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

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

Ron Margolis (NPI 1679757868)

Field	Value
Entity Type	Individual
Organization	Ron Margolis
Address	191 Main St
City	Manchester
State	CT
ZIP	06042
Taxonomy	Ophthalmology Physician
NPI Enumerated	December 24, 2007

Payer Source	Total Paid
Medicare	$3.5M
Medicaid	$0

Key Findings

This provider is an ophthalmology physician based in MANCHESTER, CT with an NPI enumerated on 2007-12-24 (~19 years ago), indicating long tenure in the Medicare program. Lifetime Medicare revenue on file is $3.5M and there is no Medicaid billing on file, so the practice is effectively single-payer (Medicare) in the available claims data.

Revenue is highly concentrated in a small set of procedure/drug codes: the precomputed top-3 Medicare codes account for 76.6% of this provider's total Medicare revenue. The single largest driver is J0178 (50.4% of Medicare revenue), followed by J2777 (20.6%) and 67028 (5.5%), which together dominate billed Medicare dollars for this clinician.

The code mix and descriptions point to a retina-focused, injection-centric practice model: large shares come from anti-VEGF intravitreal agents (J0178 aflibercept, J2777 faricimab and J2778 ranibizumab) plus the intravitreal injection procedure 67028. High utilization of retinal imaging (92134) and established-patient eye exams (92012, 92014) further supports a workflow oriented around repeated visits, imaging, and therapeutic injections for retinal disease.

Despite the concentration in injection-related revenue, the dataset characterizes the provider's national standing on the top injection codes as not exceptional. J0178 ranks #280 of 3204 providers (91th percentile) and is labeled "typical, unremarkable volume for this code," J2777 ranks #387 of 2039 (81th percentile, "typical, unremarkable volume"), and 67028 ranks #481 of 4255 (89th percentile, "typical, unremarkable volume"); these positions suggest active participation in the national cohort but not dominance as a national outlier for these services.

This provider shows exceptionally high activity for certain diagnostic and exam codes relative to national peers: 92012 ranks #224 of 17177 (99th percentile, labeled "extreme outlier, far above typical national volume"), 92134 ranks #595 of 26868 (98th percentile, labeled "extreme outlier, far above typical national volume"), and 92014 ranks #1810 of 35415 (95th percentile, labeled "notably above typical national volume"). These large exam and imaging volumes imply substantial follow-up and diagnostic throughput that complements the high-volume injection practice.

Use of unclassified biologic/drug codes is material but not dominant: J3590 contributes $187.2K (5.3% of Medicare revenue) and is labeled "typical, unremarkable volume," while J3490 contributes $35.4K (1.0% of Medicare revenue) and ranks low nationally (7th percentile, labeled "typical, unremarkable volume"). The presence of these unclassified drug codes points to occasional use of non-standard or newly coded therapies but not widespread reliance on them in the billing mix.

From a payer and network strategy standpoint, this provider should be treated as a Medicare-focused retina specialist with a predictable revenue base driven by intravitreal agents and high-frequency diagnostic follow-up. The absence of Medicaid claims means analysts should not expect Medicaid-based volume or contracting behavior from this clinician in the available data and should instead benchmark against Medicare peers, especially on injection, imaging, and established-patient exam utilization.

Medicare: Complete Services Breakdown

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

24 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,610	$680	$1.8M
J2777	Injection, faricimab‑svoa, 0.1 mg	24,960	$30	$723.9K
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.	1,860	$100	$191.8K
J3590	Unclassified biologics	90	$2,100	$187.2K
J2778	Injection, ranibizumab, 0.1 mg	980	$180	$175K
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…	1,360	$80	$103.4K
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…	960	$100	$97.1K
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.	2,620	$30	$89.2K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	420	$120	$50.4K
J3490	Unclassified drugs	20	$1,770	$35.4K

Showing 1–10 of 24

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 24 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Connecticut Distribution

Ron Margolis — 6 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Connecticut

Full comparison — all codes billed, vs. state median

24 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	3	40	830	$690	$713.1K
J2777	6	30	8,190	$30	$340.4K
J3590	2	10	50	$2,090	$127.3K
J2778	5	20	410	$180	$117.8K
J3490	20	20	50	$1,380	$76K
67028	3	50	540	$100	$66.4K
J2781	7	10	440	$120	$55.7K
67042	5	10	20	$1,130	$22.6K
67210	4	10	30	$430	$19.7K
92014	11	580	100	$90	$18.6K

Showing 1–10 of 24

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Retina Consultants PC	CT	Ophthalmology Physician	$0	$25.8M
Michael Ruddat	CT	Ophthalmology Physician	$2.7M	$0
Jerry Neuwirth	CT	Ophthalmology Physician	$2.5M	$0
Marion Stoj	CT	Ophthalmology Physician	$2.4M	$0
Scott Walter	CT	Retina Specialist (Ophthalmology) Physician	$1.8M	$0
Greg Budoff	CT	Retina Specialist (Ophthalmology) Physician	$705.2K	$0
Tavish Nanda	MA	Ophthalmology Physician	$490.9K	$0
Noam Rudnick	CT	Ophthalmology Physician	$243.4K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ambulance Service Of Manchester, LLC	CT	Land Ambulance	$3.3M	$20.4M
Community Child Guidance Clinic, Inc.	CT	Adolescent and Children Mental Health Clinic/Center	$0	$9.3M
Manchester Public Schools	CT	Local Education Agency (LEA)	$0	$6.5M
Peter Judson	CT	Ophthalmology Physician	$2.6M	$0
Ronald Albert	CT	General Practice Dentistry	$0	$1.3M
Jeffrey Ranaudo	CT	Vascular Surgery Physician	$319.3K	$0
Hazar Dahhan	CT	Cardiovascular Disease Physician	$318.1K	$0
Walgreen Co	CT	Pharmacy	$140.3K	$43.3K
John Pietropaoli	CT	Vascular Surgery Physician	$137.2K	$0
Daniel Veltri	CT	Sports Medicine (Orthopaedic Surgery) Physician	$91.3K	$0

Ron Margolis — 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