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

Why is the Medicaid comparison limited to South Carolina 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. South Carolina (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.

Jeffrey Gross (NPI 1427059351)

Field	Value
Entity Type	Individual
Organization	Jeffrey Gross
Address	7620 Trenholm Road Ext
City	Columbia
State	SC
ZIP	29223
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	August 2, 2005

Payer Source	Total Paid
Medicare	$3M
Medicaid	$0

Key Findings

This provider is a retina-focused ophthalmologist whose Medicare billing is heavily dominated by intravitreal injection therapies and retina imaging. The top three revenue-driving codes are J0178, Q5128, and J2777 — together they account for 75.4% of the provider’s Medicare revenue — and the single code J0178 alone accounts for $1.6M of the $3M total Medicare revenue, indicating an injection-centered service line focused on anti-VEGF therapy.

Revenue concentration is pronounced: the provider’s Medicare portfolio totals $3M and the precomputed top-three share of 75.4% shows that a small set of high-cost injectable drugs drives the majority of income. J0178 represents 54.7% of Medicare revenue, while Q5128 and J2777 contribute 11.3% and 9.5% respectively, which signals dependence on drug reimbursement for financial performance.

Payer mix is effectively single-payer Medicare: there is $3M in Medicare revenue and no Medicaid billing on file, so this practice’s public-payer volume and financial exposure are concentrated in Medicare beneficiaries rather than a mixed Medicaid population. This limits insights into Medicaid competitive positioning because no in-state Medicaid activity is reported.

Competitive standing on the principal injection codes is mixed: J0178 ($1.6M) ranks #359 of 3204 providers (89th percentile) but is characterized in the data as “typical, unremarkable volume,” while Q5128 ($339.2K) ranks #83 of 373 (78th percentile) and J2777 ($285.6K) ranks #1000 of 2039 (51th percentile), both described as typical volumes. In short, the provider is a consistent national participant for major anti-VEGF products but not framed as a dominant outlier on those specific drug codes.

Non-drug procedure and diagnostic volumes are relatively high versus peers and support a longitudinal retinal care model: 92134 (retinal OCT) has $48.2K revenue and ranks in the 95th percentile (described as notably above typical), 92012 (intermediate ophthalmologic exam) has $56K revenue and ranks in the 97th percentile (notably above typical), and 92250 (fundus photography) is an extreme outlier in the 98th percentile with $20.7K revenue. These elevated imaging and established-patient E/M volumes are consistent with frequent follow-up and monitoring visits typical for chronic retinal disease management.

The provider shows unusually high procedural/visit billing for certain E/M and imaging codes relative to national peers: 99213 registers as an “extreme outlier, far above typical national volume” with 973 claims and $61.3K revenue, and 92250 is also labeled an extreme outlier at the 98th percentile. This pattern suggests heavier-than-typical follow-up visit and diagnostic imaging throughput in addition to injection therapy.

There is selective use of drug codes beyond the primary anti-VEGF agents: J3490 (unclassified drugs) accounts for $49.7K with a high average paid/claim ($1841) but ranks low nationally at the 15th percentile, indicating limited and idiosyncratic use of unclassified drug billing. Lower-volume oncology/adjunct injections such as J9035 (bevacizumab) and procedure codes like 67028 are present but described as typical, unremarkable volumes, reinforcing that most revenue arises from the primary anti-VEGF drugs rather than broad diversification across many drug types.

The provider has long tenure in Medicare billing, with NPI enumeration dated 2005-08-02 (~21 years ago), which aligns with the observed high follow-up and imaging volumes that accumulate in established specialty retina practices. For payer strategy and network decisions, expect a Medicare-centric retina practice model with concentrated revenue from a few high-cost injectable codes and high surveillance imaging and E/M throughput rather than diversified Medicaid exposure.

Medicare: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,400	$690	$1.6M
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	1,560	$220	$339.2K
J2777	Injection, faricimab‑svoa, 0.1 mg	10,200	$30	$285.6K
J2778	Injection, ranibizumab, 0.1 mg	1,470	$180	$268.1K
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.	1,700	$90	$156.6K
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…	970	$60	$61.3K
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	$60	$56K
J3490	Unclassified drugs	30	$1,840	$49.7K
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.	1,720	$30	$48.2K
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…	550	$80	$44.7K

Showing 1–10 of 16

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Carolina Distribution

Jeffrey Gross — 3 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. state median

16 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	13	50	970	$690	$1.1M
J2777	26	40	15,960	$30	$594.7K
J2778	14	30	1,440	$180	$337.4K
Q5128	5	10	1,150	$220	$273.3K
67028	16	50	1,140	$90	$110.3K
J3490	45	50	70	$510	$57.7K
J9035	24	40	200	$50	$26.1K
92014	107	540	160	$80	$24.3K
92012	12	240	110	$60	$14.2K
92235	20	30	50	$100	$11K

Showing 1–10 of 16

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Palmetto Retina Center LLC	SC	Ophthalmology Physician	$0	$10.6M
John Payne	SC	Ophthalmology Physician	$4M	$0
John Wells	SC	Ophthalmology Physician	$3.9M	$0
Joshua Robinson	MI	Ophthalmology Physician	$3.7M	$0
William Clark	SC	Ophthalmology Physician	$3.3M	$0
Barron Fishburne	SC	Retina Specialist (Ophthalmology) Physician	$3.3M	$0
David Johnson	SC	Retina Specialist (Ophthalmology) Physician	$3M	$0
Oksana Demediuk	GA	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Daniel Will	SC	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
Eugene Long	GA	Hematology & Oncology Physician	$1.9M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jamison Consultant's, LLC	SC	Mental Health Counselor	$0	$15.3M
About Play LLC	SC	Early Intervention Provider Agency	$0	$13.3M
State Of South Carolina	SC	Clinical Medical Laboratory	$0	$9.1M
Midlands Dental Group, P.l.	SC	Dental Clinic/Center	$0	$7.7M
Palmetto Surgery Center LLC	SC	Ambulatory Surgical Clinic/Center	$1.4M	$4.6M
Healthcare Etc, LLC	SC	In Home Supportive Care Agency	$0	$5.4M
Restorative Health Services Of Sc, LLC	SC	In Home Supportive Care Agency	$0	$3.9M
Dent,s Alternative Adult Daycare Health Services,llp	SC	Adult Day Care Clinic/Center	$0	$3.6M
Medogun PA	SC	Pediatric Adolescent Medicine Physician	$0	$2.5M
Carolina Children's Dentistry, PA	SC	Pediatric Dentistry	$0	$2M

Jeffrey Gross — 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