Physician
Pacific Retina Care. LLC
Pacific Retina Care. LLC was paid $1.55M by Medicaid between Jan 2018 and Dec 2024, across 26 billing codes. Its largest line is J0178, Injection, aflibercept, 1 mg — 62% of everything it billed.
33Billing provider infoPACIFIC RETINA CARE. LLC
WAIPAHU, HI 96797
WAIPAHU, HI 96797
33aNPI1619118825assigned 03/18/2009
33bProvider typeOphthalmology Physician
28Total paid$1.55M
24GClaims33,661
24DCodes billed26
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Ophthalmology Physician providers in Hawaii
Rank by total paid#2 of 40
Median peer was paid$50K
This provider vs. median31×
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 | 6,276 | $345K | |
| 2019 | 5,782 | $293K | |
| 2020 | 4,784 | $255K | |
| 2021 | 4,818 | $162K | |
| 2022 | 4,791 | $147K | |
| 2023 | 4,429 | $141K | |
| 2024incomplete | 2,781 | $206K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 62% | 769 | 637 | $960K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 11% | 3,420 | 3,123 | $175K |
| 67028 | Intravitreal injection of a pharmacologic agent | 8.4% | 1,030 | 868 | $131K |
| 92250 | 5.8% | 2,421 | 2,302 | $89K | |
| 92134 | 4.9% | 2,834 | 2,378 | $76K | |
| 92226 | 3.8% | 2,889 | 1,295 | $59K | |
| 92201 | 1.8% | 1,533 | 1,105 | $28K | |
| S9999 | Sales tax | <1% | 385 | 255 | $6K |
| 5010F | <1% | 2,988 | 2,283 | $5K | |
| 1036F | <1% | 2,567 | 2,054 | $5K | |
| 2022F | <1% | 3,188 | 2,456 | $4K | |
| 92202 | <1% | 257 | 223 | $3K |
14 more codes
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | <1% | 4,424 | $3K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 38 | $2K |
| G9903 | Patient screened for tobacco use and identified as a tobacco non-user | <1% | 3,590 | $2K |
| A4550 | Surgical trays | <1% | 400 | $1K |
| 99072 | <1% | 240 | $1K | |
| 92225 | <1% | 49 | $896.24 | |
| G9902 | Patient screened for tobacco use and identified as a tobacco user | <1% | 124 | $0.10 |
| 4177F | <1% | 113 | $0.01 | |
| 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 | <1% | 57 | $0.01 |
| G9906 | Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy) | 0% | 123 | $0.00 |
| 99024 | 0% | 35 | $0.00 | |
| 2019F | 0% | 36 | $0.00 | |
| 4004F | 0% | 137 | $0.00 | |
| 0517F | 0% | 14 | $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 officialTAFOYA, MARK (OWNER)