Northeast Wisconsin Retina Associates SC

Northeast Wisconsin Retina Associates SC was paid $2.42M by Medicaid between Jan 2018 and Dec 2024, across 9 billing codes. Its largest line is J0178, Injection, aflibercept, 1 mg — 55% of everything it billed.

33Billing provider infoNORTHEAST WISCONSIN RETINA ASSOCIATES SC
APPLETON, WI 54914

33aNPI1437164175assigned 07/30/2006

33bProvider typeRetina Specialist (Ophthalmology) Physician

28Total paid$2.42M

24GClaims33,025

24DCodes billed9

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Retina Specialist (Ophthalmology) Physician providers in Wisconsin

Rank by total paid#1 of 5

Median peer was paid$4K

This provider vs. median572×

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	3,149	$102K
2019	3,747	$161K
2020	4,003	$233K
2021	5,864	$464K
2022	5,407	$397K
2023	6,473	$607K
2024incomplete	4,382	$457K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
J0178	Injection, aflibercept, 1 mg	55%	1,991	1,383	$1.32M
67028	Intravitreal injection of a pharmacologic agent	28%	9,423	8,311	$679K
92134		8.5%	14,229	12,059	$205K
J9035	Injection, bevacizumab, 10 mg	8.3%	6,566	4,514	$202K
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%	417	316	$7K
92014	Ophthalmological services: medical examination and evaluation, comprehensive, established patient	<1%	129	120	$3K
92012	Ophthalmological services: medical examination and evaluation, intermediate, established patient	<1%	240	204	$3K
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%	16	14	$859.39
99204	Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	<1%	14	12	$554.51

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 officialDEBRUIN, AMY (BILLING DEPARTMENT MANAGER)