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NPI 1972503993 · Lexington, KY · Retina Specialist (Ophthalmology) Physician
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John Kitchens is a retina specialist (ophthalmology) physician provider located in Lexington, Kentucky. 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 | John Kitchens |
| Address | 120 N Eagle Creek Dr |
| City | Lexington |
| State | KY |
| ZIP | 40509 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | August 1, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.5M |
| Medicaid | $514.7K |
Practice is strongly procedure- and drug-centered consistent with a retina specialist: the Medicare top codes are dominated by intravitreal drug administrations (J0178, J2777, J2778) and procedure 67028, indicating the operation runs a high-volume clinic-based injection program supported by retinal imaging and E/M visits. The single largest Medicare code is J0178 (aflibercept) with $2.2M in revenue, and 92134 (retinal imaging) also appears among high-volume services, reinforcing a workflow built around frequent injections plus imaging follow-up.
Medicare revenue is heavily concentrated in a small set of drug codes: the precomputed top-3 Medicare codes account for 86.2% of this provider’s Medicare revenue, demonstrating operational and financial dependence on a narrow set of high-cost intravitreal medications. This concentration suggests the provider’s financial performance is sensitive to changes in reimbursement or utilization for those specific retinal drug products.
On Medicaid the revenue concentration is even more pronounced: the precomputed top-3 Medicaid codes account for 98.7% of this provider’s Medicaid revenue, with J0178 (aflibercept) alone representing $369.5K or 71.9% of Medicaid revenue. Medicaid income is therefore almost entirely driven by aflibercept injections plus the associated injection procedure (67028) and retinal imaging (92134), indicating very little diversification of services within that payer.
Payer mix is skewed toward Medicare in scale: lifetime Medicare revenue is $3.5M compared with $514.7K in Medicaid, so Medicare is the dominant revenue source. This gap implies the practice primarily serves an older Medicare population for its high-revenue retina services while maintaining a smaller Medicaid footprint.
National competitive standing for key Medicare codes shows pockets of exceptional volume: J0178 ranks #148 of 3204 providers nationally (95th percentile) and is described as notably above typical national volume, indicating the provider is a top-tier aflibercept user nationally. In addition, 92134 (retinal imaging) and 99213 (E/M for established patients) are flagged as extreme outliers (97th and 98th percentiles respectively), which signals unusually high throughput on imaging and routine follow-up visits compared with peers.
Other Medicare codes show typical volumes relative to peers: J2777 (faricimab) ranks in the 78th percentile and J2778 (ranibizumab) is at the 63rd percentile nationally, reflecting solid but not dominant participation in newer and alternative intravitreal agents. Several surgical and higher-complexity codes (e.g., 67036) appear at middle-percentile ranks, consistent with a clinic that focuses on injections and imaging rather than frequent posterior-segment surgery.
State-level standing on Medicaid is upper-tier but not uniformly dominant: J0178 ranks #4 of 9 in-state (63rd percentile), and 67028 ranks #10 of 31 (70th percentile), indicating the provider is among the larger Medicaid aflibercept injectors and injection-procedure performers in Kentucky though not the single top provider. Retinal imaging for Medicaid (92134) ranks #18 of 74 (77th percentile), supporting the view that the practice performs above-average imaging volume for Medicaid patients in-state.
Provider tenure is long-established: the NPI was enumerated on 2005-08-01 (~21 years ago), consistent with a sustained clinical presence. That longevity, combined with concentrated high-volume injection services, suggests an experienced retina practice structured around recurring intravitreal therapy and follow-up imaging visits.
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 | 3,210 | $680 | $2.2M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 23,040 | $30 | $668.2K |
| J2778 | Injection, ranibizumab, 0.1 mg | 950 | $180 | $174.6K |
| 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. | 1,880 | $90 | $167.3K |
| J3490 | Unclassified drugs | 50 | $1,780 | $94.1K |
| 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. | 2,350 | $30 | $61.1K |
| 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… | 890 | $60 | $50.4K |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 270 | $120 | $32.4K |
| J3590 | Unclassified biologics | 90 | $370 | $31.6K |
| 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… | 220 | $90 | $19.2K |
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 | 3 | 40 | 870 | $690 | $858.5K |
| J2777 | 5 | 30 | 11,040 | $30 | $399.1K |
| J2778 | 6 | 20 | 700 | $180 | $148.3K |
| 67028 | 6 | 50 | 650 | $90 | $72.9K |
| J2781 | 3 | 10 | 380 | $120 | $48.4K |
| 67036 | 11 | 20 | 20 | $910 | $28.1K |
| J3490 | 8 | 10 | 50 | $370 | $27.2K |
| J3590 | 30 | 40 | 160 | $60 | $17K |
| 99214 | 2,066 | 7,230 | 110 | $70 | $14.1K |
| 99213 | 96 | 7,250 | 80 | $50 | $7.7K |
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 | 250 | $1,480 | $369.5K |
| 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. | 730 | $150 | $110.1K |
| 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. | 890 | $30 | $27.7K |
| J9035 | Injection, bevacizumab, 10 mg | 90 | $60 | $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… | 60 | $30 | $1.9K |
How this provider's Medicaid billing volume and revenue compare to other Kentucky providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Kentucky median
5 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 4 | 10 | 210 | $640 | $1.4M |
| 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… | 2,850 | 3,340 | 1,020 | $30 | $296K |
| 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. | 10 | 30 | 350 | $70 | $165.3K |
| J9035 | Injection, bevacizumab, 10 mg | 10 | 20 | 120 | $130 | $96.1K |
| 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. | 18 | 70 | 210 | $20 | $29.2K |
Other providers in the same ZIP code as John Kitchens, ranked by combined Medicare and Medicaid revenue.
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