Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Washington for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Washington only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Washington (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

George Ko (NPI 1205890514)

Field	Value
Entity Type	Individual
Organization	George Ko
Address	4300 Talbot Rd S
City	Renton
State	WA
ZIP	98055
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	April 13, 2006

Payer Source	Total Paid
Medicare	$1.7M
Medicaid	$0

Key Findings

This provider’s Medicare practice generates $1.7M in lifetime Medicare revenue and is highly concentrated: the top 3 Medicare codes by revenue account for 80.6% of total Medicare revenue. There is no Medicaid billing on file, so all recorded public-payer revenue is effectively from Medicare.

Anti-VEGF injections and intravitreal procedures dominate the clinical mix. J0178 (1.6K claims, $688 avg paid/claim, $1.1M revenue, 63.6% of Medicare revenue), J2778 (854 claims, $181 avg paid/claim, $154.6K revenue, 9.1%), and 67028 (1.3K claims, $104 avg paid/claim, $133.3K revenue, 7.9%) together drive the practice’s billed services and indicate a retina-focused, injection-heavy service line.

Although injections account for the majority of revenue, the provider also reports relatively high volumes of diagnostic and office exam activity that support retina care. Codes 92014 (998 claims, $96.8K revenue) and 92012 (671 claims, $49K revenue) are described as notably above typical national volume, and retinal imaging codes such as 92134 (1.5K claims, $47.6K revenue) and 92250 (682 claims, $21.8K revenue) are likewise notably above typical national volume, suggesting substantial clinic throughput and imaging capacity.

On competitive standing for the practice’s highest-revenue injections, national ranks indicate presence but not dominance: J0178 is characterized as a typical, unremarkable volume (ranked in the 76th percentile relative to peers), J2778 is also typical, and 67028 is typical as well. In other words, this provider is an established participant in anti-VEGF and intravitreal services but not an extreme outlier nationally for those codes.

There are occasional higher-cost surgical and ancillary services but they are a minority of revenue. 67042 (18 claims, $954 avg paid/claim, $17.2K revenue) appears with typical volume for a vitrectomy-related procedure, and compounded drug billing J7999 (354 claims, $74 avg paid/claim, $26.2K revenue) is present at a typical level, indicating some use of compounded preparations and infrequent surgical interventions without making up the revenue base.

The payer mix is effectively single-payer at the public benefit level: Medicare accounts for all reported public-payor activity and Medicaid shows none on file. This concentration exposes the practice to Medicare policy and reimbursement changes more than to state Medicaid dynamics.

The provider’s NPI has been enumerated since 2006-04-13 (~20 years), signaling a long-tenured practice that likely benefits from an established referral network and sustained Medicare billing patterns over time. This tenure, combined with the injection-heavy revenue mix and above-typical diagnostic volumes, suggests a stable, retina-focused outpatient practice model with mature patient flow.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,570	$690	$1.1M
J2778	Injection, ranibizumab, 0.1 mg	850	$180	$154.6K
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.	1,280	$100	$133.3K
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…	1,000	$100	$96.8K
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…	670	$70	$49K
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.	1,490	$30	$47.6K
J7999	Compounded drug, not otherwise classified	350	$70	$26.2K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	680	$30	$21.8K
67042	In this procedure, the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina…	20	$950	$17.2K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	160	$90	$14.3K

Showing 1–10 of 18

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Washington Distribution

George Ko — 2 of 18 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. state median

18 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	22	90	470	$680	$597.2K
J2778	6	30	510	$180	$117.1K
67028	26	110	550	$90	$72.9K
67042	24	40	30	$1,190	$39.2K
92242	11	20	50	$210	$19.7K
92014	13	790	110	$80	$16.8K
J7999	9	70	150	$70	$15.9K
99214	3,532	10,860	100	$80	$13.6K
92012	16	220	70	$70	$12.9K
J9035	10	40	70	$50	$10.9K

Showing 1–10 of 18

Related Providers

Other providers that share a Tax Identification Number (TIN) with George Ko, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Retina Institute, PLLC	WA	Retina Specialist (Ophthalmology) Physician	$0	$5.5M
Eric Subong	WA	Ophthalmology Physician	$4.2M	$0
Laura Teasley	CA	Ophthalmology Physician	$2.4M	$0
Scott Warden	WA	Ophthalmology Physician	$2.3M	$0
Benjamin Reiss	WA	Retina Specialist (Ophthalmology) Physician	$1.9M	$0
David Drucker	WA	Retina Specialist (Ophthalmology) Physician	$1.8M	$0
George Peters	MA	Ophthalmology Physician	$1.6M	$0
Kenneth Fung	WA	Ophthalmology Physician	$1.6M	$0
Linda Day	MI	Retina Specialist (Ophthalmology) Physician	$395.6K	$0
Jay Haynie	WA	Optometrist	$394.5K	$0

Nearby Providers

Other providers in the same ZIP code as George Ko, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Public Hospital District 1 Of King County	WA	General Acute Care Hospital	$0	$120.6M
Valley Medical Group-renton	WA	General Acute Care Hospital	$0	$28.3M
Associated Emergency Room Physicians, Inc P.s.	WA	Emergency Medicine Physician	$0	$12M
Valley Children's Clinic	WA	Pediatric Adolescent Medicine Physician	$0	$5.2M
Proliance Surgery Center At Valley, LLC	WA	Ambulatory Surgical Clinic/Center	$3.3M	$0
Vantage Radiology & Diagnostic Services, A Professional Services Corp	WA	Diagnostic Radiology Physician	$0	$2.6M
Renton Regional Fire Authority	WA	Land Ambulance	$229.9K	$186.7K
Craig Fujisaki	WA	Dermatology Physician	$376.9K	$0
Timothy Alton	WA	Orthopaedic Surgery Physician	$313.4K	$0
William Barrett	WA	Orthopaedic Surgery Physician	$272.7K	$0

George Ko — Billing Profile & Reimbursement Data

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George Ko — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References