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RETINA CONSULTANTS PC

Ophthalmology·MANCHESTER, CT·NPI: 1093748071Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$25.8M

$25,780,119

Total Claims

244K

Beneficiaries

169K

1.4 claims/patient

Avg Cost/Claim

$106

Monthly Spending Trend

Yearly Spending

2018
$2.6M
+24%
2019
$3.2M
-1%
2020
$3.1M
+22%
2021
$3.8M
+10%
2022
$4.2M
+13%
2023
$4.7M
-9%
2024
$4.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 29 distinct procedure codes. The top code (J0178 (Injection, aflibercept, 1 mg)) accounts for 71% of total spending.

J0178Normal range

Injection, aflibercept, 1 mg

$18.2M

36K claims · 70.7%

Your Cost: $504.64/claim|Median: $730.09
0.7× median
J2777Normal range

$2.1M

4,442 claims · 8.1%

Your Cost: $469.31/claim|Median: $858.80
0.5× median
67028Normal range

Intravitreal injection of a pharmacologic agent

$1.6M

48K claims · 6.0%

Your Cost: $32.18/claim|Median: $58.82
0.5× median
J2778Normal range

$1.3M

2,750 claims · 5.2%

Your Cost: $483.33/claim|Median: $403.28
1.2× median
92250Normal range

Fundus photography with interpretation and report

$543K

20K claims · 2.1%

Your Cost: $27.77/claim|Median: $27.95
1.0× median
92012Normal range

Ophthalmological exam, intermediate, established patient

$415K

32K claims · 1.6%

Your Cost: $13.08/claim|Median: $38.23
0.3× median
92014Normal range

Ophthalmological exam, comprehensive, established patient

$402K

20K claims · 1.6%

Your Cost: $19.71/claim|Median: $47.08
0.4× median
92134Normal range

$349K

49K claims · 1.4%

Your Cost: $7.09/claim|Median: $15.46
0.5× median
67228Normal range

$157K

1,309 claims · 0.6%

Your Cost: $120.17/claim|Median: $256.67
0.5× median
99204Normal range

Office/outpatient visit, new patient, mod-high complexity

$154K

3,034 claims · 0.6%

Your Cost: $50.66/claim|Median: $84.03
0.6× median
J3590Top 25%

Unclassified biologic drug injection

$116K

311 claims · 0.5%

Your Cost: $373.46/claim|Median: $24.77
15.1× median
92235Normal range

$101K

2,922 claims · 0.4%

Your Cost: $34.68/claim|Median: $42.71
0.8× median
92226Normal range

$88K

9,427 claims · 0.3%

Your Cost: $9.33/claim|Median: $12.45
0.7× median
J0177Normal range

$73K

153 claims · 0.3%

Your Cost: $478.25/claim|Median: $869.28
0.6× median
99214Normal range

Office/outpatient visit, est. patient, mod-high complexity

$42K

1,368 claims · 0.2%

Your Cost: $30.69/claim|Median: $53.41
0.6× median
J9035Normal range

Injection, bevacizumab, 10 mg

$28K

914 claims · 0.1%

Your Cost: $31.06/claim|Median: $43.71
0.7× median
J2781Normal range

$26K

117 claims · 0.1%

Your Cost: $223.05/claim|Median: $469.82
0.5× median
92202Normal range

$25K

10K claims · 0.1%

Your Cost: $2.42/claim|Median: $7.06
0.3× median
67210Normal range

$24K

128 claims · 0.1%

Your Cost: $190.04/claim|Median: $249.34
0.8× median
J0179Top 1%

Avelumab (Bavencio) injection, 10 mg

$13K

39 claims · 0.1%

Your Cost: $345.19/claim|Median: $174.69
2.0× median
99215Normal range

Office/outpatient visit, high complexity

$11K

254 claims · 0.0%

Your Cost: $44.51/claim|Median: $74.09
0.6× median
76512Normal range

$6K

136 claims · 0.0%

Your Cost: $45.75/claim|Median: $43.41
1.1× median
92225Normal range

$6K

423 claims · 0.0%

Your Cost: $13.70/claim|Median: $17.59
0.8× median
92020Normal range

$3K

388 claims · 0.0%

Your Cost: $8.65/claim|Median: $12.46
0.7× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$3K

52 claims · 0.0%

Your Cost: $57.33/claim|Median: $111.09
0.5× median
92201Normal range

$1K

517 claims · 0.0%

Your Cost: $2.50/claim|Median: $12.88
0.2× median
99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$816

104 claims · 0.0%

Your Cost: $7.84/claim|Median: $37.81
0.2× median
76510Normal range

$667

33 claims · 0.0%

Your Cost: $20.22/claim|Median: $58.86
0.3× median
99072Normal range

$0

13 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.54

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