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NPI 1447299631 · Great Neck, NY · Ophthalmology Physician
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Juan Romero is a ophthalmology physician provider located in Great Neck, New York. This profile covers 23 Medicare and 16 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 | Juan Romero |
| Address | 600 Northern Blvd |
| City | Great Neck |
| State | NY |
| ZIP | 11021 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | June 5, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.1M |
| Medicaid | $441.8K |
This is a retina-focused Ophthalmology practice whose revenue mix is dominated by intravitreal drug therapy: Medicare receipts are led by J0178 (J0178 – aflibercept) with $1.7M in revenue, followed by J2777 and Q5128 as the next-highest Medicare drug codes. The presence of multiple branded and biosimilar anti-VEGF codes (J0178, Q5128, J2778, J2777) plus counts for intravitreal injection procedure 67028 indicates routine, high-volume retinal injection services are the core service line.
Medicare revenue is highly concentrated: the precomputed top-three Medicare codes account for 73.6% of this provider’s total Medicare revenue, with J0178 alone representing 56.2% ($1.7M) of Medicare receipts. That concentration makes the practice materially dependent on a small set of high-cost injectable drugs for its Medicare topline.
Medicaid revenue is even more concentrated: the precomputed top-three Medicaid codes account for 90.9% of the provider’s total Medicaid revenue, led by J0178 at $272.5K (61.4%), followed by 67028 ($85.4K, 19.2%) and J2778 ($45.5K, 10.2%). This shows the provider’s Medicaid activity is overwhelmingly tied to the same injection-heavy service mix seen in Medicare, with very little ancillary diversification.
Payer mix is heavily Medicare-weighted: reported lifetime Medicare revenue is $3.1M versus $441.8K in Medicaid, indicating Medicare is the dominant source of professional revenue for this clinician. While the provider participates in both payers, Medicare scale is multiple times larger and will drive most network or contracting leverage.
Competitive standing by code is mixed: on Medicare J0178 ranks #310 of 3204 providers nationally (90th percentile), signaling an above-average national presence for aflibercept injections despite the data label of “typical, unremarkable volume.” By contrast, Q5128 ranks #124 of 373 (67th percentile) and J2777 ranks #1018 of 2039 (50th percentile), showing stronger-than-average positioning for some anti-VEGF products but only routine participation for others.
Diagnostic imaging is a notable outlier on Medicare: 92134 appears as 2.6K claims and $96.5K revenue (3.1% of Medicare revenue) and is flagged as an “extreme outlier, far above typical national volume” at the 98th percentile (rank #606 of 26868). The provider’s high-volume retinal imaging footprint (also large claim counts for 92134 in Medicaid: 3K claims, $23.8K revenue) suggests an intensive imaging workflow that supports the injection program.
In-state competitive posture for Medicaid injections is solid but not dominant: J0178 ranks #33 of 101 providers in-state (68th percentile) and 67028 ranks #34 of 262 (87th percentile), indicating the provider is a meaningful regional participant in intravitreal injections but not the single dominant provider statewide. Relatively small denominators for some Medicaid drug ranks (for example J2778 rank #5 of 11) imply caution interpreting percentile signals for less-common codes.
Practice tenure is long-standing: the NPI was enumerated on 2006-06-05 (~20 years ago), consistent with an established referral base and operational continuity required to sustain a high-volume injection and imaging practice. Combined with concentrated drug revenue, the longevity suggests stable clinical focus rather than a recently pivoted business model.
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 | 2,540 | $690 | $1.7M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 9,900 | $30 | $287.1K |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 1,160 | $220 | $250.9K |
| 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. | 1,640 | $110 | $183.5K |
| J2778 | Injection, ranibizumab, 0.1 mg | 700 | $190 | $128.6K |
| 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. | 2,610 | $40 | $96.5K |
| J3490 | Unclassified drugs | 40 | $1,990 | $73.5K |
| Q5124 | Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg | 350 | $180 | $61.3K |
| 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… | 680 | $80 | $52.2K |
| 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… | 630 | $80 | $51.5K |
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 | 25 | 230 | 560 | $690 | $693K |
| J2777 | 46 | 120 | 7,740 | $30 | $364.9K |
| Q5128 | 11 | 20 | 1,170 | $220 | $268.3K |
| J2778 | 28 | 70 | 510 | $180 | $131.6K |
| J2781 | 28 | 40 | 520 | $120 | $75.1K |
| Q5124 | 7 | 20 | 310 | $170 | $69.7K |
| 67028 | 31 | 300 | 400 | $100 | $65.9K |
| J3490 | 80 | 120 | 60 | $470 | $50.8K |
| 92014 | 777 | 2,220 | 160 | $100 | $29.3K |
| 67036 | 32 | 50 | 20 | $940 | $23.5K |
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.
16 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 600 | $460 | $272.5K |
| 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. | 2,250 | $40 | $85.4K |
| J2778 | Injection, ranibizumab, 0.1 mg | 120 | $380 | $45.5K |
| 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. | 2,980 | $10 | $23.8K |
| 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… | 540 | $10 | $7.1K |
| 92226 | N/A | 510 | $1 | $2.1K |
| J9035 | Injection, bevacizumab, 10 mg | 80 | $30 | $1.9K |
| 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… | 300 | $10 | $1.8K |
| 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… | 50 | $30 | $1.5K |
| 92235 | The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken… | 10 | $90 | $1.1K |
Showing 1–10 of 16
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
16 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 33 | 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… | 14,548 | 19,110 | 360 | $70 | $321K |
| J2778 | Injection, ranibizumab, 0.1 mg | 5 | 10 | 110 | $500 | $160.1K |
| 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… | 1,910 | 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… | 576 | 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. | 34 | 260 | 420 | $70 | $65.6K |
| J9035 | Injection, bevacizumab, 10 mg | 98 | 150 | 170 | $80 | $36.7K |
| 92235 | The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken… | 90 | 100 | 150 | $60 | $32.9K |
| 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. | 97 | 730 | 370 | $20 | $30K |
| 92226 | N/A | 142 | 400 | 270 | $20 | $12.6K |
Showing 1–10 of 16
Other providers in the same ZIP code as Juan Romero, 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 |
| Vincent Deramo | NY | Ophthalmology Physician | $4M | $15.1K |
| Eric Shakin | NY | Ophthalmology Physician | $3.3M | $291.7K |
| 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 |
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