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NPI 1326249558 · Suffern, NY · Retina Specialist (Ophthalmology) Physician
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Jeffrey Josef is a retina specialist (ophthalmology) physician provider located in Suffern, New York. This profile covers 17 Medicare and 19 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 | Jeffrey Josef |
| Address | 257 Lafayette Ave Ste 350 |
| City | Suffern |
| State | NY |
| ZIP | 10901 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | May 28, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $5.6M |
| Medicaid | $3.4M |
This provider reports $5.6M in lifetime Medicare revenue and $3.4M in lifetime Medicaid revenue, indicating Medicare is the larger payer by scale rather than a single‑payer operation. The presence of substantial revenue on both programs suggests an ambulatory specialty practice that serves both Medicare and Medicaid populations.
Medicare revenue is highly concentrated: the top three Medicare codes account for 84.9% of this provider’s total Medicare revenue. Those top Medicare drivers are J2777 ($3.4M, 60.4% of Medicare revenue), J0178 ($1.1M, 20.4%), and 67028 ($233.4K, 4.2%), which together point to a business built around intravitreal drug delivery and injection visits.
Medicaid revenue is even more concentrated: the top three Medicaid codes account for 93.7% of this provider’s total Medicaid revenue. The Medicaid mix is dominated by J0178 ($2.6M, 77.6%), with J2777 ($363.7K, 10.8%) and 65800 ($176.6K, 5.3%) rounding out the top three, indicating near‑dependency on a single high‑value injectable for Medicaid reimbursement.
The procedural and drug code mix (large volumes of J2777, J0178, and high claim counts for 92134 and injection codes) supports the interpretation that this is a retina‑focused ambulatory practice operating a high‑throughput injection clinic with routine retinal imaging. For Medicare, 92134 appears frequently (3K claims, $109.6K) which aligns with a practice workflow that pairs intravitreal injections with frequent retinal OCT imaging.
On Medicare this provider is a national outlier for multiple codes: J2777 ranks #12 of 2039 providers nationally (99th percentile; extreme outlier) and 92134 ranks #425 of 26868 providers nationally (98th percentile; extreme outlier); 65800 also ranks #2 of 96 providers nationally (99th percentile; extreme outlier). These rank/percentile signals characterize the provider as a dominant national participant for specific retina drug and procedure codes rather than a modest local contributor.
On Medicaid the provider is a statewide leader for key drug codes: J0178 ranks #1 of 101 providers in-state (100th percentile; extreme outlier) and J2777 ranks #3 of 15 in-state (86th percentile). The state‑level dominance for J0178 (77.6% of Medicaid revenue) indicates strong market share in Medicaid for aflibercept administration in this region.
The strong reliance on a small number of high‑value injectable codes (notably J2777 in Medicare and J0178 in Medicaid) creates revenue concentration and utilization exposure: J2777 alone generates $3.4M of Medicare revenue while J0178 generates $2.6M of Medicaid revenue. Such concentration is operationally efficient for an injection‑centric retina practice but also represents a single‑therapy sensitivity that payers and contracting teams will likely prioritize in utilization management and pricing negotiations.
The provider’s NPI was enumerated 2007-05-28 (~19 years ago), indicating an established tenure in the marketplace. Combined with the high specialty volumes and national/state outlier rankings, the longevity supports a mature retina practice model with sustained high utilization of intravitreal therapies and retinal diagnostics.
