Physician

Sophie Cai, MD

According to 2025 Medicare claims, Sophie Cai, MD (NPI: 1275914699) practices ophthalmology in the Chattanooga, TN-GA market, with the plurality of this provider's patient population coming from Hamilton, TN. This provider's primary affiliated billing organization is SOUTHEASTERN RETINA ASSOCIATES, P.C. (NPI: 1104097310; TIN: 621094813) and primary practice location at 37343-4556.

Cai's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 252 traditional Medicare patients, billed 2,690 HCPCS/CPT codes, and received $254,356 in Medicare payments. The top billing code was 92004 (New patient complete exam of visual system). Part D data shows 174 prescription claims across 56 beneficiaries totaling $8,163 in drug costs, led by Prednisolone Acetate (Prednisolone Acetate). No Open Payments records. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has moved sharply higher in recent years, from $7,913 to $254,356. Concurrently, Part D prescription costs have moved up and down with repeated peaks and valleys, starting at $7,975 and ending at $8,163. For DME billing, this provider has fewer than 5 years of reported data, so a reliable trend cannot be assigned.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	N/R	N/R	N/R
2016	N/R	N/R	N/R
2017	N/R	N/R	N/R
2018	N/R	N/R	N/R
2019	67	124	$7,913
2020	82	132	$10,405
2021	199	632	$75,186
2022	339	1,269	$178,301
2023	339	3,589	$544,375
2024	252	2,690	$254,356

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	N/R	N/R	N/R
2016	55	105	$7,975
2017	103	346	$43,339
2018	115	432	$25,178
2019	193	642	$33,083
2020	208	665	$41,102
2021	150	458	$38,847
2022	44	99	$5,067
2023	62	262	$13,603
2024	56	174	$8,163

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

No connected DME records

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
92004	New patient complete exam of visual system	61	61	$104
67028	Injection of drug into eye	66	133	$95
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	42	61	$88
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	142	209	$63
92134	Imaging of retina	230	419	$29

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Prednisolone Acetate	Prednisolone Acetate	19	705	$880
Ketorolac Tromethamine	Ketorolac Tromethamine	41	1,074	$636
Erythromycin	Erythromycin Base	27	390	$261
Latanoprost	Latanoprost	23	1,241	$230

Top 5 DME services in 2024

No connected or detailed DME service-level records for 2024.

Open Payments Summary

No connected Open Payments records were found for this physician in General Payments, Research Payments, or Ownership / Investment Interests.

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FAQ

What Medicare data is available for Sophie Cai, MD?

Tedicare shows public-source Medicare data for Sophie Cai, MD (NPI 1275914699), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Sophie Cai, MD have ACO affiliation data?

No ACO affiliation record is shown in the available Tedicare data for this profile.

What billing organization is linked to Sophie Cai, MD?

Sophie Cai, MD is linked to SOUTHEASTERN RETINA ASSOCIATES, P.C. (billing NPI 1104097310) in the available physician profile data.

Does Sophie Cai, MD have Open Payments data?

No connected Open Payments records are shown for this physician in the available General Payments, Research Payments, or Ownership / Investment Interests data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.