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

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

Michael Klufas (NPI 1346558392)

Field	Value
Entity Type	Individual
Organization	Michael Klufas
Address	4060 Butler Pike
City	Plymouth Meeting
State	PA
ZIP	19462
Taxonomy	Ophthalmology Physician
NPI Enumerated	September 23, 2010

Payer Source	Total Paid
Medicare	$7M
Medicaid	$0

Key Findings

This provider is effectively single-payer in scale: total Medicare revenue is $7M and there is no Medicaid billing on file. That concentration means Medicare activity drives the entire measurable billing profile and payer strategies should treat this as a Medicare-centric practice.

Revenue is heavily concentrated in a very small set of drugs and procedures: precomputed data show the top 3 Medicare codes by revenue account for 70.8% of this provider's total Medicare revenue. The largest single contributor is J0178 (44.9% of Medicare revenue, $3.1M), followed by J2777 (17.4%, $1.2M) and J2778 (8.4%, $588.7K).

Clinical mix and service-line implications point to a retina-focused, injection-centric practice: the top codes J0178, J2777, and J2778 are intravitreal biologic injections (aflibercept, faricimab, ranibizumab) and J2781 and Q5128 also represent intravitreal agents/biosimilars. That combination — high volumes of drug administration codes paired with retinal imaging codes — is consistent with a practice organized around frequent injection visits and ongoing macular degeneration/retina care.

Diagnostic and clinic throughput is unusually high for certain codes: 92134 shows 5.3K claims and $168K revenue and is a 100th percentile extreme outlier, and 92012 shows 2.8K claims and $194.4K revenue and is also a 100th percentile extreme outlier. These volumes indicate substantial OCT/retinal imaging and intermediate eye exam activity to support monitoring between injections.

The provider performs some surgical retinal procedures but at far lower volume than injections: codes 67042 (16 claims, $15.1K) and 67039 (19 claims, $14.7K) appear on the file with typical national standing for surgical codes, indicating occasional vitreoretinal surgery on top of a dominant injection/imaging practice. Surgical revenue is a small share compared with intravitreal drug revenue.

This clinician is a national high-volume outlier for selected injection and procedural codes: J0178 ranks #38 of 3204 providers nationally (99th percentile; extreme outlier, far above typical national volume for this code) and 67028 ranks #49 of 4255 providers nationally (99th percentile; extreme outlier). Such rankings reflect dominance in aflibercept administration and standalone intravitreal injection procedures relative to peers.

Code-level nuance: J2777 shows very large absolute claim volume (42.1K claims, $1.2M) but is characterized in the data as rank #152 of 2039 (93th percentile; typical, unremarkable volume), and Q5128 (2.6K claims, $572.2K) ranks #47 of 373 (88th percentile). This combination suggests heavy use of both originator and newer biologic/biosimilar agents, with some codes reflecting unusually concentrated local practice patterns while others match expected peer behavior.

The provider has a long Medicare tenure (NPI enumerated 2010-09-23 (~16 years ago)), indicating established referral patterns and steady presence in Medicare networks. For payers and network managers, that tenure plus the heavy dependence on injection/monitoring revenue implies predictable utilization patterns but also concentration risk if formulary or care-pathway changes alter intravitreal agent mix or reimbursement.

Medicare: Complete Services Breakdown

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

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	4,620	$680	$3.1M
J2777	Injection, faricimab‑svoa, 0.1 mg	42,060	$30	$1.2M
J2778	Injection, ranibizumab, 0.1 mg	3,120	$190	$588.7K
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	2,650	$220	$572.2K
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.	3,560	$100	$370.1K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	1,680	$120	$201.6K
J3490	Unclassified drugs	110	$1,770	$196.4K
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…	2,780	$70	$194.4K
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.	5,250	$30	$168K
J3590	Unclassified biologics	50	$2,300	$106K

Showing 1–10 of 23

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 23 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Pennsylvania Distribution

Michael Klufas — 8 of 23 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. state median

23 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	3	140	830	$690	$865.1K
Q5128	15	20	3,830	$220	$838.7K
J2778	18	70	1,030	$190	$417.1K
J2777	3	100	7,950	$30	$360.2K
J2781	2	20	690	$120	$109.1K
67028	10	180	600	$90	$87.5K
J3590	6	10	40	$1,690	$78K
J7999	85	110	100	$120	$33.3K
67042	31	50	20	$1,100	$31.9K
J3490	29	110	60	$70	$27.9K

Showing 1–10 of 23

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Nemours Foundation	DE	Multi-Specialty Clinic/Center	$0	$172M
The Nemours Foundation	FL	Children's Hospital	$0	$104.9M
The Nemours Foundation	DE	Children's Hospital	$0	$104M
The Nemours Foundation	FL	Multi-Specialty Clinic/Center	$0	$46.2M
Nemours Children's Health, Downtown Orlando, Specialty Care	FL	Multi-Specialty Clinic/Center	$0	$44.4M
Nemours Children's Health, Jacksonville, Specialty Care	FL	Multi-Specialty Clinic/Center	$0	$23.6M
Sedigheh Ebadi	FL	Pediatrics Physician	$0	$10.1M
Children's Health Alliance, LLC	FL	Pediatrics Physician	$0	$9.6M
Omesh Gupta	PA	Ophthalmology Physician	$7.1M	$80
Mitchell Fineman	PA	Ophthalmology Physician	$7M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gemma Services	PA	Psychiatric Residential Treatment Facility	$0	$23.8M
Access Services Inc	PA	Community/Behavioral Health Agency	$0	$8.3M
Richard Kaiser	PA	Ophthalmology Physician	$6.6M	$0
Allen Chiang	PA	Ophthalmology Physician	$6.6M	$0
Carl Regillo	PA	Ophthalmology Physician	$6.5M	$0
Allen Ho	PA	Ophthalmology Physician	$6.4M	$0
Yoshihiro Yonekawa	PA	Ophthalmology Physician	$6.4M	$0
James Vander	PA	Ophthalmology Physician	$6.3M	$0
Marc Spirn	PA	Ophthalmology Physician	$6.3M	$0
Arunan Sivalingam	PA	Ophthalmology Physician	$6M	$0

Michael Klufas — 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