Physician

James C Lai, M.D.

According to 2025 Medicare claims, James Lai, M.D. (NPI: 1871606186) practices ophthalmology in the Urban Honolulu, HI market, with the plurality of this provider's patient population coming from Honolulu, HI. This provider's primary affiliated billing organization is RETINA CONSULTANTS OF HAWAII INC (NPI: 1124089446; TIN: 990300258) and primary practice location at 96814-1871.

Lai's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 963 traditional Medicare patients, billed 25,319 HCPCS/CPT codes, and received $1,366,414 in Medicare payments. The top billing code was 92014 (Established patient complete exam of visual system). Part D data shows 492 prescription claims across 161 beneficiaries totaling $54,341 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 changed little. Concurrently, Part D prescription costs have fallen sharply in recent years, from $77,361 to $54,341. 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	965	8,091	$1,273,530
2016	1,024	8,265	$1,443,749
2017	1,081	8,252	$1,515,951
2018	1,080	8,425	$1,575,425
2019	1,038	7,628	$1,444,914
2020	906	7,412	$1,395,754
2021	1,023	7,895	$1,546,819
2022	969	9,133	$1,375,555
2023	1,006	21,649	$1,480,865
2024	963	25,319	$1,366,414

Part D Events Trend

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

Year	Patients	Claims	Drug Cost
2015	165	449	$77,361
2016	167	447	$70,119
2017	178	469	$70,220
2018	199	541	$289,162
2019	187	551	$425,211
2020	177	519	$504,915
2021	201	560	$420,693
2022	185	467	$172,784
2023	180	480	$73,588
2024	161	492	$54,341

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
92014	Established patient complete exam of visual system	842	1,171	$95
67028	Injection of drug into eye	213	804	$91
92012	Established patient problem focused exam of visual system	267	577	$67
92134	Imaging of retina	864	1,766	$32
92250	Photography of the retina	223	289	$30

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Prednisolone Acetate	Prednisolone Acetate	120	6,064	$8,345
Bromfenac Sodium	Bromfenac Sodium	45	1,798	$8,241
Brimonidine Tartrate	Brimonidine Tartrate	45	2,977	$2,499
Ketorolac Tromethamine	Ketorolac Tromethamine	76	2,668	$2,437
Moxifloxacin	Moxifloxacin Hcl	82	1,015	$2,389

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 James C. Lai, M.D.?

Tedicare shows public-source Medicare data for James C. Lai, M.D. (NPI 1871606186), 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 James C. Lai, M.D. have ACO affiliation data?

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

What billing organization is linked to James C. Lai, M.D.?

James C. Lai, M.D. is linked to RETINA CONSULTANTS OF HAWAII INC (billing NPI 1124089446) in the available physician profile data.

Does James C. Lai, M.D. 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.