Loading...
NPI 1467613216 · Great Neck, NY · Ophthalmology Physician
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Jonathan Jonisch is a ophthalmology physician provider located in Great Neck, New York. This profile covers 27 Medicare and 10 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 | Jonathan Jonisch |
| Address | 600 Northern Blvd |
| City | Great Neck |
| State | NY |
| ZIP | 11021 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | June 24, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $6.4M |
| Medicaid | $940.9K |
This provider generates the majority of its billing from Medicare ($6.4M) with a materially smaller Medicaid footprint ($940.9K), indicating Medicare is the primary revenue source for the practice rather than balanced dual-payer activity. The two payers are both active, but Medicare revenue dominates the scale of operations.
Revenue is highly concentrated by code: the top three Medicare codes account for 81.3% of the provider's Medicare revenue, and the top three Medicaid codes account for 93.2% of Medicaid revenue. For Medicare the dominant lines are J0178, Q5128 and 67028, showing the practice relies on a very narrow set of high-value services.
The CPT/HCPCS mix indicates a retina-focused ophthalmology operation centered on intravitreal anti-VEGF injections and associated procedures. High Medicare revenue for J0178 (5.7K claims, $691 avg paid/claim, $3.9M revenue, 60.9% of Medicare revenue), Q5128 (4.3K claims, $216 avg paid/claim, $933.8K revenue, 14.5% of Medicare revenue) and frequent use of 67028 (3.4K claims, $115 avg paid/claim, $386.3K revenue, 6.0% of Medicare revenue) point to routine, high-volume injection therapy workflows consistent with treatment of chronic retinal disease and follow-up injection visits.
The provider is a standout nationally on key Medicare codes: J0178 ranks #17 of 3204 providers (100th percentile; extreme outlier) and Q5128 ranks #18 of 373 providers (95th percentile; notably above typical national volume), while 67028 ranks #62 of 4255 providers (99th percentile; extreme outlier). These rankings characterize the provider as a major national deliverer of aflibercept injections and intravitreal procedures under Medicare.
On Medicaid this provider also concentrates revenue in anti-VEGF drugs: J0178 accounts for $524.5K (55.7% of Medicaid revenue) and J2778 accounts for $232.7K (24.7% of Medicaid revenue), with the three leading Medicaid codes making up 93.2% of Medicaid revenue. While J0178 ranks #15 of 101 in-state (86th percentile; typical, unremarkable volume) and J2778 ranks #4 of 11 in-state (70th percentile; typical, unremarkable volume), the practice is less dominant in state Medicaid rankings than it is nationally for Medicare.
Diagnostic imaging volumes support a combined diagnostic-and-treatment model: 92134 shows high utilization on Medicare (4.4K claims, $37 avg paid/claim, $163.2K revenue, 2.5% of Medicare revenue) and also appears among top Medicaid codes (2.6K claims, $11 avg paid/claim, $28.1K revenue). The presence of large 92134 claim counts and high injection volumes suggests integrated retinal imaging and injection sessions that enable frequent follow-up dosing.
The practice reports material revenue under unclassified drug billing (J3490: 154 claims, $2120 avg paid/claim, $326.5K revenue, 5.1% of Medicare revenue, ranked #455 of 2838 nationally at the 84th percentile), indicating a non‑negligible portion of Medicare revenue is coded to unclassified drug lines. This pattern may reflect use of billed items outside standard HCPCS drug codes or high-cost single claims and merits attention when reviewing drug administration and fee schedules.
The provider has an established billing tenure with an NPI enumerated 2008-06-24 (~18 years ago), supporting a long-standing practice profile; the sustained high volumes on specific retinal therapies over time are consistent with an established, procedure‑focused ophthalmology practice rather than a recently opened clinic.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
27 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 5,680 | $690 | $3.9M |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 4,320 | $220 | $933.8K |
| 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. | 3,360 | $120 | $386.3K |
| J3490 | Unclassified drugs | 150 | $2,120 | $326.5K |
| 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. | 4,410 | $40 | $163.2K |
| Q5124 | Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg | 790 | $180 | $139.7K |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 1,130 | $120 | $135K |
| 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… | 1,320 | $80 | $106.8K |
| 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… | 910 | $80 | $68.4K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 2,160 | $30 | $62.6K |
Showing 1–10 of 27
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 27 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
27 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 1 | 230 | 560 | $690 | $693K |
| J2777 | 108 | 120 | 7,740 | $30 | $364.9K |
| Q5128 | 1 | 20 | 1,170 | $220 | $268.3K |
| J2778 | 63 | 70 | 510 | $180 | $131.6K |
| J2781 | 3 | 40 | 520 | $120 | $75.1K |
| Q5124 | 4 | 20 | 310 | $170 | $69.7K |
| 67028 | 1 | 300 | 400 | $100 | $65.9K |
| J3490 | 22 | 120 | 60 | $470 | $50.8K |
| 92014 | 602 | 2,220 | 160 | $100 | $29.3K |
| 99214 | 26,402 | 30,450 | 90 | $100 | $19K |
Showing 1–10 of 27
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.
10 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 970 | $540 | $524.5K |
| J2778 | Injection, ranibizumab, 0.1 mg | 420 | $560 | $232.7K |
| 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. | 2,630 | $50 | $120.8K |
| 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. | 2,550 | $10 | $28.1K |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 110 | $250 | $27K |
| 92226 | N/A | 430 | $10 | $3.9K |
| J9035 | Injection, bevacizumab, 10 mg | 90 | $30 | $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… | 100 | $20 | $1.5K |
| 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… | 10 | $30 | $380 |
| 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… | 60 | $10 | $290 |
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
10 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 15 | 100 | 280 | $650 | $369.9K |
| J2778 | Injection, ranibizumab, 0.1 mg | 4 | 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… | 2,329 | 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… | 984 | 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. | 26 | 260 | 420 | $70 | $65.6K |
| J9035 | Injection, bevacizumab, 10 mg | 89 | 150 | 170 | $80 | $36.7K |
| 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. | 111 | 730 | 370 | $20 | $30K |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 1 | 10 | 110 | $250 | $26.9K |
| 92226 | N/A | 161 | 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… | 216 | 320 | 190 | $20 | $10.7K |
Other providers in the same ZIP code as Jonathan Jonisch, 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 |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.