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NPI 1417177569 · Great Neck, NY · Ophthalmology Physician
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David Rhee is a ophthalmology physician provider located in Great Neck, New York. This profile covers 24 Medicare and 7 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 Rhee |
| Address | 600 Northern Blvd |
| City | Great Neck |
| State | NY |
| ZIP | 11021 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | April 30, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $4M |
| Medicaid | $73.4K |
This profile is strongly consistent with a medical-retina practice centered on intravitreal biologic therapy and high-throughput retinal imaging: the single largest Medicare code is J0178 (48.0% of Medicare revenue), and the top drug and procedure codes appearing in the Medicare top-25 (J0178, Q5128, J2777, J2778, J2781 and 67028) are all intravitreal injections or retina-focused services. High counts for 92134 (computerized retinal imaging) and frequent injection procedure coding (67028) support a workflow that combines office-based injections with diagnostic imaging on the same patient population.
Revenue concentration on Medicare is heavy and drug-driven: the precomputed top 3 Medicare codes account for 65.5% of this provider's total Medicare revenue, and J0178 alone represents $1.9M (48.0% of Medicare revenue). This concentration implies that a small set of intravitreal drug administrations is the primary revenue engine and a material driver of practice economics.
Against national Medicare peers this provider shows unusually high throughput for several retina services: J0178 ranks #217 of 3204 providers nationally (93rd percentile) and 92134 ranks in the 99th percentile (described as an extreme outlier), indicating both drug-administration volume and retinal imaging volume well above typical national levels. 67028 also ranks notably above typical national volume (92nd percentile), reinforcing that injection procedures are a comparative strength.
The provider bills a mix of originator biologics, newer agents, and biosimilars, indicating rapid adoption of multiple retinal therapies: notable codes include Q5128 (cimerli biosimilar) with $371.9K Medicare revenue, J2777 (faricimab) with $335.8K Medicare revenue, and J2781 (pegcetacoplan) at $123.2K. This spread of drug codes suggests a practice that treats a range of retinal diagnoses and is actively using both branded drugs and biosimilars rather than relying on a single agent.
Payer mix is heavily skewed toward Medicare: reported lifetime Medicare revenue is $4M compared with total Medicaid revenue of $73.4K, so the provider is effectively Medicare-dominant in scale. Medicaid billing exists but is a small fraction of the overall revenue base, meaning reimbursement risk and utilization patterns will be largely driven by Medicare dynamics.
Medicaid activity is concentrated in a different set of services than Medicare: the precomputed top 3 Medicaid codes account for 88.4% of Medicaid revenue, with 67028 alone representing $38.1K (52.0% of Medicaid revenue) and 92134 contributing $14.8K (20.2%). By contrast J0178 is only $11.9K (16.3% of Medicaid revenue) and ranks low in-state for that drug (10th percentile), implying far fewer high-cost biologic administrations billed to Medicaid than to Medicare.
Within the in-state Medicaid market the provider is a moderate procedural and imaging participant rather than a dominant drug supplier: 67028 ranks #85 of 262 providers in-state (68th percentile) and 92134 ranks #178 of 728 providers in-state (76th percentile), both described as typical, unremarkable volumes. The low in-state rank for J0178 (10th percentile) further indicates the provider’s Medicaid caseload does not mirror its Medicare biologic volume.
The provider has an established billing history and operational tenure: the NPI was enumerated on 2007-04-30 (~19 years ago), which, combined with consistently high volumes on procedure and imaging codes (for example 92134 and 67028), points to a long-standing, volume-oriented retina practice that primarily serves Medicare beneficiaries. This longevity plus concentrated drug revenue suggests any payer or network contracting strategy should prioritize coverage and authorization pathways for intravitreal biologics and high-frequency imaging services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
24 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2,810 | $690 | $1.9M |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 1,710 | $220 | $371.9K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 11,580 | $30 | $335.8K |
| J3490 | Unclassified drugs | 150 | $1,920 | $285.6K |
| J2778 | Injection, ranibizumab, 0.1 mg | 1,290 | $190 | $240.9K |
| 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. | 2,150 | $110 | $240.2K |
| 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. | 3,750 | $40 | $135K |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 1,040 | $120 | $123.2K |
| 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… | 1,170 | $80 | $89.9K |
| 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… | 1,070 | $80 | $86.9K |
Showing 1–10 of 24
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 24 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
24 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 17 | 230 | 560 | $690 | $693K |
| J2777 | 39 | 120 | 7,740 | $30 | $364.9K |
| Q5128 | 5 | 20 | 1,170 | $220 | $268.3K |
| J2778 | 9 | 70 | 510 | $180 | $131.6K |
| J2781 | 4 | 40 | 520 | $120 | $75.1K |
| Q5124 | 13 | 20 | 310 | $170 | $69.7K |
| 67028 | 14 | 300 | 400 | $100 | $65.9K |
| J3490 | 24 | 120 | 60 | $470 | $50.8K |
| 92014 | 565 | 2,220 | 160 | $100 | $29.3K |
| 67036 | 14 | 50 | 20 | $940 | $23.5K |
Showing 1–10 of 24
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.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 890 | $40 | $38.1K |
| 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. | 1,480 | $10 | $14.8K |
| J0178 | Injection, aflibercept, 1 mg | 30 | $430 | $11.9K |
| 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… | 200 | $20 | $4.6K |
| 92226 | N/A | 350 | $10 | $3.2K |
| 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… | 40 | $10 | $410 |
| 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… | 70 | $10 | $360 |
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
7 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 90 | 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… | 15,526 | 19,110 | 360 | $70 | $321K |
| 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… | 832 | 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. | 85 | 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. | 178 | 730 | 370 | $20 | $30K |
| 92226 | N/A | 175 | 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… | 209 | 320 | 190 | $20 | $10.7K |
Other providers in the same ZIP code as David Rhee, 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 |
| Kenneth Graham | NY | Ophthalmology Physician | $5.6M | $64.5K |
| Brett Rosenblatt | NY | Ophthalmology Physician | $5.5M | $9.3K |
| David Poon | NY | Ophthalmology Physician | $4.1M | $796.1K |
| Jeffrey Shakin | NY | Ophthalmology Physician | $4.4M | $82.4K |
| David Fastenberg | NY | Ophthalmology Physician | $4.4M | $31.2K |
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