #762 of 3204 (76th percentile) which is characterized as typical/unremarkable volume for that code, whereas 92134 ranks #1298 of 26868 (95th percentile) and is described as notably above typical national volume — indicating a strong national-level footprint for retinal imaging but a more typical positioning for anti-VEGF injections. On Medicaid in-state comparisons, J0178 ranks #5 of 6 (20th percentile) and 67028 ranks #8 of 12 (36th percentile), so the provider is not a statewide leader in injectable volume despite Medicaid revenue concentration in those codes.
Several codes are statistical outliers on Medicare volumes: 92134 and 92012 are both reported as notably above typical national volume (92134 at the 95th percentile, 92012 at the 94th percentile), and 99204 is also noted as notably above typical national volume (95th percentile). These elevated percentiles for imaging and certain E/M codes suggest the provider sees a concentrated population requiring diagnostic imaging and higher-complexity new-patient workups.
Operational and reimbursement implications are clear given the billing mix: heavy reliance on high-cost intravitreal agents means drug acquisition, inventory, and buy-and-bill administration are likely essential operational components. The listed average paid amounts illustrate payer differences for the same drug code (J0178 average paid/claim $696 on Medicare vs $1295 on Medicaid), underlining how reimbursement per claim varies by payer and could materially affect margins.
Provider tenure supports an established practice footprint: NPI was enumerated on 2012-04-25 (~14 years ago), indicating sustained presence in the market. Combined with concentrated revenue streams and above‑typical imaging volumes, this suggests a stable, retina-focused practice that would be sensitive to reimbursement changes for the small set of high-revenue codes it depends on.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
18 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1,590 | $700 | $1.1M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 6,600 | $30 | $191.4K |
| 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. | 880 | $100 | $83.4K |
| 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. | 1,730 | $30 | $50.1K |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 390 | $120 | $45.2K |
| 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… | 690 | $60 | $44.4K |
| J2778 | Injection, ranibizumab, 0.1 mg | 150 | $160 | $23.9K |
| 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… | 170 | $90 | $15.5K |
| 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… | 140 | $100 | $14.4K |
| 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… | 80 | $90 | $6.8K |
Showing 1–10 of 18
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
18 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 12 | 40 | 620 | $690 | $683.2K |
| J2777 | 28 | 20 | 13,140 | $30 | $523.9K |
| J2778 | 19 | 10 | 870 | $180 | $224.3K |
| J2781 | 9 | 20 | 960 | $120 | $126.6K |
| 67028 | 28 | 60 | 440 | $90 | $61.7K |
| J7999 | 46 | 20 | 120 | $70 | $16.9K |
| 92014 | 166 | 330 | 140 | $70 | $16.6K |
| 99214 | 3,150 | 4,080 | 80 | $80 | $11.6K |
| 92134 | 19 | 250 | 70 | $30 | $7.6K |
| 92012 | 4 | 160 | 60 | $50 | $5.9K |
Showing 1–10 of 18
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 | 230 | $1,300 | $296.6K |
| 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. | 480 | $200 | $94K |
| 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. | 1,080 | $20 | $21.6K |
| 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… | 260 | $20 | $6.3K |
| 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… | 40 | $60 | $2.1K |
How this provider's Medicaid billing volume and revenue compare to other Utah providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Utah median
5 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 5 | 10 | 460 | $460 | $282K |
| 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. | 8 | 10 | 1,350 | $100 | $124K |
| 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… | 9 | 30 | 60 | $100 | $65K |
| 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… | 176 | 270 | 80 | $100 | $41.6K |
| 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. | 9 | 20 | 430 | $30 | $36K |
Other providers in the same ZIP code as Lisa Leishman, ranked by combined Medicare and Medicaid revenue.
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