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NPI 1013361229 · Bernardsville, NJ · Ophthalmology Physician
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Effy Ojuok is a ophthalmology physician provider located in Bernardsville, New Jersey. This profile covers 17 Medicare and 2 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Effy Ojuok |
| Address | 150 Morristown Rd Ste 100 |
| City | Bernardsville |
| State | NJ |
| ZIP | 07924 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | April 14, 2016 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.3M |
| Medicaid | $0 |
This profile is effectively single‑payer: the provider reports Total Medicare revenue of $1.3M and Total Medicaid revenue of $0, indicating virtually no Medicaid billing on file and a Medicare‑dependent revenue base. That payer concentration means the provider’s financial and operational risk is tightly coupled to Medicare policy and reimbursement for ophthalmic drugs and procedures.
Revenue is highly concentrated in a few drug codes: the precomputed top 3 Medicare codes account for 81.6% of the provider’s total Medicare revenue, driven by J0178 ($840.6K, 64.1% of Medicare revenue), J3490 ($146.2K, 11.2%), and J2781 ($82.8K, 6.3%). This concentration highlights reliance on a narrow set of high‑value injectable therapies and makes the practice sensitive to changes in drug pricing, coverage, or utilization management.
Clinical/service‑line mix is consistent with a medical retina/in-office injection practice: J0178 (aflibercept) shows 1.3K claims with a $664 avg paid/claim and is the single largest revenue driver, and J2781 (pegcetacoplan) shows 690 claims with a $120 avg paid/claim. Procedural support for in‑office injections appears in the portfolio (67028 — 811 claims, $97 avg paid/claim, $78.7K revenue), indicating the practice administers intravitreal therapies as a routine, clinic‑based service.
Diagnostic and continuity‑of‑care activity is a meaningful secondary revenue stream: 92014 (established comprehensive eye exam) has 749 claims, $105 avg paid/claim and $78.6K revenue and ranks #2930 of 35415 (92th percentile; typical, unremarkable volume), while 92134 (retinal imaging) has 1.1K claims, $35 avg paid/claim and $39.3K revenue and ranks #1998 of 26868 (93th percentile; typical, unremarkable volume). These high relative percentiles show above‑average throughput for exam and imaging services even as drug therapy dominates revenue.
On competitive standing for top drugs the provider is a modest national participant rather than a dominant center: J0178 ranks #1032 of 3204 (68th percentile; typical, unremarkable volume), J3490 ranks #1183 of 2838 (58th percentile; typical, unremarkable volume), and J2781 ranks #196 of 490 (59th percentile; typical, unremarkable volume). In short, the provider bills substantial volumes of leading retinal drugs but sits near the middle of national peers rather than near the top.
Practice tenure is established but not long‑standing: the NPI was enumerated 2016-04-14 (~10 years ago), indicating around a decade of Medicare enrollment which supports longitudinal data availability but suggests the provider is not among the longest‑tenured national practices.
Procedural breadth skews away from surgical retina: lower revenue and low percentile ranks for surgical/ancillary procedures (e.g., 67145 — 12 claims, $202 avg paid/claim, $2.4K revenue, rank #761 of 861, 5th percentile; 92235 — 24 claims, $116 avg paid/claim, $2.8K revenue, rank #1581 of 2192, 27th percentile) indicate limited surgical laser or extensive operative retina activity. This reinforces the interpretation that the business model focuses on medical injection therapy and diagnostics rather than retinal surgery.
For payers and network managers the key implications are operational and utilization risks tied to injectable drug use: heavy dependence on high‑value injectables like J0178 (1.3K claims, $664 avg paid/claim) suggests prior authorization, step therapy, and drug‑cost management policies will materially affect spend. The absence of Medicaid billing ($0) also means state‑program access and reimbursement considerations are unlikely to influence this provider’s revenue mix, but could signal a gap in access to care for Medicaid populations in the local market.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
17 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1,270 | $660 | $840.6K |
| J3490 | Unclassified drugs | 70 | $2,090 | $146.2K |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 690 | $120 | $82.8K |
| 67028 | The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye. | 810 | $100 | $78.7K |
| 92014 | An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group… | 750 | $110 | $78.6K |
| 92134 | The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes. | 1,120 | $40 | $39.3K |
| 92012 | For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any… | 230 | $80 | $17.8K |
| 92004 | The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits. | 80 | $120 | $9K |
| 92201 | The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece… | 260 | $20 | $5.5K |
| 92235 | The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken… | 20 | $120 | $2.8K |
Showing 1–10 of 17
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
17 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 14 | 90 | 880 | $690 | $693.6K |
| 67028 | 19 | 100 | 810 | $100 | $91.1K |
| J2781 | 1 | 20 | 570 | $120 | $88.8K |
| 92014 | 28 | 1,130 | 160 | $100 | $34.9K |
| J3490 | 4 | 120 | 70 | $230 | $30.2K |
| 92012 | 93 | 800 | 140 | $70 | $18.5K |
| 92235 | 26 | 70 | 60 | $120 | $17.3K |
| 99213 | 6,392 | 14,090 | 100 | $70 | $13.1K |
| 92134 | 26 | 700 | 90 | $30 | $10K |
| 92004 | 62 | 900 | 40 | $110 | $8K |
Showing 1–10 of 17
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 92014 | An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group… | 100 | $0 | $0 |
| 92134 | The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes. | 70 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other New Jersey providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Jersey median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 92014 | An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group… | 539 | 730 | 470 | $20 | $51K |
| 92134 | The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes. | 82 | 110 | 330 | $20 | $36.6K |
Other providers in the same ZIP code as Effy Ojuok, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Maria Costea Misthos | NJ | Internal Medicine Physician | $188.4K | $0 |
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