Physician
West Coast Retina Medical Group, INC.
West Coast Retina Medical Group, INC. was paid $2.84M by Medicaid between Jan 2018 and Nov 2024, across 17 billing codes. Its largest line is 67028, Intravitreal injection of a pharmacologic agent — 51% of everything it billed.
33Billing provider infoWEST COAST RETINA MEDICAL GROUP, INC.
SAN FRANCISCO, CA 94109
SAN FRANCISCO, CA 94109
33aNPI1053389064assigned 03/08/2006
33bProvider typeOphthalmology Physician
28Total paid$2.84M
24GClaims30,388
24DCodes billed17
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Ophthalmology Physician providers in California
Rank by total paid#38 of 759
Median peer was paid$35K
This provider vs. median81×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 3,719 | $164K | |
| 2019 | 4,410 | $176K | |
| 2020 | 3,754 | $168K | |
| 2021 | 4,646 | $233K | |
| 2022 | 4,945 | $383K | |
| 2023 | 5,227 | $1.08M | |
| 2024incomplete | 3,687 | $638K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 67028 | Intravitreal injection of a pharmacologic agent | 51% | 9,684 | 8,414 | $1.44M |
| J0178 | Injection, aflibercept, 1 mg | 33% | 871 | 681 | $935K |
| 92134 | 8.8% | 11,945 | 11,316 | $250K | |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 4.5% | 3,033 | 2,960 | $128K |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | 1.2% | 870 | 834 | $34K |
| J9035 | Injection, bevacizumab, 10 mg | <1% | 302 | 254 | $17K |
| J7999 | Compounded drug, not otherwise classified | <1% | 1,766 | 1,469 | $16K |
| 92201 | <1% | 469 | 452 | $8K | |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | <1% | 95 | 92 | $5K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | <1% | 47 | 47 | $2K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 28 | 27 | $1K |
| 92202 | <1% | 139 | 136 | $916.97 |
5 more codes
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialHIGGINBOTHAM, BENJAMIN (COO)
| Provider | Location | Paid |
|---|---|---|
| Blue Mountain Eye PLLC | Walla Walla, WA | $55K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.