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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
Sister Sites: OpenMedicaid ยท OpenFeds ยท OpenSpending

ยฉ 2026 OpenMedicare. Independent data journalism. Built by TheDataProject.ai

Methodologyโ€ขDownload Data
  1. Home
  2. Providers
  3. Kenneth Graham
๐Ÿ‘๏ธ
Individual

Kenneth Graham

NPI: 1457464778
Great Neck, NY
10 years of data
Ophthalmology
$47.1M
Total Payments
179
Beneficiaries
260.3K
Services
3.17x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$47.1M
Specialty median$383.7K
Rank #58 of 189 in specialty

๐Ÿ“‹ Key Findings

1Billed $47.1M over 10 years
23.17x markup ratio (above median)
399th percentile in Ophthalmology by payments
4104 services/day โ€” unusually high
513 procedures with >3x markup

This provider averages 104 services per working day

Based on 260.3K total services over 10 years (250 working days/year). Learn about impossible service volumes โ†’

๐Ÿ”Ž Data Analysis

This provider's $47.1M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.

Averaging 104 services per working day raises questions about billing patterns.

Medicare payments to this provider grew 65% from 2014 to 2023.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid โ€” the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$565.44$187.603.01x$377.84$3.4M18.0K16
2015$570.33$191.562.98x$378.77$3.8M19.8K17
2016$553.16$187.822.95x$365.34$4.3M23.0K15
2017$543.59$180.673.01x$362.92$4.4M24.5K18
2018$524.22$167.883.12x$356.34$5.0M29.9K17
2019$561.18$173.113.24x$388.07$5.5M31.5K15
2020$659.46$200.923.28x$458.54$4.7M23.5K16
2021$715.99$217.283.30x$498.71$5.2M24.1K21
2022$776.39$229.343.39x$547.05$5.2M22.6K20
2023$417.36$128.193.26x$289.17$5.6M43.4K24

Top Procedures (20)

J2778Injection, ranibizumab, 0.1 mg
$20.3M
73.3K services$277.51/svc2.89x markup
J0178Injection, aflibercept, 1 mg
$16.0M
21.9K services$731.38/svc2.78x markup
67028Injection of drug into eyeโš  6.7x markup
$2.7M
26.4K services$101.15/svc6.73x markup
92012Established patient problem focused exam of visual system
$1.6M
20.1K services$77.28/svc2.67x markup
92134Imaging of retinaโš  4.5x markup
$1.5M
39.9K services$38.13/svc4.46x markup
92014Established patient complete exam of visual systemโš  3.2x markup
$1.1M
10.3K services$106.29/svc3.16x markup
J2777Injection, faricimab-svoa, 0.1 mg
$647.6K
22.9K services$28.33/svc2.45x markup
92226Examination of eye by ophthalmoscope with retinal drawingโš  3.8x markup
$615.6K
20.0K services$30.74/svc3.81x markup
J7312Injection, dexamethasone, intravitreal implant, 0.1 mgโš  3.3x markup
$452.4K
3.0K services$150.66/svc3.30x markup
99204New patient office or other outpatient visit, 45-59 minutes
$356.2K
2.5K services$144.33/svc2.60x markup
Q5128Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mgโš  3.7x markup
$265.1K
1.2K services$214.47/svc3.73x markup
92235Exam of retinal blood vessels using a special camera after injection of a dye
$249.5K
1.9K services$133.91/svc2.72x markup
99213Established patient office or other outpatient visit, 20-29 minutesโš  3.7x markup
$221.5K
2.8K services$80.27/svc3.74x markup
J3490Unclassified drugs
$183.1K
80 services$2.3K/svc2.01x markup
J9035Injection, bevacizumab, 10 mgโš  6.5x markup
$142.5K
2.5K services$57.40/svc6.47x markup
67228Destruction of leaking blood vessels of retina using laserโš  5.9x markup
$129.2K
305 services$423.62/svc5.90x markup
92225Examination of eye by ophthalmoscope with retinal drawingโš  3.7x markup
$82.7K
2.0K services$41.62/svc3.70x markup
92201Extended exam of the back part of the eye with retinal drawingโš  4.0x markup
$71.3K
3.2K services$22.21/svc4.05x markup
92004New patient complete exam of visual systemโš  3.4x markup
$56.9K
430 services$132.39/svc3.40x markup
Q5124Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mgโš  4.6x markup
$53.1K
305 services$174.19/svc4.59x markup
Show detailed table โ–พ
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
J2778Injection, ranibizumab, 0.1 mg73.3K$20.3M$277.512.89x
J0178Injection, aflibercept, 1 mg21.9K$16.0M$731.382.78x
67028Injection of drug into eye26.4K$2.7M$101.156.73x
92012Established patient problem focused exam of visual system20.1K$1.6M$77.282.67x
92134Imaging of retina39.9K$1.5M$38.134.46x
92014Established patient complete exam of visual system10.3K$1.1M$106.293.16x
J2777Injection, faricimab-svoa, 0.1 mg22.9K$647.6K$28.332.45x
92226Examination of eye by ophthalmoscope with retinal drawing20.0K$615.6K$30.743.81x
J7312Injection, dexamethasone, intravitreal implant, 0.1 mg3.0K$452.4K$150.663.30x
99204New patient office or other outpatient visit, 45-59 minutes2.5K$356.2K$144.332.60x
Q5128Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg1.2K$265.1K$214.473.73x
92235Exam of retinal blood vessels using a special camera after injection of a dye1.9K$249.5K$133.912.72x
99213Established patient office or other outpatient visit, 20-29 minutes2.8K$221.5K$80.273.74x
J3490Unclassified drugs80$183.1K$2.3K2.01x
J9035Injection, bevacizumab, 10 mg2.5K$142.5K$57.406.47x
67228Destruction of leaking blood vessels of retina using laser305$129.2K$423.625.90x
92225Examination of eye by ophthalmoscope with retinal drawing2.0K$82.7K$41.623.70x
92201Extended exam of the back part of the eye with retinal drawing3.2K$71.3K$22.214.05x
92004New patient complete exam of visual system430$56.9K$132.393.40x
Q5124Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg305$53.1K$174.194.59x

Markup Analysis

Charge-to-Payment Ratio

3.17x

This provider submits charges 3.17 times higher than what Medicare actually pays.

What This Means

A markup ratio of 3.17x means for every $100 Medicare pays, this provider initially charges $317. This is higher than the national average.

Location

Great Neck, NY

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

Similar Providers

Other Ophthalmology providers in NY for peer comparison.

Kenneth Graham (you)
$47.1M
Jonathan Jonisch, MD
$52.3M
Jeffrey Josef, M.D.
$52.2M
Brett Rosenblatt
$50.0M
Glenn Stoller, M.D.
$46.4M
James Klancnik, MD
$44.0M
Show detailed table โ–พ
ProviderLocationTotal PaymentsStatus
Jonathan Jonisch, MDGreat Neck, NY$52.3Mโœ“ Clear
Jeffrey Josef, M.D.Suffern, NY$52.2Mโœ“ Clear
Brett RosenblattGreat Neck, NY$50.0Mโœ“ Clear
Glenn Stoller, M.D.Rockville Centre, NY$46.4Mโœ“ Clear
James Klancnik, MDNew York, NY$44.0Mโœ“ Clear

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Data Sources

  • โ€ข Centers for Medicare & Medicaid Services (CMS)
  • โ€ข Medicare Provider Utilization and Payment Data (2014-2023)
  • โ€ข National Plan and Provider Enumeration System (NPPES)

Last Updated: February 2026 (data through 2023, the latest CMS release)

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.

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