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

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

Richard Johnston (NPI 1154398824)

Field	Value
Entity Type	Individual
Organization	Richard Johnston
Address	6525 France Ave S
City	Edina
State	MN
ZIP	55435
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	March 2, 2006

Payer Source	Total Paid
Medicare	$1.7M
Medicaid	$0

Key Findings

This provider is a retina specialist focused on intravitreal pharmacologic therapy and retina-focused office care: the top revenue drivers are J0178 ($700K, 41.0% of Medicare revenue), J2777 ($586.3K, 34.3%), and 67028 ($111.9K, 6.6%), and these three codes together account for 81.8% of the provider's total Medicare revenue. The code mix (heavy anti-VEGF drug billing plus a vitreous injection procedure) aligns with an injection-centric retina practice that manages chronic retinal disease with frequent in-office injections and related monitoring.

Revenue is highly concentrated in a small set of drug/procedure codes: the precomputed top-three share of 81.8% underscores that most Medicare dollars flow from anti-VEGF/faricimab and isolated intravitreal injections. That concentration implies the provider’s financial performance is strongly tied to utilization and reimbursement of a few high-value injection codes rather than a broad mix of ancillary services.

The payer footprint is effectively single-payer Medicare: lifetime Medicare revenue is $1.7M while there is no Medicaid billing on file. This means analyses of access, utilization, and financial risk for this NPI should focus on Medicare dynamics rather than state Medicaid patterns.

On competitive standing for the top drug and injection codes, the provider is a modest-to-typical national participant: J0178 ranks #1270 of 3204 (60th percentile, labeled typical/unremarkable), J2777 ranks #500 of 2039 (76th percentile, typical/unremarkable), and 67028 ranks #992 of 4255 (77th percentile, typical/unremarkable). Those percentiles indicate steady, serviceable volumes for these revenue-driving codes but do not reflect national dominance in these specific supplies or procedures.

Beyond injections, the provider reports notably high volumes for comprehensive established exams and retinal imaging: 92014 generated $103.1K (1.2K claims) and ranks in the 97th percentile (notably above typical), while 92134 produced $54.8K (1.8K claims) at the 96th percentile (notably above typical). High billing for these evaluation and imaging codes is consistent with active monitoring and follow-up of retinal disease, supporting the injection-focused care model.

Surgical and procedural retina activity appears present but limited relative to injection volume: 67041 (15 claims, $13.5K) and 67036 (17 claims, $10.1K) are reported with ranks toward the middle of their peer distributions (33rd and 40th percentiles, labeled typical/unremarkable). This suggests the practice performs some vitreoretinal procedures but is not primarily a high-volume surgical retina center.

There are notable contrasts within E/M coding that reflect specialty billing patterns: 99204 (143 claims, $17.4K) ranks in the 95th percentile (notably above typical), indicating above-typical new patient comprehensive visits, while 99213 (13 claims, $858) ranks in the 2nd percentile (typical/unremarkable) and is very low in relative volume. These differences likely reflect the clinic’s mix of specialty consults and procedure-driven follow-up visits rather than a general primary-care outpatient mix.

The NPI has long tenure in Medicare billing, enumerated on 2006-03-02 (~20 years ago), which supports interpretation of these patterns as established practice behavior rather than short-term or startup activity. Lifetime Medicare revenue of $1.7M combined with long tenure suggests a stable, medium-scale specialty practice concentrated on retina injections and associated diagnostic monitoring.

Medicare: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	1,020	$690	$700K
J2777	Injection, faricimab‑svoa, 0.1 mg	20,940	$30	$586.3K
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.	1,320	$90	$111.9K
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…	1,160	$90	$103.1K
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.	1,830	$30	$54.8K
J2778	Injection, ranibizumab, 0.1 mg	240	$180	$43K
J9035	Injection, bevacizumab, 10 mg	390	$50	$21.3K
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…	140	$120	$17.4K
67041	In this procedure, the provider removes scar tissue from the retinal membrane that obscures vision. He removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical…	20	$900	$13.5K
92235	The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken…	120	$110	$12.3K

Showing 1–10 of 19

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Minnesota Distribution

Richard Johnston — 5 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. state median

19 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	17	40	580	$690	$743.4K
J2777	5	20	6,120	$30	$411.1K
J2778	14	20	500	$180	$121K
67028	13	80	420	$90	$64.8K
67036	5	10	20	$1,140	$37.5K
67041	7	10	20	$1,090	$25.1K
J9035	11	40	220	$50	$16.9K
92014	2	830	100	$80	$11.9K
92012	41	200	60	$60	$8.8K
92235	4	40	40	$110	$6.9K

Showing 1–10 of 19

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
North Memorial Health Care	MN	Ambulance	$0	$112.8M
Fairview Health Services	MN	General Acute Care Hospital	$0	$90.4M
Regions Hospital	MN	General Acute Care Hospital	$0	$44.4M
Fairview Express Care	MN	Specialist	$0	$33.1M
North Memorial Health Care	MN	General Acute Care Hospital	$0	$32.5M
Fairview Health Services	MN	General Acute Care Hospital	$0	$30M
Fairview Health Services	MN	Emergency Medicine Physician	$0	$26.6M
Fairview Health Services	MN	General Acute Care Hospital	$0	$17.2M
University Of Minnesota Health Clinics And Surgery Center, Inc.	MN	Clinic/Center	$0	$16.3M
Regions Hospital	MN	Emergency Medicine Physician	$0	$15.1M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Emergency Physicians Professional Association	MN	Emergency Medicine Physician	$0	$72.7M
Vitreoretinal Surgery PLLC	MN	Ophthalmology Physician	$0	$27.8M
Professional Resource Network - Prn - Corporation	MN	Home Health Agency	$0	$12.4M
Virtual Radiologic Professionals, LLC	MN	Diagnostic Radiology Physician	$0	$11.3M
Mental Health Systems PC	MN	Psychologist	$0	$11M
Premier Obgyn Of Minnesota PLLC	MN	Obstetrics & Gynecology Physician	$0	$7M
Noran Neurological Clinic P.A.	MN	Specialist	$0	$6M
Nura Surgical Center LLC	MN	Ambulatory Surgical Clinic/Center	$5.3M	$581.7K
Southdale Pediatric Associates, Ltd	MN	Multi-Specialty Clinic/Center	$0	$5.3M
David Parke	MN	Ophthalmology Physician	$4.8M	$0

Richard Johnston — 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