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NPI 1760786982 · Plymouth Meeting, PA · Ophthalmology Physician
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Ajay Kuriyan is a ophthalmology physician provider located in Plymouth Meeting, Pennsylvania. This profile covers 21 Medicare and 3 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 | Ajay Kuriyan |
| Address | 4060 Butler Pike Ste 200 |
| City | Plymouth Meeting |
| State | PA |
| ZIP | 19462 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | January 3, 2011 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $5.3M |
| Medicaid | $6.6K |
This provider is effectively Medicare‑driven: reported lifetime Medicare revenue is $5.3M versus $6.6K in Medicaid, indicating Medicare accounts for the vast majority of billed revenue and Medicaid is negligible in scale. The gap suggests payer strategies, reimbursement changes, or formulary differences that affect high‑cost drug utilization will predominantly influence this provider’s topline.
Medicare revenue is highly concentrated in intravitreal drug administration: the top 3 Medicare codes (J0178, J2777, Q5128) account for 76.0% of this provider’s Medicare revenue, led by J0178 at $2.5M (46.7% of Medicare revenue) and J2777 at $1M (19.5%). This concentration implies the practice’s financial performance is tightly linked to retinal injectable therapies rather than broad primary ophthalmology E/M services.
Clinical mix and service line signal a retina‑focused practice: large volumes of retinal imaging and injection codes (e.g., 92134 with 5.1K claims and 67028 with 2.9K claims) alongside high‑revenue drug codes indicate routine, high‑frequency intravitreal therapy and monitoring for retinal disease. The presence of diagnostic imaging (92134) and repeated drug administration procedures supports an operational model centered on chronic retina care rather than episodic general ophthalmology.
This provider ranks well above peers on several high‑impact codes, indicating a dominant local/national presence for certain services: J0178 ranks #103 of 3204 providers nationally (97th percentile) and 67028 ranks #112 of 4255 (97th percentile), both labeled as "notably above typical national volume." Additionally, 92012 and 92134 are listed as "extreme outlier, far above typical national volume," confirming unusually high throughput for intermediate eye exams and retinal imaging relative to national peers.
Medicaid billing is fully concentrated in a narrow set of services: the top 3 Medicaid codes account for 100.0% of the provider’s Medicaid revenue, with 92134 contributing $4.6K (69.6%), 67028 $1.3K (19.8%), and 92014 $704 (10.6%). In‑state rank positions are modest to low (e.g., 92134 at 58th percentile in‑state and 67028 at the 6th percentile), implying the provider is not a statewide leader in Medicaid retinal services despite higher relative Medicare volumes.
While injections and imaging dominate, the provider also bills a range of office visits and surgical retina codes at smaller volumes—examples include 92012 ($161.9K, 3.1% of Medicare revenue), 92014 ($69.1K, 1.3%), and several retinal surgery CPTs (67108, 67042, 67113) each representing fractional shares of Medicare revenue. This mix indicates the practice delivers both procedural retina care and some comprehensive/office‑based ophthalmology services, but those E/M and surgical codes are secondary to drug and imaging revenue.
The provider’s NPI tenure suggests an established practice footprint: enumerated on 2011-01-03 (~15 years ago), which supports the high cumulative volumes observed for chronic retina codes and may reflect long‑standing referral pathways and patient panels. Longevity combined with extreme percentile rankings on key codes suggests entrenched clinical workflows focused on intravitreal therapy and retinal imaging.
Operational and reimbursement sensitivity is elevated because a small number of high‑cost injectable codes drive most revenue; changes in coverage, reimbursement, or utilization patterns for J0178, J2777, or biosimilars like Q5128 would disproportionately affect total Medicare revenue. Payers and network planners should note this concentration when evaluating utilization management, contracting, or prior‑authorization programs tied to retinal biologics and imaging services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
21 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 3,580 | $690 | $2.5M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 35,460 | $30 | $1M |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 2,400 | $220 | $518.8K |
| J2778 | Injection, ranibizumab, 0.1 mg | 2,210 | $190 | $418.4K |
| 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. | 2,850 | $100 | $273.9K |
| 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… | 2,490 | $70 | $161.9K |
| 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. | 5,060 | $30 | $151.7K |
| 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… | 830 | $80 | $69.1K |
| J3490 | Unclassified drugs | 30 | $1,890 | $54.8K |
| 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… | 270 | $120 | $31.3K |
Showing 1–10 of 21
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
21 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 8 | 140 | 830 | $690 | $865.1K |
| Q5128 | 17 | 20 | 3,830 | $220 | $838.7K |
| J2778 | 23 | 70 | 1,030 | $190 | $417.1K |
| J2777 | 7 | 100 | 7,950 | $30 | $360.2K |
| 67028 | 17 | 180 | 600 | $90 | $87.5K |
| J7999 | 39 | 110 | 100 | $120 | $33.3K |
| 67042 | 27 | 50 | 20 | $1,100 | $31.9K |
| J3490 | 94 | 110 | 60 | $70 | $27.9K |
| 92014 | 106 | 1,570 | 130 | $80 | $21K |
| 67108 | 7 | 20 | 20 | $910 | $20.1K |
Showing 1–10 of 21
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 390 | $10 | $4.6K |
| 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. | 30 | $50 | $1.3K |
| 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… | 60 | $10 | $700 |
How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Pennsylvania median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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. | 91 | 100 | 330 | $70 | $85.4K |
| 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… | 614 | 860 | 240 | $40 | $37K |
| 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. | 77 | 180 | 290 | $20 | $24.8K |
Other providers in the same ZIP code as Ajay Kuriyan, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Gemma Services | PA | Psychiatric Residential Treatment Facility | $0 | $23.8M |
| Access Services Inc | PA | Community/Behavioral Health Agency | $0 | $8.3M |
| Michael Klufas | PA | Ophthalmology Physician | $7M | $0 |
| Richard Kaiser | PA | Ophthalmology Physician | $6.6M | $0 |
| Allen Chiang | PA | Ophthalmology Physician | $6.6M | $0 |
| Carl Regillo | PA | Ophthalmology Physician | $6.5M | $0 |
| Allen Ho | PA | Ophthalmology Physician | $6.4M | $0 |
| Yoshihiro Yonekawa | PA | Ophthalmology Physician | $6.4M | $0 |
| James Vander | PA | Ophthalmology Physician | $6.3M | $0 |
| Marc Spirn | PA | Ophthalmology Physician | $6.3M | $0 |
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