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NPI 1376861864 · Great Neck, NY · Ophthalmology Physician
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David Poon is a ophthalmology physician provider located in Great Neck, New York. This profile covers 23 Medicare and 15 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 | David Poon |
| Address | 600 Northern Blvd Ste 216 |
| City | Great Neck |
| State | NY |
| ZIP | 11021 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | May 10, 2010 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $4.1M |
| Medicaid | $796.1K |
This provider’s revenue base is concentrated in Medicare: Total Medicare revenue is $4.1M compared with Total Medicaid revenue of $796.1K, so Medicare is the dominant payer by scale. The difference in magnitude indicates the practice’s operations are oriented primarily toward Medicare beneficiaries rather than Medicaid business.
Medicare billing is highly concentrated: the top 3 Medicare codes account for 76.3% of this provider’s total Medicare revenue. A single code, J0178, generates $2.5M (61.2% of Medicare revenue) and ranks #94 of 3204 nationally (97th percentile; notably above typical national volume), while Q5128 and J2777 contribute $313.1K (7.6%) and $304.5K (7.4%) respectively. This mix shows dependence on high-volume retinal drug administration codes.
Clinical/service-line profile: the code mix is dominated by intravitreal injections and retinal imaging, consistent with a retina-focused ophthalmology practice. High-revenue codes include J0178 (aflibercept injections), J2777 and J2778 (newer/biosimilar anti-VEGF agents), 67028 (intravitreal injection), and 92134 (computerized retinal imaging), indicating routine, repeated in-office injection procedures combined with frequent diagnostic imaging.
Medicare competitive standing shows pockets of very high throughput: 92134 appears as an extreme outlier (3.8K claims, $135.2K revenue; ranks #169 of 26868 providers nationally, 99th percentile; extreme outlier), and 99213 also ranks at the 99th percentile (#3740 of 457151; extreme outlier). Together with J0178’s 97th percentile rank, these metrics point to unusually high volume of retinal imaging and follow-up E/M visits relative to national peers.
Medicaid revenue is even more concentrated around injection services: the top 3 Medicaid codes account for 90.6% of Medicaid revenue. J0178 and J2778 together make up the bulk ($316.1K and $308.8K respectively, 39.7% and 38.7% of Medicaid revenue), and 67028 adds $97.5K (12.2%), signaling that Medicaid billing similarly centers on intravitreal drug administration and related procedures.
State-level competitive posture for Medicaid is strong for specific injection codes: J2778 ranks #2 of 11 in-state (90th percentile) and J0178 ranks #27 of 101 in-state (74th percentile), indicating the provider is a leading in-state biller for ranibizumab injections and a solid contributor for aflibercept among Medicaid peers. 67028 also ranks highly in-state (#30 of 262, 89th percentile), reinforcing the provider’s role in procedural volume.
Operational risk and contracting implications: the practice’s heavy reliance on a small number of high-revenue drug codes (top 3 Medicare codes = 76.3% of Medicare revenue; top 3 Medicaid codes = 90.6% of Medicaid revenue) creates exposure to drug-specific reimbursement changes, prior authorization policies, and biosimilar substitution dynamics. Payers and network analysts should flag this concentration for utilization management and to evaluate the impact of changes in unit pricing or access to specific injectable agents.
Tenure and capacity signals: the NPI was enumerated on 2010-05-10 (~16 years ago), indicating an established practice with a sustained presence. Combined with repeated high-volume service lines (frequent injections, imaging, and E/M visits), the tenure supports the interpretation that these billing patterns reflect stable operational capacity rather than a transient spike.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
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 | 3,640 | $690 | $2.5M |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 1,440 | $220 | $313.1K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 10,500 | $30 | $304.5K |
| 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. | 2,170 | $110 | $243K |
| J2778 | Injection, ranibizumab, 0.1 mg | 870 | $190 | $161.1K |
| 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. | 3,760 | $40 | $135.2K |
| 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… | 1,240 | $80 | $93.9K |
| 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… | 930 | $80 | $74.1K |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 410 | $120 | $48.6K |
| Q5124 | Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg | 230 | $180 | $40.5K |
Showing 1–10 of 23
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
Full comparison — all codes billed, vs. state median
23 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 9 | 230 | 560 | $690 | $693K |
| J2777 | 42 | 120 | 7,740 | $30 | $364.9K |
| Q5128 | 7 | 20 | 1,170 | $220 | $268.3K |
| J2778 | 21 | 70 | 510 | $180 | $131.6K |
| J2781 | 26 | 40 | 520 | $120 | $75.1K |
| Q5124 | 14 | 20 | 310 | $170 | $69.7K |
| 67028 | 13 | 300 | 400 | $100 | $65.9K |
| J3490 | 105 | 120 | 60 | $470 | $50.8K |
| 92014 | 702 | 2,220 | 160 | $100 | $29.3K |
| 67108 | 25 | 30 | 20 | $1,040 | $17.7K |
Showing 1–10 of 23
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.
15 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 700 | $450 | $316.1K |
| J2778 | Injection, ranibizumab, 0.1 mg | 660 | $470 | $308.8K |
| 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. | 2,380 | $40 | $97.5K |
| 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. | 3,070 | $10 | $30.7K |
| 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… | 850 | $20 | $19.4K |
| 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… | 200 | $30 | $6.6K |
| 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… | 810 | $10 | $4.9K |
| 92226 | N/A | 570 | $10 | $4K |
| 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… | 80 | $50 | $3.8K |
| 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… | 140 | $20 | $3.1K |
Showing 1–10 of 15
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
15 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 27 | 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… | 12,095 | 19,110 | 360 | $70 | $321K |
| J2778 | Injection, ranibizumab, 0.1 mg | 2 | 10 | 110 | $500 | $160.1K |
| 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… | 2,033 | 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… | 1,447 | 2,440 | 330 | $70 | $92.6K |
| 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… | 458 | 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. | 30 | 260 | 420 | $70 | $65.6K |
| 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. | 89 | 730 | 370 | $20 | $30K |
| 92226 | N/A | 125 | 400 | 270 | $20 | $12.6K |
| 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… | 69 | 320 | 190 | $20 | $10.7K |
Showing 1–10 of 15
Other providers in the same ZIP code as David Poon, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| C And T Homecare Services LLC | NY | In Home Supportive Care Agency | $0 | $847.7M |
| North Shore-lij Medical PC | NY | Urology Physician | $0 | $388.1M |
| First Choice Home Care Inc | NY | Home Health Agency | $0 | $28M |
| Welllife Network Inc. | NY | Clinic/Center | $0 | $22M |
| Regioncare Inc. | NY | Home Infusion Agency | $40.1K | $9.4M |
| Philip Ferrone | NY | Ophthalmology Physician | $3.1M | $10.5K |
| Shahram Shamekh | NY | Internal Medicine Physician | $673.3K | $1.4M |
| Angela Azar | NY | Dermatology Physician | $104.5K | $1.5M |
| Alireza Shirvani | NY | Hospitalist Physician | $1.4M | $178K |
| Stephanie Buck-haskin | NY | Obstetrics & Gynecology Physician | $56.1K | $1.4M |
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