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RETINA INSTITUTE OF CALIFORNIA MEDICAL GROUP, A CALIFORNIA MEDICAL PAR

Ophthalmology·PASADENA, CA·NPI: 1760541569Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$64.3M

$64,253,440

Total Claims

1.3M

Beneficiaries

1.2M

1.1 claims/patient

Avg Cost/Claim

$51

Monthly Spending Trend

Yearly Spending

2018
$4.3M
+71%
2019
$7.3M
+16%
2020
$8.5M
+12%
2021
$9.5M
+10%
2022
$10.4M
+17%
2023
$12.2M
-0%
2024
$12.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (67028 (Intravitreal injection of a pharmacologic agent)) accounts for 27% of total spending.

67028Top 25%

Intravitreal injection of a pharmacologic agent

$17.4M

95K claims · 27.1%

Your Cost: $183.53/claim|Median: $58.82
3.1× median
92134Top 25%

$5.5M

178K claims · 8.6%

Your Cost: $30.99/claim|Median: $15.46
2.0× median
66984Top 25%

Extracapsular cataract removal with IOL insertion

$4.8M

9,090 claims · 7.5%

Your Cost: $531.79/claim|Median: $268.70
2.0× median
J2778Normal range

$4.5M

16K claims · 7.0%

Your Cost: $280.00/claim|Median: $403.28
0.7× median
92014Normal range

Ophthalmological exam, comprehensive, established patient

$4.4M

182K claims · 6.8%

Your Cost: $23.89/claim|Median: $47.08
0.5× median
J9035Normal range

Injection, bevacizumab, 10 mg

$3.5M

62K claims · 5.4%

Your Cost: $55.68/claim|Median: $43.71
1.3× median
68761Normal range

$3.4M

44K claims · 5.3%

Your Cost: $76.42/claim|Median: $60.32
1.3× median
92235Normal range

$3.3M

57K claims · 5.1%

Your Cost: $57.30/claim|Median: $42.71
1.3× median
92012Normal range

Ophthalmological exam, intermediate, established patient

$2.5M

101K claims · 3.9%

Your Cost: $24.96/claim|Median: $38.23
0.7× median
92250Normal range

Fundus photography with interpretation and report

$2.2M

57K claims · 3.4%

Your Cost: $37.69/claim|Median: $27.95
1.3× median
92004Normal range

Ophthalmological exam, comprehensive, new patient

$1.6M

55K claims · 2.5%

Your Cost: $29.18/claim|Median: $59.72
0.5× median
67228Normal range

$1.5M

6,963 claims · 2.3%

Your Cost: $208.94/claim|Median: $256.67
0.8× median
99204Normal range

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

$1.1M

18K claims · 1.7%

Your Cost: $63.34/claim|Median: $84.03
0.8× median
99214Normal range

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

$1.1M

34K claims · 1.7%

Your Cost: $31.72/claim|Median: $53.41
0.6× median
67210Normal range

$1.0M

3,660 claims · 1.6%

Your Cost: $274.06/claim|Median: $249.34
1.1× median
99213Normal range

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

$834K

35K claims · 1.3%

Your Cost: $23.58/claim|Median: $37.81
0.6× median
V2020Normal range

Frames, purchases

$722K

54K claims · 1.1%

Your Cost: $13.31/claim|Median: $19.33
0.7× median
92133Normal range

$519K

25K claims · 0.8%

Your Cost: $20.72/claim|Median: $19.09
1.1× median
92136Top 25%

$436K

12K claims · 0.7%

Your Cost: $35.99/claim|Median: $18.31
2.0× median
Q5128Normal range

$430K

2,010 claims · 0.7%

Your Cost: $214.05/claim|Median: $502.53
0.4× median
92340Normal range

Fitting of spectacles, except for aphakia

$425K

