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

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

James Johnson (NPI 1215926985)

Field	Value
Entity Type	Individual
Organization	James Johnson
Address	125 W Yellowstone Ave
City	Cody
State	WY
ZIP	82414
Taxonomy	Surgery Physician
NPI Enumerated	October 17, 2005

Payer Source	Total Paid
Medicare	$295.8K
Medicaid	$0

Key Findings

JAMES JOHNSON is a surgery physician based in Cody, WY with an NPI enumerated on 2005-10-17 (≈21 years ago). His lifetime Medicare revenue on file is $295.8K and there is no Medicaid billing on file, indicating a long-tenured, Medicare-focused practice footprint rather than a dual-payer mix.

Revenue is highly concentrated in a narrow set of venous procedure codes: the precomputed top 3 Medicare codes account for 90.9% of his total Medicare revenue. Those top drivers are 36482 ($163.7K, 55.3% of Medicare revenue), 36475 ($70.6K, 23.9%), and 36465 ($34.6K, 11.7%), showing dependence on a small number of procedure types for the bulk of reimbursement.

The code mix (36482, 36475, 36465 and related add-ons) reflects a procedural, vein-focused surgical practice centered on endovenous ablation and sclerotherapy for varicose veins rather than broad primary care or general surgery. Low-dollar E/M codes (e.g., 99214, 99213) and ultrasound guidance (76942) appear only as minor revenue contributors, reinforcing that the operation is procedure-driven outpatient vascular/vein therapy.

For 36482 (chemical adhesive ablation of the first vein) he reported 123 claims with $1331 avg paid/claim and $163.7K revenue, and ranks #78 of 710 providers nationally (89th percentile; typical, unremarkable volume). That rank places him above most peers nationally on volume for this code, even though the CMS descriptor characterizes the level as typical and unremarkable.

36475 (radiofrequency ablation of the first vein) accounts for 84 claims and $70.6K revenue and ranks #187 of 1221 providers nationally (85th percentile; typical, unremarkable volume), indicating relatively higher utilization of radiofrequency ablation versus many peers. By contrast, 36465 (foam sclerotherapy for a single truncal vein) is smaller at 33 claims and $34.6K and ranks #593 of 989 providers nationally (39th percentile; typical, unremarkable volume), showing that not all vein modalities are used at the same intensity.

Several add-on and supporting codes show concentrated usage against small national peer sets: for example, 36483 (add-on chemical adhesive for subsequent veins) appears with 39 claims and $4.2K revenue and the provider ranks #7 of 33 providers nationally (81th percentile; typical, unremarkable volume). This suggests the provider is among a limited set of clinicians who bill these adjunctive add-on codes with above-average rank within a small cohort.

From a payer and network perspective, the absence of any Medicaid billing on file makes this effectively a single-payer (Medicare) revenue profile. That concentration increases payer-side exposure to reimbursement and referral shifts within Medicare and suggests limited participation in state Medicaid networks or managed Medicaid contracts.

Overall scale is modest in dollar terms—$295.8K lifetime Medicare revenue—with a highly concentrated, specialty procedural mix and long tenure. For competitive analysis, this looks like a niche outpatient vein-ablation practice that is nationally above-average on its top ablation codes but operates at a small absolute revenue scale and would be characterized as a modest but specialized participant in the Medicare market.

Medicare: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
36482	In this procedure, the provider inserts a chemical adhesive through a catheter into an incompetent vein in an extremity to ablate the vein. The provider reports this code for treatment of the first…	120	$1,330	$163.7K
36475	In this procedure, the provider inserts a specially designed radiofrequency probe through the skin and destroys the wall of a diseased vein in an extremity. The provider reports this code for…	80	$840	$70.6K
36465	In this procedure, the provider injects a noncompounded foam sclerosing solution into a single incompetent truncal vein of the extremity under ultrasound guidance to guide the dispersion of foam,…	30	$1,050	$34.6K
36471	In this procedure, the provider injects a sclerosing solution into more than one incompetent veins of the same leg, most commonly to treat varicose veins. It may be used to treat other vascular…	50	$150	$6.8K
36476	In this add–on procedure the provider inserts a specially designed radiofrequency probe through the skin to destroy the wall of a diseased vein in an extremity. The provider performs this procedure…	30	$230	$6.3K
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…	50	$100	$5.1K
36483	In this add–on procedure, the provider inserts a chemical adhesive through a catheter into an incompetent vein in an extremity to ablate the vein. The provider performs this procedure to ablate…	40	$110	$4.2K
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…	20	$110	$1.8K
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…	20	$70	$1.6K
76942	Ultrasonography uses sound waves of higher frequencies (above the normal hearing capacity of a healthy human, i.e., 20 kHz) to visualize inner organs. When the sound waves pass through the human…	40	$20	$1K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 10 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Wyoming Distribution

James Johnson — 2 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. state median

10 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
36482	1	10	50	$1,330	$91.9K
36475	1	10	50	$840	$45.6K
36465	1	10	30	$1,040	$30.1K
99214	516	780	100	$80	$14.8K
99213	758	850	110	$60	$9.9K
36476	1	10	30	$220	$6.3K
36471	2	10	50	$140	$5.9K
99204	246	340	30	$110	$5K
36483	1	10	40	$110	$4.2K
76942	6	40	20	$30	$980

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nathan Steinle	CA	Retina Specialist (Ophthalmology) Physician	$9.5M	$0
Prema Abraham	SD	Retina Specialist (Ophthalmology) Physician	$7.1M	$0
Kyle Thompson	ID	Retina Specialist (Ophthalmology) Physician	$4.5M	$0
Douglas Holmes	WY	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Mitchell Goff	UT	Retina Specialist (Ophthalmology) Physician	$3.8M	$0
Richard Kinsey	TN	Anatomic Pathology & Clinical Pathology Physician	$3.3M	$147.3K
Brendan Girschek	AZ	Ophthalmology Physician	$3.2M	$0
John Bormes	SD	Ophthalmology Physician	$2.6M	$0
John Purviance	WY	Radiation Oncology Physician	$2.5M	$0
Cary Chisholm	TX	Anatomic Pathology & Clinical Pathology Physician	$2.5M	$24.7K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northern Ddsp, Inc.	WY	Developmentally Disabled Services Day Training Agency	$0	$9.1M
Hands 2 Help, LLC.	WY	Home Health Agency	$0	$2.9M
Big Horn Basin Childrens Clinic PC	WY	Pediatrics Physician	$0	$997.5K
West Park Hospital District	WY	Critical Access Hospital	$0	$950.8K
Northern Wyoming Surgical Center, LLC	WY	Ambulatory Surgical Clinic/Center	$865.9K	$0
Guardian Flight LLC	WY	Air Ambulance	$738.8K	$0
West Park Hospital District	WY	Multi-Specialty Clinic/Center	$0	$726.1K
Cailyn Dallman	WY	Case Manager/Care Coordinator	$0	$630.7K
Barry Welch	WY	Ophthalmology Physician	$430.2K	$0
Allen Gee	WY	Neurology Physician	$344K	$0

James Johnson — 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