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PROVIDER PROFILE · NPI 1164450201

Paul RaphaelianMD

PRACTICEASSOCIATED RETINAL CONSULTANTS, PCSee all providers at this practice →
OphthalmologyNorton Shores, MII
CROSS-REFERENCE

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ProviderScore
OIG/SAM exclusion screening, sanctions history
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QUALITY · MIPS · 2024
Final MIPS score
95.3
Quality
91.4
Cost
0.0
Improvement activities
40.0
Promoting interop.
100.0
Payment adjustment
0.85%
Group
FACILITY AFFILIATIONS

Hospital & Facility Affiliations (1)

CCN 230066
Hospital
PRESCRIBING · PART D · 2024
Total Rx claims
498
Beneficiaries
—
Total drug cost
$14K
Distinct drugs
7
Brand share
21.3%
Top prescribed drugs
Prednisolone Acetate141 claims
Latanoprost124 claims
Dorzolamide Hcl/Timolol Maleat106 claims
Timolol Maleate57 claims
Ketorolac Tromethamine45 claims
INDUSTRY PAYMENTS · OPEN PAYMENTS · 2024
No data available for this provider in 2024.
MEDICARE UTILIZATION · PART B · 2024
Total beneficiaries
1,252
Unique beneficiaries
—
Total services
18,927
Distinct HCPCS
12
Medicare payment
$1.3M
Peer benchmark
Q1
Q2
Q3
Q4
Q5
Total Medicare services vs. 608 Ophthalmology providers in MI — top quintile (cohort median 1,582).
REFERRAL NETWORK

Where Paul Raphaelian's patients come from & go

Directional shared-patient flow from Medicare claims — who sends patients to this provider (inbound) and where this provider's patients go next (outbound). 33 inbound referrers · 62 outbound destinations.

Receives referrals from
Inbound — who sends patients here
PhysicianPatientsVisits
NPI 1225066327281835
MERCY PHYSICIAN NETWORK267686
SPECTRUM HEALTH PRIMARY CARE PARTNERS52128
Susan Holibaugh
Podiatry · Muskegon, MI
3183
MERCY HEALTH PARTNERS3057
NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION2869
Gregory Downer
Nephrology · Muskegon, MI
2469
Edward Sara
Diagnostic Radiology · Indianapolis, IN
2433
Lawrence Mallon
Vascular Surgery · Muskegon, MI
2245
John Stephenson
Diagnostic Radiology · Farmington Hills, MI
2227
OTTO, KENNETH2138
KINZIGER, MARK2143
Refers patients to
Outbound — where patients go next
PhysicianPatientsVisits
REGENTS OF THE UNIVERSITY OF MICHIGAN369938
NPI 1225066327285885
MERCY PHYSICIAN NETWORK267654
MERCY HEALTH PARTNERS194411
SPECTRUM HEALTH PRIMARY CARE PARTNERS51122
SPECTRUM HEALTH HOSPITALS3573
MERCY HEALTH PARTNERS3475
Susan Holibaugh
Podiatry · Muskegon, MI
3389
TRINITY HEALTH GRAND HAVEN HOSPITAL3386
NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION3175
Anthony Barclay
Diagnostic Radiology · Holland, MI
2836
FLES, ROBERT2832
Source: CMS Physician Shared Patient Patterns (30-day window, Medicare FFS). Direction = a beneficiary seen by the first provider, then the second, within 30 days; a proxy for referral, not a documented referral. Pairs with fewer than 11 shared beneficiaries are suppressed.