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

Why is the Medicaid comparison limited to Kansas 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. Kansas (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.

Abraham Poulose (NPI 1497753560)

Field	Value
Entity Type	Individual
Organization	Abraham Poulose
Address	11261 Nall Ave
City	Leawood
State	KS
ZIP	66211
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	July 12, 2005

Payer Source	Total Paid
Medicare	$1.8M
Medicaid	$0

Key Findings

This provider is effectively single-payer in public programs: total Medicare revenue is $1.8M while there is no Medicaid billing on file, indicating Medicare accounts for the provider's entire reported public-payer activity and Medicaid does not contribute to the revenue mix. Analysts should treat this profile as Medicare-centric when assessing payer risk, access and utilization patterns.

Revenue concentration is high: the precomputed top 3 Medicare codes by revenue account for 83.1% of the provider's total Medicare revenue, signaling that a narrow set of services—primarily high-cost intravitreal injections—drive the practice’s Medicare income. This level of concentration suggests sensitivity to changes in reimbursement or utilization for those specific drugs and injection-related services.

Clinical/service-line implications point to a retina-focused ophthalmology practice centered on intravitreal pharmacotherapy and retinal imaging. J0178 (aflibercept) alone represents $1.2M and 69.8% of Medicare revenue, supplemented by 67028 (injection procedure) and J2777 (faricimab), indicating routine, high-volume anti-VEGF/anti‑VEGF–class biologic administration and associated office-based injection services.

Competitive standing for the dominant drug code is typical rather than dominant: J0178 ranks #637 of 3204 providers nationally (80th percentile), which is a solid but not leading national position—consistent with being a successful regional retina specialist but not among the very highest-volume national injectors. Other high-volume diagnostic/procedural codes like 92134 and J9035 show notably above-typical (92134 at the 95th percentile) or high (J9035 at the 95th percentile) national placements, underscoring a strong footprint in imaging and use of multiple anti-VEGF agents.

There is a mix of both typical and outlier-level E/M and imaging volume: 99213 is an extreme outlier at the 99th percentile nationally, suggesting unusually high billing of this common established-patient office visit code relative to peers; concurrently, 92134 (retinal imaging) is notably above typical national volume (95th percentile). Together these patterns suggest a high throughput of established patients who receive injections and imaging in-office.

Procedure-level diversity outside the injection/imaging core is limited but present: the provider bills a range of retinal surgical and laser codes (e.g., 67108, 67228) and cataract-related codes (66984, 66821) that together contribute small shares of revenue. These lower-revenue procedural items indicate the practice performs some surgical and laser interventions but that they are a minor component compared with intravitreal pharmacotherapy.

Tenure in the Medicare program is long: the NPI was enumerated on 2005-07-12 (~21 years ago), indicating an established practice history which may correlate with an entrenched referral base and consistent Medicare patient volume. This long tenure supports interpreting current utilization as steady-state practice patterns rather than an early-career growth signal.

From a payer-management perspective, the financial picture is driven by high-cost drug use and frequent office visits: with J0178 ($1.2M) plus J2777 and J9035 among top revenue generators, payers should focus utilization management and cost-containment reviews on biologic selection, medical necessity for repeat injections, and documentation supporting frequent 99213 visits which are billed at an extreme national percentile.

Medicare: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,790	$690	$1.2M
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.	1,650	$80	$136.5K
J2777	Injection, faricimab‑svoa, 0.1 mg	3,420	$30	$99.2K
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…	1,110	$60	$69K
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…	750	$80	$56K
J9035	Injection, bevacizumab, 10 mg	880	$50	$46.5K
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.	1,680	$30	$45.4K
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	70	$390	$27.8K
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…	190	$60	$10.6K
67108	The provider repairs a detached retina using heat produced by a laser beam or by freezing the tissues. He may attach a scleral buckle to simplify the passage of fluid through and behind the retina or…	10	$890	$9.8K

Showing 1–10 of 20

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Kansas Distribution

Abraham Poulose — 5 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kansas

Full comparison — all codes billed, vs. state median

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	13	30	1,770	$690	$1.3M
J2777	25	30	12,060	$30	$575.7K
67028	13	40	1,170	$90	$111.4K
66984	91	300	40	$430	$67.4K
67108	18	20	20	$1,130	$24.8K
66821	88	110	60	$210	$24.8K
92014	27	530	180	$70	$18.5K
92235	17	30	60	$90	$12.3K
J9035	1	10	60	$50	$11.4K
99213	45	4,330	90	$50	$8.7K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Children's Mercy Hospital	MO	Children's Hospital	$0	$221M
University Health Physicians	MO	Internal Medicine Physician	$0	$102.8M
The Children's Mercy Hospital	MO	Pediatrics Physician	$0	$53.6M
The Children's Mercy Hospital	MO	Durable Medical Equipment & Medical Supplies	$0	$28.3M
The Children's Mercy Hospital	KS	Children's Hospital	$0	$22.3M
The Children's Mercy Hospital	MO	Ambulance	$0	$13.4M
Children's Mercy-community Choice Pediatrics	MO	Pediatrics Physician	$0	$9M
David Dyer	KS	Ophthalmology Physician	$7.5M	$0
Bassam Mattar	KS	Hematology & Oncology Physician	$7.2M	$0
Pavan Reddy	KS	Hematology & Oncology Physician	$6.7M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Doctors Hospital, LLC	KS	General Acute Care Hospital	$0	$46.4M
Mosaic	KS	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$18M
Destiny Home Health	KS	Home Health Agency	$0	$6.9M
Care Alternatives Of Missouri, LLC	KS	Community Based Hospice Care Agency	$0	$6.4M
Ku Medwest Ambulatory Surgery Center, LLC	KS	Ambulatory Surgical Clinic/Center	$4.6M	$5.7K
Novamed Eye Surgery Center Of Overland Park, LLC	KS	Ambulatory Surgical Clinic/Center	$2.9M	$24.9K
Mark Thompson	KS	Radiation Oncology Physician	$2.6M	$0
Kenon Qamar	KS	Radiation Oncology Physician	$2.5M	$0
Minuteclinic Diagnostic Of Kansas PA	KS	Family Nurse Practitioner	$0	$2.1M
Signature Medical Group Of Kc, P.A.	KS	Orthopaedic Surgery Physician	$0	$1.8M

Abraham Poulose — 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