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 Colorado for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Colorado 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. Colorado (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.

Justin Kanoff (NPI 1326205048)

Field	Value
Entity Type	Individual
Organization	Justin Kanoff
Address	1400 Dry Creek Dr
City	Longmont
State	CO
ZIP	80503
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	May 20, 2008

Payer Source	Total Paid
Medicare	$1.7M
Medicaid	$0

Key Findings

Practice profile and service mix: JUSTIN KANOFF is a Retina Specialist (Ophthalmology) with an NPI enumerated 2008-05-20 (~18 years ago), and his Medicare billing pattern is dominated by intravitreal drug therapy and related retinal procedures. The top billed items are medication administration and high-cost ophthalmic drugs (J0178, J2777, J2781) alongside procedure codes such as 67028 for isolated intravitreal injection and diagnostic imaging codes (92134, 92250), consistent with a retina-focused outpatient injection and imaging practice.

Revenue concentration in Medicare: Total Medicare revenue is $1.7M and the precomputed top-3 Medicare codes account for 75.8% of that total. The top three revenue drivers are J0178 ($822K, 48.9%), J2777 ($355K, 21.1%), and 67028 ($97.1K, 5.8%), indicating most Medicare dollars flow from a small set of high-value injection and drug-supply codes.

Payer mix and single-payer exposure: This provider reports $1.7M in Medicare revenue and has none below for Medicaid (no Medicaid billing on file), making the operation effectively single-payer Medicare in scale. Lack of Medicaid activity means competitive or referral dynamics in state Medicaid markets are not visible and revenue sensitivity is concentrated to Medicare reimbursement and ophthalmic drug pricing.

Competitive standing for top drug codes: On national comparisons the largest drug code, J0178 (aflibercept), generates $822K and ranks #1077 of 3204 providers nationally (66th percentile; typical, unremarkable volume). J2777 (faricimab) shows very high claim volume (12.2K claims) with $355K revenue and ranks #866 of 2039 (57th percentile; typical, unremarkable volume), while 67028 ranks #1456 of 4255 (66th percentile; typical, unremarkable volume), together suggesting this provider is a solid but not dominant national participant for these core retina injections.

Procedure, E&M and imaging mix: Office visits and diagnostic imaging together contribute meaningful but smaller shares of Medicare revenue — for example 92014 accounts for $74.6K and ranks #2266 of 35415 (94th percentile; notably above typical national volume), 92134 accounts for $40.6K and ranks #1732 of 26868 (94th percentile; notably above typical national volume), and 99213 accounts for $45.4K and ranks #16661 of 457151 (96th percentile; notably above typical national volume). These elevated percentiles for E&M and imaging indicate an active schedule of follow-up visits and retinal imaging that supports the high-volume injection practice.

Statistical outliers and atypical volumes: The provider is an extreme outlier on fundus photography 92250 ($26.1K, rank #373 of 25087, 99th percentile; extreme outlier, far above typical national volume), signaling unusually high use of fundus photography relative to peers. By contrast, some drug billing shows more modest national positioning (e.g., J3490 at $76.1K ranks #1883 of 2838, 33th percentile; typical, unremarkable volume), and other intravitreal-related codes like J2781 ($50.4K) sit at #325 of 490 (32th percentile; typical, unremarkable volume).

Operational and reimbursement implications: The practice’s revenue profile is highly dependent on a small number of high-revenue drug codes — notably J0178 ($822K) and J2777 ($355K) — and on related injection procedure billing (67028). That concentration (top-3 = 75.8% of Medicare revenue) creates exposure to changes in injectable drug reimbursement, compound drug policy, or utilization shifts in anti-VEGF and newer agents, which would materially affect practice revenue.

Referral and capacity signal: High claim counts for injectables (e.g., J0178 with 1.2K claims and J2777 with 12.2K claims) combined with elevated imaging and E&M percentiles suggest this provider maintains substantial throughput for retina patients, with workflow and imaging capacity that supports frequent follow-up and treatment cycles typical of chronic retinal disease management.

Medicare: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,220	$680	$822K
J2777	Injection, faricimab‑svoa, 0.1 mg	12,240	$30	$355K
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.	950	$100	$97.1K
J3490	Unclassified drugs	40	$1,860	$76.1K
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…	860	$90	$74.6K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	420	$120	$50.4K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	650	$70	$45.4K
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.	1,310	$30	$40.6K
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…	340	$100	$33K
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,…	870	$30	$26.1K

Showing 1–10 of 21

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Colorado Distribution

Justin Kanoff — 3 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. state median

21 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	18	60	740	$690	$618.3K
J2777	16	40	8,910	$30	$456.1K
J2781	8	10	470	$120	$79.4K
67028	30	80	670	$100	$73.3K
67036	18	30	20	$1,100	$37.3K
J3490	43	60	50	$290	$23.1K
J7999	25	50	230	$70	$21.5K
66821	117	180	40	$240	$15.5K
92014	19	670	100	$80	$15.2K
92235	15	50	50	$110	$12.2K

Showing 1–10 of 21

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Elisha Tilton	CO	Ophthalmology Physician	$1.9M	$0
Carl Noble	CO	Retina Specialist (Ophthalmology) Physician	$1.7M	$0
Matthew Manry	CO	Retina Specialist (Ophthalmology) Physician	$1.6M	$0
Micah Rothstein	CO	Glaucoma Specialist (Ophthalmology) Physician	$283.4K	$0
Anjali Sheth	CO	Glaucoma Specialist (Ophthalmology) Physician	$234K	$0
Mansi Parikh	CO	Glaucoma Specialist (Ophthalmology) Physician	$167.1K	$0
Joel Meyers	CO	Ophthalmic Plastic and Reconstructive Surgery Physician	$154.7K	$0
Aimee Verner	CO	Cornea and External Diseases Specialist Physician	$138.2K	$0
Taylor Bowman	WY	Optometrist	$91.3K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kirk Mitchell	CO	Geriatric Medicine (Internal Medicine) Physician	$27.1M	$1M
Advanced Vision Surgery Center LLC	CO	Ambulatory Surgical Clinic/Center	$1.8M	$0
Front Range Orthopedic Surgery Center LLC	CO	Ambulatory Surgical Clinic/Center	$190.1K	$0
William Cooney	CO	Sports Medicine (Orthopaedic Surgery) Physician	$184.2K	$0
Timothy Pater	CO	Orthopaedic Hand Surgery Physician	$183.1K	$0
Nirav Shah	CO	Sports Medicine (Orthopaedic Surgery) Physician	$153.4K	$0
George Chaus	CO	Orthopaedic Trauma Physician	$139.3K	$0
Tamara Bockman	CO	Psychiatric/Mental Health Registered Nurse	$111.3K	$0
Elliot Good	CO	Psychiatric/Mental Health Nurse Practitioner	$107.8K	$0
Matthew Gerlach	CO	Orthopaedic Surgery of the Spine Physician	$97.3K	$0

Justin Kanoff — 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