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

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

Sean Koh (NPI 1588667620)

Field	Value
Entity Type	Individual
Organization	Sean Koh
Address	1100 Johnson Ferry Rd Ne
City	Atlanta
State	GA
ZIP	30342
Taxonomy	Ophthalmology Physician
NPI Enumerated	May 23, 2005

Payer Source	Total Paid
Medicare	$2.5M
Medicaid	$0

Key Findings

This provider’s lifetime Medicare revenue is $2.5M and there is no Medicaid billing on file, so the available claims data describe an effectively single‑payer (Medicare) footprint in this dataset rather than a mixed payer practice. The absence of Medicaid billing means any Medicaid-related competitive or access conclusions cannot be drawn from the supplied records.

Revenue is highly concentrated in intravitreal drug administration: the precomputed top-3 Medicare codes (J2778, J0178, J2777) account for 78.8% of this provider's total Medicare revenue, indicating the practice is heavily dependent on retinal injectable therapeutics as its core revenue stream. Individually, J2778 accounts for $780.6K (31.6%), J0178 accounts for $663.2K (26.9%), and J2777 accounts for $499.4K (20.2%) of Medicare revenue, which together dominate the payer mix.

The procedural and service mix points to a retina/medical retina focus: high revenue and volume for J2778, J0178, and J2777 (ranibizumab, aflibercept, faricimab) combined with above-typical utilization of retinal imaging (92134) suggest routine intravitreal therapy supported by frequent diagnostic OCT imaging. Supporting procedure codes such as 67028 (vitreous chamber injection as an isolated procedure, $166.9K, 6.8%) further reinforce a workflow centered on injections and retina-directed procedures rather than high volumes of primary care E/M visits.

Competitive standing is mixed by code: J2778 ranks #58 of 1208 nationally (95th percentile) but is labeled “typical, unremarkable volume,” indicating a relatively high national placement without being an extreme outlier; J0178 ranks #1321 of 3204 (59th percentile) and J2777 ranks #630 of 2039 (69th percentile), both noted as typical for their code populations. For retinal imaging, 92134 ranks #881 of 26868 (97th percentile) and is described as “notably above typical national volume,” which signals a genuine strength in imaging services relative to peers.

Practice-level E/M coding appears modest compared with the drug and imaging revenue: 92014 (established comprehensive exam) generated $79.4K and ranks #2154 of 35415 (94th percentile; notably above typical national volume), while common office E/M codes such as 99213/99214 generate only small portions of revenue ($2.1K and $2.4K respectively) and rank in lower national percentiles. This pattern is consistent with a specialist who conducts procedure-driven visits and relies less on general office visit billing.

There are a few notable single-code observations that merit attention from a payment-analysis perspective: J3490 (Unclassified drugs) produced $76K (3.1% of Medicare revenue) with a high average paid/claim of $1768 and ranks #1813 of 2838 (35th percentile), which indicates occasional use of high-cost items billed under an unclassified code; 92134’s very high percentile (97th) is a clear statistical signal of above-typical imaging activity. These are operational flags worth deeper chart-level review if clinical or contract questions arise.

Tenure data show the provider’s NPI was enumerated on 2005-05-23 (~21 years ago), indicating long-standing enrollment in Medicare. That tenure supports the interpretation that the current code mix reflects an established practice pattern rather than a very recent shift in specialty or service offerings.

Taken together, the dataset portrays a procedure-centric ophthalmology practice focused on intravitreal therapeutics and retinal imaging with Medicare as the dominant (sole recorded) public payer; revenue concentration in three injectable drug codes (78.8%) raises business risk tied to utilization or reimbursement changes for those specific agents, while high imaging volume (92134) is a competitive strength relative to national peers.

Medicare: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2778	Injection, ranibizumab, 0.1 mg	4,410	$180	$780.6K
J0178	Injection, aflibercept, 1 mg	960	$690	$663.2K
J2777	Injection, faricimab‑svoa, 0.1 mg	17,220	$30	$499.4K
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.	1,670	$100	$166.9K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	720	$120	$86.8K
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…	880	$90	$79.4K
J3490	Unclassified drugs	40	$1,770	$76K
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.	2,180	$30	$69.7K
J9035	Injection, bevacizumab, 10 mg	260	$50	$13.3K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	100	$120	$12.2K

Showing 1–10 of 15

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Georgia Distribution

Sean Koh — 4 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. state median

15 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	34	70	970	$680	$700.6K
J2777	18	40	14,100	$30	$524.3K
J2778	2	30	1,170	$180	$286.2K
67028	12	80	720	$90	$71.9K
J2781	1	10	320	$120	$43.6K
67108	9	10	10	$1,260	$25.2K
J3490	33	50	50	$320	$19.8K
92014	43	850	130	$80	$19.7K
99214	11,965	13,640	120	$80	$17.8K
J9035	19	70	120	$50	$10.3K

Showing 1–10 of 15

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Stephanie Vanderveldt	GA	Ophthalmology Physician	$4.1M	$0
Sri Krishna Mukkamala	GA	Hospitalist Physician	$3.4M	$0
Alexander Bottini	GA	Retina Specialist (Ophthalmology) Physician	$3M	$0
David Chin Yee	GA	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Gregory Lee	GA	Ophthalmology Physician	$2.9M	$6.3K
Robert Stoltz	GA	Specialist	$2.6M	$0
Hyung Cho	GA	Ophthalmology Physician	$2.5M	$0
Atul Sharma	GA	Ophthalmology Physician	$2.2M	$0
Mark Rivellese	GA	Ophthalmology Physician	$2.1M	$0
Rahul Komati	IL	Retina Specialist (Ophthalmology) Physician	$1.9M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Scottish Rite Children's Medical Center	GA	Pediatric Hematology & Oncology Physician	$0	$493.4M
Life Hope Labs LLC	GA	Clinical Medical Laboratory	$8.3M	$7.3K
The Childrens Center For Digestive Health Care LLC	GA	Pediatric Gastroenterology Physician	$0	$8.1M
Northside Emergency Associates, LLC	GA	Emergency Medicine Physician	$0	$6.1M
Atlanta Perinatal Consultants, LP	GA	Neonatal-Perinatal Medicine Physician	$0	$4.8M
Children's Orthopaedics Of Atlanta P.C.	GA	Orthopaedic Surgery Physician	$0	$2.5M
Paul Sutej	GA	Rheumatology Physician	$2.4M	$0
Childrens Care Pediatrics, PC	GA	Pediatrics Physician	$0	$1.9M
Resurgens Surgery Center LLC	GA	Ambulatory Surgical Clinic/Center	$1.7M	$0
Daniel Oh	GA	Retina Specialist (Ophthalmology) Physician	$1.7M	$0

Sean Koh — Billing Profile & Reimbursement Data

Sign up for Sean Koh — Billing Profile & Reimbursement Data policy alerts

Sean Koh — Billing Profile & Reimbursement Data

Sign up for Sean Koh — Billing Profile & Reimbursement Data policy alerts

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