37K claims · 0.7%

Your Cost: $11.63/claim|Median: $19.46
0.6× median
92083Normal range

Visual field exam, extended testing, bilateral

$403K

20K claims · 0.6%

Your Cost: $20.57/claim|Median: $29.82
0.7× median
92015Normal range

Determination of refractive state

$385K

79K claims · 0.6%

Your Cost: $4.87/claim|Median: $10.36
0.5× median
68810Normal range

$366K

3,363 claims · 0.6%

Your Cost: $108.73/claim|Median: $102.56
1.1× median
66821Normal range

$308K

3,161 claims · 0.5%

Your Cost: $97.58/claim|Median: $83.06
1.2× median
J0178Normal range

Injection, aflibercept, 1 mg

$280K

797 claims · 0.4%

Your Cost: $351.80/claim|Median: $730.09
0.5× median
92020Normal range

$242K

18K claims · 0.4%

Your Cost: $13.24/claim|Median: $12.46
1.1× median
92341Normal range

$209K

12K claims · 0.3%

Your Cost: $17.53/claim|Median: $22.77
0.8× median
67031Top 25%

$143K

1,634 claims · 0.2%

Your Cost: $87.43/claim|Median: $49.22
1.8× median
68020Normal range

$82K

1,110 claims · 0.1%

Your Cost: $73.68/claim|Median: $73.68
1.0× median
92002Normal range

Intermediate eye exam, new patient

$70K

3,347 claims · 0.1%

Your Cost: $21.03/claim|Median: $41.61
0.5× median
99203Normal range

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

$70K

927 claims · 0.1%

Your Cost: $75.24/claim|Median: $57.85
1.3× median
92201Normal range

$64K

5,013 claims · 0.1%

Your Cost: $12.85/claim|Median: $12.88
1.0× median
76514Top 25%

$54K

6,268 claims · 0.1%

Your Cost: $8.55/claim|Median: $6.67
1.3× median
92242Normal range

$50K

698 claims · 0.1%

Your Cost: $71.92/claim|Median: $73.42
1.0× median
92226Top 25%

$47K

2,021 claims · 0.1%

Your Cost: $23.13/claim|Median: $12.45
1.9× median
76512Normal range

$44K

1,502 claims · 0.1%

Your Cost: $29.37/claim|Median: $43.41
0.7× median
67800Top 1%

$42K

731 claims · 0.1%

Your Cost: $57.81/claim|Median: $57.81
1.0× median
J7999Normal range

$40K

1,970 claims · 0.1%

Your Cost: $20.33/claim|Median: $6.94
2.9× median
67820Top 25%

$33K

1,550 claims · 0.1%

Your Cost: $21.59/claim|Median: $11.69
1.8× median
65205Top 25%

$32K

828 claims · 0.0%

Your Cost: $38.20/claim|Median: $17.91
2.1× median
92060Normal range

$31K

1,131 claims · 0.0%

Your Cost: $27.38/claim|Median: $35.83
0.8× median
65778Normal range

$29K

1,095 claims · 0.0%

Your Cost: $26.35/claim|Median: $282.76
0.1× median
67700Normal range

$28K

572 claims · 0.0%

Your Cost: $48.73/claim|Median: $102.58
0.5× median
92025Normal range

$26K

1,503 claims · 0.0%

Your Cost: $17.26/claim|Median: $17.08
1.0× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$22K

266 claims · 0.0%

Your Cost: $83.35/claim|Median: $111.09
0.8× median
99212Normal range

Office/outpatient visit, low complexity

$19K

1,163 claims · 0.0%

Your Cost: $16.71/claim|Median: $25.06
0.7× median
J2777Normal range

$15K

32 claims · 0.0%

Your Cost: $457.95/claim|Median: $858.80
0.5× median
67108Normal range

$14K

14 claims · 0.0%

Your Cost: $967.20/claim|Median: $868.00
1.1× median
66982Normal range

$13K

26 claims · 0.0%

Your Cost: $480.82/claim|Median: $375.52
1.3× median

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