Physician
High Country Macula Retina and Vitreous PC
High Country Macula Retina and Vitreous PC was paid $814K by Medicaid between Jan 2018 and Jul 2021, across 17 billing codes. Its largest line is J0178, Injection, aflibercept, 1 mg — 25% of everything it billed.
33Billing provider infoHIGH COUNTRY MACULA RETINA AND VITREOUS PC
ALBUQUERQUE, NM 87107
ALBUQUERQUE, NM 87107
33aNPI1477666568assigned 08/16/2006
33bProvider typeOphthalmology Physician
28Total paid$814K
24GClaims17,280
24DCodes billed17
24AFirst – last monthJan 2018 – Jul 2021
Compared with peers
Next to other Ophthalmology Physician providers in New Mexico
Rank by total paid#5 of 15
Median peer was paid$511K
This provider vs. median1.6×
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 | 5,601 | $308K | |
| 2019 | 4,927 | $226K | |
| 2020 | 4,499 | $195K | |
| 2021 | 2,253 | $86K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 25% | 283 | 255 | $204K |
| 92134 | 24% | 7,783 | 7,075 | $195K | |
| 67028 | Intravitreal injection of a pharmacologic agent | 22% | 3,445 | 3,178 | $177K |
| J9035 | Injection, bevacizumab, 10 mg | 9.4% | 1,424 | 1,348 | $77K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 7.5% | 1,775 | 1,669 | $61K |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | 4.3% | 1,124 | 1,060 | $35K |
| 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 | 3.4% | 277 | 271 | $28K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 3.0% | 379 | 361 | $25K |
| 92235 | <1% | 127 | 111 | $7K | |
| 92250 | <1% | 139 | 124 | $5K | |
| 99072 | <1% | 168 | 156 | $445.24 | |
| J7999 | Compounded drug, not otherwise classified | <1% | 28 | 27 | $282.00 |
5 more codes
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 169 | $0.00 |
| 5010F | 0% | 96 | $0.00 | |
| G9974 | Dilated macular exam performed, including documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage and the level of macular degeneration severity | 0% | 25 | $0.00 |
| G8397 | Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy | 0% | 26 | $0.00 |
| 4177F | 0% | 12 | $0.00 |
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 officialSELIGSON, MICHAEL (CEO)