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 |
|---|---|---|---|---|
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 116,160 | $30 | $3.4M |
| J0178 | Injection, aflibercept, 1 mg | 1,650 | $690 | $1.1M |
| 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. | 2,200 | $110 | $233.4K |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 1,500 | $120 | $180K |
| 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… | 1,050 | $110 | $120K |
| J3490 | Unclassified drugs | 60 | $1,750 | $110.4K |
| 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. | 2,960 | $40 | $109.6K |
| 65800 | In this procedure, the provider drains fluid from the anterior chamber of the eye and also removes thin, watery fluid that fills the space between the cornea and the iris, known as the aqueous.… | 730 | $110 | $81.9K |
| 92242 | The provider injects two different special dyes into one or both eyes that cause the blood vessels to stand out in photographic images timed so that multiple frames are taken in rapid succession. He… | 220 | $250 | $55.8K |
| 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… | 660 | $80 | $55.5K |
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 | 50 | 230 | 560 | $690 | $693K |
| J2777 | 1 | 120 | 7,740 | $30 | $364.9K |
| J2781 | 1 | 40 | 520 | $120 | $75.1K |
| 67028 | 11 | 300 | 400 | $100 | $65.9K |
| J3490 | 57 | 120 | 60 | $470 | $50.8K |
| 92242 | 4 | 20 | 110 | $240 | $33K |
| 92014 | 122 | 2,220 | 160 | $100 | $29.3K |
| 99214 | 24,801 | 30,450 | 90 | $100 | $19K |
| 92012 | 136 | 1,640 | 100 | $70 | $17.4K |
| 65800 | 1 | 10 | 70 | $110 | $16.2K |
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.
19 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 4,420 | $590 | $2.6M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 430 | $840 | $363.7K |
| 65800 | In this procedure, the provider drains fluid from the anterior chamber of the eye and also removes thin, watery fluid that fills the space between the cornea and the iris, known as the aqueous.… | 4,010 | $40 | $176.6K |
| 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… | 1,880 | $30 | $64.1K |
| 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. | 4,170 | $20 | $62.5K |
| 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… | 1,240 | $40 | $50.9K |
| 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. | 600 | $30 | $16.8K |
| 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… | 480 | $10 | $6.3K |
| 92242 | The provider injects two different special dyes into one or both eyes that cause the blood vessels to stand out in photographic images timed so that multiple frames are taken in rapid succession. He… | 50 | $70 | $3.8K |
| 92226 | N/A | 240 | $10 | $2.6K |
Showing 1–10 of 19
How this provider's Medicaid billing volume and revenue compare to other New York providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New York median
19 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1 | 100 | 280 | $650 | $369.9K |
| 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… | 16,997 | 19,110 | 360 | $70 | $321K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 3 | 20 | 120 | $720 | $173.2K |
| 99204 | The provider sees a new 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 provider… | 3,494 | 3,820 | 100 | $130 | $99.7K |
| 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… | 662 | 2,440 | 330 | $70 | $92.6K |
| 65800 | In this procedure, the provider drains fluid from the anterior chamber of the eye and also removes thin, watery fluid that fills the space between the cornea and the iris, known as the aqueous.… | 1 | 10 | 2,030 | $40 | $88.2K |
| 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… | 258 | 1,460 | 310 | $60 | $88.1K |
| 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. | 113 | 260 | 420 | $70 | $65.6K |
| 92242 | The provider injects two different special dyes into one or both eyes that cause the blood vessels to stand out in photographic images timed so that multiple frames are taken in rapid succession. He… | 7 | 10 | 150 | $120 | $49.2K |
| J9035 | Injection, bevacizumab, 10 mg | 107 | 150 | 170 | $80 | $36.7K |
Showing 1–10 of 19
Other providers in the same ZIP code as Jeffrey Josef, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Good Samaritan Hospital Of Suffern | NY | General Acute Care Hospital | $0 | $19M |
| Cdx Diagnostics, Inc. | NY | Clinical Medical Laboratory | $5.9M | $3.6M |
| Rishi Bajaj | NY | Interventional Cardiology Physician | $615.4K | $352K |
| Ainat Beniaminovitz | NY | Cardiovascular Disease Physician | $618.6K | $4K |
| Joel Selter | NY | Specialist | $374.8K | $0 |
| Nirmala Nanjappa | NY | Internal Medicine Physician | $181.7K | $157.8K |
| Zvi Sternberg | NY | Physical Therapist | $284.2K | $11.3K |
| Jonathan Schlosser | NY | Endocrinology, Diabetes & Metabolism Physician | $283.5K | $0 |
| Mark Wells | NY | Podiatrist | $243.5K | $90 |
| Yoram Amsalem | NY | Interventional Cardiology Physician | $182.1K | $46.9K |
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