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

Why is the Medicaid comparison limited to Maryland 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. Maryland (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 Butler (NPI 1174521264)

Field	Value
Entity Type	Individual
Organization	John Butler
Address	6511 Deer Pointe Drive
City	Salisbury
State	MD
ZIP	21804
Taxonomy	Ophthalmology Physician
NPI Enumerated	July 12, 2005

Payer Source	Total Paid
Medicare	$4.3M
Medicaid	$0

Key Findings

This provider’s Medicare business is concentrated in intravitreal drug administration and retinal diagnostics, consistent with a retina-focused ophthalmology practice. The top drug code J0178 shows 3.9K claims, $690 avg paid/claim, and $2.7M revenue (62.7% of this provider's total Medicare revenue), and other intravitreal drug codes such as J2777 and J2778 also appear in the top line items; imaging codes like 92134 and 92235 further support a high-volume retinal monitoring workflow.

Revenue is highly concentrated in a very small set of services: the precomputed top 3 Medicare codes by revenue account for 84.6% of this provider's total Medicare revenue. In particular, J0178 ($2.7M, 62.7%), J2777 ($718.6K, 16.8%), and 67028 ($216.9K, 5.1%) dominate the $4.3M lifetime Medicare revenue, indicating the practice derives most of its Medicare dollars from a narrow mix of high-value injectable therapies and related procedures.

Payer mix is effectively single-payer at the claims level: this provider has $4.3M in total Medicare revenue and no Medicaid billing on file, so Medicare is the primary — and essentially sole — public payer in the dataset. This concentration means reimbursement or utilization changes in Medicare drug or retina procedure policies would disproportionately affect the provider’s revenue.

Competitive standing on key injection and imaging codes is strong nationally for some items and typical for others. The provider ranks #77 of 3204 for J0178 (98th percentile, notably above typical national volume) and #251 of 4255 for 67028 (94th percentile, notably above typical national volume), while J2777 sits at #396 of 2039 (81th percentile, typical, unremarkable volume) and J2778 is #427 of 1208 (65th percentile, typical, unremarkable volume).

The provider is a long-tenured enumerant with NPI registered on 2005-07-12 (~21 years ago), indicating an established local presence and sustained Medicare participation. That tenure, combined with large volumes on chronic-treatment codes, suggests an ongoing ambulatory retina practice rather than a transient or recently opened clinic.

Diagnostic and follow-up services are a clear operational emphasis: 92134 appears with 4K claims, $32 avg paid/claim, $127.8K revenue (3.0% of total) and is labeled an extreme outlier, far above typical national volume, while office E/M code 99214 shows 841 claims, $94 avg paid/claim, $79.1K revenue (1.9% of total) and is described as notably above typical national volume. These patterns indicate regular, high-frequency monitoring visits and imaging consistent with ongoing management of chronic retinal disease.

The practice also performs surgical and advanced procedural retina work in addition to injections: codes such as 67042 (27 claims, $893 avg paid/claim, $24.1K revenue) and 67036 (17 claims, $590 avg paid/claim, $10K revenue) appear in the top list, showing a nontrivial surgical footprint. While surgical volumes are smaller by revenue share, their presence alongside high injection volume suggests capacity for both ambulatory injection clinics and selected operative interventions.

Adoption patterns for newer or less-established therapies are mixed: J2777 (faricimab) shows large claim volume with 24.8K claims, $29 avg paid/claim, $718.6K revenue (16.8% of total) and is rated typical, unremarkable volume, while J2781 (pegcetacoplan) has 270 claims, $120 avg paid/claim, $32.4K revenue (0.8% of total) and is also described as typical, unremarkable volume. This indicates the provider actively uses multiple drug therapies for retinal disease but does not present an outlier adoption pattern for the lesser-represented agents according to the supplied national comparisons.

Medicare: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	3,880	$690	$2.7M
J2777	Injection, faricimab‑svoa, 0.1 mg	24,780	$30	$718.6K
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.	2,310	$90	$216.9K
J2778	Injection, ranibizumab, 0.1 mg	1,030	$170	$176.6K
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.	3,990	$30	$127.8K
99214	The provider sees an established 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…	840	$90	$79.1K
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…	710	$90	$63.5K
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…	830	$70	$55.3K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	270	$120	$32.4K
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…	270	$110	$29.1K

Showing 1–10 of 20

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Maryland Distribution

John Butler — 3 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. state median

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	3	100	950	$690	$887.3K
J2777	17	70	8,520	$30	$487.3K
J2781	16	20	620	$120	$258.6K
J2778	19	50	650	$180	$207.8K
67028	9	120	700	$100	$101.5K
92014	129	620	210	$90	$44K
67042	9	30	20	$1,060	$25.4K
99214	764	10,270	150	$90	$24.1K
67036	10	20	20	$960	$22K
67210	12	20	30	$430	$21K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Zaaira Ahmad	MD	Ophthalmology Physician	$3.3M	$0
Travis Peck	MD	Ophthalmology Physician	$2.5M	$0
Jeffrey Benner	MD	Ophthalmology Physician	$1.5M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wraparound Maryland, Inc	MD	Case Management Agency	$0	$18.4M
Go-getters, Inc.	MD	Community/Behavioral Health Agency	$0	$14.7M
Board Of Education Of Wicomico County	MD	Local Education Agency (LEA)	$0	$14.6M
Healthport	MD	Community/Behavioral Health Agency	$0	$10.9M
Chesapeake Pediatric & Adolescent Associates, PA	MD	Pediatric Adolescent Medicine Physician	$0	$6.6M
Healthport	MD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.5M
Coastal Hospice Inc	MD	Community Based Hospice Care Agency	$0	$5.3M
Children's Medical Group Of Salisbury, PA	MD	Pediatrics Physician	$0	$5M
Konlian,o'neill & Associates, P.A.	MD	Rehabilitation Practitioner	$0	$5M
James Rial	MD	Ophthalmology Physician	$4.7M	$510

John Butler — 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