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BAY AREA RETINA ASSOCIATES

Ophthalmology, Retina Specialist·WALNUT CREEK, CA·NPI: 1174557805Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$30.4M

$30,392,882

Total Claims

158K

Beneficiaries

146K

1.1 claims/patient

Avg Cost/Claim

$192

Monthly Spending Trend

Yearly Spending

2018
$1.5M
+29%
2019
$1.9M
+50%
2020
$2.9M
+43%
2021
$4.1M
+30%
2022
$5.4M
+29%
2023
$6.9M
+10%
2024
$7.6M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 21 distinct procedure codes. The top code (J0178 (Injection, aflibercept, 1 mg)) accounts for 64% of total spending.

J0178Top 25%

Injection, aflibercept, 1 mg

$19.6M

16K claims · 64.5%

Your Cost: $1,197.24/claim|Median: $730.09
1.6× median
67028Top 25%

Intravitreal injection of a pharmacologic agent

$5.8M

35K claims · 19.2%

Your Cost: $167.86/claim|Median: $58.82
2.9× median
J2777Top 25%

$1.5M

1,108 claims · 5.0%

Your Cost: $1,378.71/claim|Median: $858.80
1.6× median
92012Normal range

Ophthalmological exam, intermediate, established patient

$752K

23K claims · 2.5%

Your Cost: $32.25/claim|Median: $38.23
0.8× median
92134Normal range

$648K

34K claims · 2.1%

Your Cost: $19.26/claim|Median: $15.46
1.2× median
92250Normal range

Fundus photography with interpretation and report

$643K

22K claims · 2.1%

Your Cost: $29.25/claim|Median: $27.95
1.0× median
92014Normal range

Ophthalmological exam, comprehensive, established patient

$464K

12K claims · 1.5%

Your Cost: $39.14/claim|Median: $47.08
0.8× median
J9035Top 25%

Injection, bevacizumab, 10 mg

$345K

4,068 claims · 1.1%

Your Cost: $84.81/claim|Median: $43.71
1.9× median
99213Normal range

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

$122K

3,150 claims · 0.4%

Your Cost: $38.74/claim|Median: $37.81
1.0× median
99214Normal range

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

$116K

2,361 claims · 0.4%

Your Cost: $49.23/claim|Median: $53.41
0.9× median
99204Normal range

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

$115K

1,799 claims · 0.4%

Your Cost: $63.79/claim|Median: $84.03
0.8× median
92235Top 25%

$110K

1,644 claims · 0.4%

Your Cost: $66.69/claim|Median: $42.71
1.6× median
92004Normal range

Ophthalmological exam, comprehensive, new patient

$99K

1,924 claims · 0.3%

Your Cost: $51.54/claim|Median: $59.72
0.9× median
Q5124Top 1%

$6K

12 claims · 0.0%

Your Cost: $490.40/claim|Median: $183.04
2.7× median
99244Normal range

Office or other outpatient consultation, moderate complexity

$4K

42 claims · 0.0%

Your Cost: $94.17/claim|Median: $121.58
0.8× median
92225Top 25%

$3K

78 claims · 0.0%

Your Cost: $33.41/claim|Median: $17.59
1.9× median
99212Normal range

Office/outpatient visit, low complexity

$3K

94 claims · 0.0%

Your Cost: $26.63/claim|Median: $25.06
1.1× median
92226Normal range

$2K

115 claims · 0.0%

Your Cost: $13.61/claim|Median: $12.45
1.1× median
99203Normal range

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

$1K

25 claims · 0.0%

Your Cost: $57.60/claim|Median: $57.85
1.0× median
76512Normal range

$1K

29 claims · 0.0%

Your Cost: $49.03/claim|Median: $43.41
1.1× median
J7999Normal range

$1K

70 claims · 0.0%

Your Cost: $14.66/claim|Median: $6.94
2.1× median

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