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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

John Thordsen (NPI 1073659769)

Field	Value
Entity Type	Individual
Organization	John Thordsen
Address	4414 Lake Boone Trl Ste 302
City	Raleigh
State	NC
ZIP	27607
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	January 29, 2007

Payer Source	Total Paid
Medicare	$3.5M
Medicaid	$0

Key Findings

This provider is operating squarely as a retina-focused, injection-driven practice: J0178 (aflibercept) generated $2.3M and 64.8% of Medicare revenue, while J2777 and 67028 contributed $379.3K (10.7%) and $181.4K (5.1%) respectively, and the top 3 Medicare codes together account for 80.6% of the provider's Medicare revenue. The code mix (high-value intravitreal drug billing plus procedure codes for injections) indicates day-to-day operations are dominated by recurrent intravitreal therapy rather than office-based, non-procedural care.

Payer mix is effectively single‑payer Medicare: lifetime Medicare revenue is $3.5M and there is no Medicaid billing on file (none). With Medicaid absent from the record, this provider’s financial exposure and competitive positioning should be evaluated primarily in the Medicare market rather than against a dual-payer mix.

J0178 is a national high-volume outlier for this provider: it ranks #131 of 3204 providers nationally (96th percentile; notably above typical national volume), which aligns with the code producing $2.3M and the majority of Medicare revenue. That standing signals this clinician is a regional/nationally significant user of aflibercept relative to peers, while reliance on a single drug code contributes to revenue concentration risk.

Procedure and imaging capacity appears robust and integrated with the injection service line: 92134 has 1.5K claims and $42.3K in revenue (1.2% of Medicare revenue) and ranks #1507 of 26868 providers nationally (94th percentile; notably above typical national volume), and 92250 has 1.3K claims and $33K (0.9%) while ranking #108 of 25087 providers nationally (100th percentile; extreme outlier). These elevated imaging volumes suggest the practice performs much of its OCT and fundus photography in-house to support diagnosis and treatment decisions for retinal disease.

Despite high procedural throughput, evaluation-and-management revenue is a small share of total Medicare receipts: 99213 produced $70.7K (2.0% of Medicare revenue) from 1.2K claims, yet the provider ranks #4245 of 457151 providers nationally (99th percentile; extreme outlier) for volume. In plain terms, there are many short follow-up encounters reported but E/M billing contributes only a modest portion of overall revenue compared with intravitreal drug reimbursement.

The practice shows mixed competitive depth across other drug and implant codes: Q5124 (biosimilar ranibizumab, BYOOVIZ) generated $154K (4.4% of Medicare revenue) and ranks #37 of 122 providers nationally (70th percentile; typical, unremarkable volume), while J2777 (faricimab) contributed $379.3K (10.7%) but ranks #802 of 2039 (61th percentile; typical, unremarkable volume). This pattern indicates strong uptake of certain agents (notably aflibercept) alongside more typical or variable use of alternative biologics and biosimilars.

Other miscellaneous drug codes and unclassified biologics contribute modestly but nontrivially to revenue: J3490 accounted for $116.7K (3.3%) and J3590 $101.7K (2.9%), both described as typical, unremarkable volumes in national rank. These entries suggest occasional billing for non-standard or individually billed products that supplement the primary anti-VEGF revenue stream rather than replace it.

The provider is an established clinician with long tenure: NPI enumerated on 2007-01-29 (~19 years ago), and lifetime Medicare revenue of $3.5M reflects sustained Medicare activity over that period. That longevity combined with concentrated procedure-based revenue supports a profile of an established retina specialist whose market role is defined by high-volume intravitreal therapy and in-office imaging capacity.

Medicare: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	3,310	$690	$2.3M
J2777	Injection, faricimab‑svoa, 0.1 mg	13,080	$30	$379.3K
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.	1,930	$90	$181.4K
Q5124	Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg	890	$170	$154K
J3490	Unclassified drugs	50	$2,380	$116.7K
J3590	Unclassified biologics	40	$2,830	$101.7K
J2778	Injection, ranibizumab, 0.1 mg	500	$180	$90.6K
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…	1,180	$60	$70.7K
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.	1,510	$30	$42.3K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	1,320	$30	$33K

Showing 1–10 of 22

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. North Carolina Distribution

John Thordsen — 2 of 22 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. state median

22 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	6	100	950	$690	$881K
J2777	35	70	12,990	$30	$503.7K
Q5124	3	10	890	$170	$259K
J2778	28	50	620	$180	$202.2K
J3590	5	10	30	$2,570	$95K
67028	13	120	780	$90	$80K
J7312	16	20	390	$160	$56.4K
J3490	33	80	50	$450	$24.1K
99214	9,616	18,060	110	$80	$15.1K
J9035	41	90	140	$50	$13.4K

Showing 1–10 of 22

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shil Patel	VA	Ophthalmology Physician	$6.1M	$0
James Pate	NC	Ophthalmology Physician	$5.2M	$0
Nitin Gupta	NC	Ophthalmology Physician	$4.7M	$0
Rebecca Manning	NC	Retina Specialist (Ophthalmology) Physician	$3.4M	$0
William Clark	SC	Ophthalmology Physician	$3.3M	$0
Sachin Mudvari	NC	Retina Specialist (Ophthalmology) Physician	$3.2M	$0
Daniel Bennett	NC	Retina Specialist (Ophthalmology) Physician	$3M	$0
Brian Lehpamer	NC	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Elizabeth Tegins	NJ	Ophthalmology Physician	$2.7M	$0
Wasim Samara	TX	Ophthalmology Physician	$2.3M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Autism Society Of North Carolina, Inc.	NC	Community/Behavioral Health Agency	$0	$95.7M
Rex Hospital Inc.	NC	General Acute Care Hospital	$0	$25.3M
Bayada Home Health Care, Inc.	NC	Home Health Agency	$0	$24.8M
Nc Dept Of Health And Human Service	NC	Clinical Medical Laboratory	$0	$16.4M
Jeffers Mann & Artman Pediatric & Adolesent Medicine PA	NC	Pediatric Adolescent Medicine Physician	$0	$10.9M
Pediatric Therapy Associates	NC	Physical Therapist	$0	$10.2M
Blue Ridge Day Surgery Center, LP	NC	Ambulatory Surgical Clinic/Center	$1.6M	$2.2M
John Denny	NC	Retina Specialist (Ophthalmology) Physician	$2.3M	$0
Eugene Milder	NC	Retina Specialist (Ophthalmology) Physician	$2.1M	$0
Raynor Casey	NC	Retina Specialist (Ophthalmology) Physician	$1.9M	$0

John Thordsen — 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