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

Why is the Medicaid comparison limited to South 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. South 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 Renfro (NPI 1215911607)

Field	Value
Entity Type	Individual
Organization	John Renfro
Address	1126 Grove Rd
City	Greenville
State	SC
ZIP	29605
Taxonomy	Ophthalmology Physician
NPI Enumerated	November 30, 2005

Payer Source	Total Paid
Medicare	$3.1M
Medicaid	$0

Key Findings

Clinical/service-line profile centers on intravitreal anti-VEGF therapy: J0178 (2.7K claims, $688 avg paid/claim, $1.9M revenue; 60.4% of this provider's total Medicare revenue) and J2777 (21.1K claims, $29 avg paid/claim, $610.7K revenue; 19.7% of this provider's total Medicare revenue) together drive the dominant clinical activity. The presence of 67028 (2K claims, $91 avg paid/claim, $177.5K revenue) further confirms a workflow focused on injections into the vitreous chamber and ongoing retinal disease management rather than primarily refractive or routine primary care ophthalmology.

High revenue concentration is evident: the precomputed top 3 Medicare codes by revenue account for 85.8% of this provider's total Medicare revenue, and J0178 alone represents 60.4% of Medicare receipts. This level of concentration indicates that payer exposure and revenue risk are heavily tied to the utilization and reimbursement of a very small set of injection-related codes.

Payer mix is effectively single-payer Medicare: lifetime Medicare revenue is $3.1M while Total Medicaid revenue is none (no Medicaid billing on file). For contracting and network analyses, this provider should be treated as Medicare-dependent with no recorded Medicaid activity to date.

Competitive standing is strong for the flagship drug code: J0178 ranks #234 of 3204 providers nationally (93th percentile; notably above typical national volume for this code), marking the provider as a well-above-average national participant for aflibercept injections. By contrast J2777 ranks #497 of 2039 providers nationally (76th percentile; typical, unremarkable volume), indicating a solid but not dominant position for faricimab within its national peer set.

Several evaluation and diagnostic codes are extreme outliers in national volume, supporting the high-treatment intensity profile: 92012 (1.8K claims, $66 avg paid/claim, $119.4K revenue; ranks #102 of 17177 providers nationally, 99th percentile; extreme outlier) and 92134 (3.1K claims, $29 avg paid/claim, $90.6K revenue; ranks #349 of 26868 providers nationally, 99th percentile; extreme outlier). These elevated volumes of intermediate exams and retinal imaging are consistent with a high-throughput retina clinic model that pairs frequent injections with frequent monitoring visits.

Follow-up and comprehensive exam activity further supports ongoing chronic care management: 92014 (885 claims, $81 avg paid/claim, $71.7K revenue) ranks #2136 of 35415 providers nationally (94th percentile; notably above typical national volume), and 92012 and 92134 together show substantial monitoring throughput. This mix suggests routine, repeated evaluation visits and imaging are an integral part of the revenue stream and clinical pathway for injected therapeutics.

Provider tenure is long-established: NPI enumerated 2005-11-30 (~21 years ago), indicating sustained practice presence that likely supports referral relationships and an entrenched treatment rhythm for retinal disease. Longevity combined with high procedural volumes for select codes points to a mature clinical operation rather than a recently scaled clinic.

The absence of any Medicaid billing on file has operational implications: the provider is effectively single-payer (Medicare) in the public programs dataset, which may limit access for Medicaid beneficiaries and shape negotiation leverage with Medicare Advantage plans or commercial payers. Payers evaluating network adequacy or access in Greenville, SC should note the Medicare-centric footprint and consider whether additional retina-capable providers are needed for Medicaid populations.

Medicare: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,720	$690	$1.9M
J2777	Injection, faricimab‑svoa, 0.1 mg	21,060	$30	$610.7K
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.	1,950	$90	$177.4K
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…	1,810	$70	$119.4K
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.	3,120	$30	$90.6K
J2778	Injection, ranibizumab, 0.1 mg	410	$180	$72.2K
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…	890	$80	$71.7K
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…	380	$60	$23.4K
J9035	Injection, bevacizumab, 10 mg	430	$50	$22.9K
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…	150	$110	$16.9K

Showing 1–10 of 15

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Carolina Distribution

John Renfro — 2 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. state median

15 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	9	50	970	$690	$1.1M
J2777	14	40	15,960	$30	$594.7K
J2778	24	30	1,440	$180	$337.4K
67028	13	50	1,140	$90	$110.3K
J9035	16	40	200	$50	$26.1K
92014	53	540	160	$80	$24.3K
67108	8	20	20	$1,150	$24.1K
99214	6,787	7,860	160	$80	$23.2K
92012	4	240	110	$60	$14.2K
99213	1,029	7,690	100	$60	$10.8K

Showing 1–10 of 15

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Joshua Robinson	MI	Ophthalmology Physician	$3.7M	$0
Gregg Kaiser	SC	Ophthalmology Physician	$2.8M	$0
Collin Ohning	MD	Retina Specialist (Ophthalmology) Physician	$2.7M	$0
Chris Bergstrom	GA	Ophthalmology Physician	$2M	$0
James Hall	SC	Retina Specialist (Ophthalmology) Physician	$1.9M	$0
Daniel Apple	MI	Ophthalmology Physician	$1.8M	$0
Pauline Merrill	SC	Ophthalmology Physician	$1.3M	$165.2K
Gregory Christensen	SC	Ophthalmology Physician	$1.3M	$0
William Johnson	SC	Ophthalmology Physician	$390.8K	$0
Peter Goodwin	SC	Ophthalmology Physician	$383.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$86.9M
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$25M
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$22M
Heavenly Care Services Inc.	SC	Nursing Care Agency	$0	$12.1M
Speechworks, Inc.	SC	Speech-Language Pathologist	$0	$10.5M
Plan Home Health Care	SC	Nursing Care Agency	$0	$8.9M
Prisma Health-upstate	SC	General Acute Care Hospital	$0	$8.3M
Prisma Health-upstate	SC	Land Ambulance	$4.5M	$3.7M
Prisma Health-upstate	SC	Infusion Therapy Clinic/Center	$0	$7.5M
Prisma Health University Medical Group	SC	Diagnostic Radiology Physician	$0	$7.5M

John Renfro — Billing Profile & Reimbursement Data

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John Renfro — 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