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.

Barron Fishburne (NPI 1316948243)

Field	Value
Entity Type	Individual
Organization	Barron Fishburne
Address	7620 Trenholm Road Ext
City	Columbia
State	SC
ZIP	29223
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	August 2, 2005

Payer Source	Total Paid
Medicare	$3.3M
Medicaid	$0

Key Findings

This provider is a retina-focused ophthalmology practice with a clear procedural and drug-delivery profile: the three anti-VEGF intravitreal drug codes J0178, J2778, and Q5128 together account for 80.4% of Medicare revenue. Total Medicare revenue is $3.3M, and the top drug code J0178 alone generates $1.8M (56.5% of this provider's total Medicare revenue), signaling that intravitreal injections are the central revenue driver.

Revenue is highly concentrated in a small set of high-cost drug codes: J0178 ($1.8M revenue, 56.5%), J2778 ($465K revenue, 14.3%), and Q5128 ($316K revenue, 9.7%) together make up 80.4% of Medicare receipts. That concentration creates operational dependence on anti-VEGF therapy reimbursement and on coding for injectable biologics as the primary revenue stream.

The practice model implied by the mix of codes is a high-volume injection clinic with frequent follow-ups and retinal imaging: 67028 (2.2K claims, $93 avg paid/claim, $201.3K revenue, 6.2%) and evaluation code 92012 (2K claims, $61 avg paid/claim, $122.9K revenue, 3.8%) together reflect many procedure encounters and established-patient office visits. National-statistical labels reinforce this operational intensity: 67028 is described as "notably above typical national volume" (rank #313 of 4255, 93th percentile) and 92012 is an "extreme outlier, far above typical national volume" (rank #75 of 17177, 100th percentile), consistent with frequent follow-up and injection workflows.

Competitive standing on flagship drug codes is above-average but not monopolistic: J0178 ranks #257 of 3204 providers nationally (92th percentile; typical, unremarkable volume for this code), J2778 ranks #144 of 1208 (88th percentile; typical), and Q5128 ranks #93 of 373 (75th percentile; typical). These ranks indicate the provider is a meaningful national-level participant in aflibercept and ranibizumab administration, and shows above-median uptake of the ranibizumab biosimilar Q5128 relative to peers.

The provider is effectively single-payer in the public claims data: Medicare revenue is $3.3M and there is "no Medicaid billing on file." This absence of Medicaid billing implies limited state-Medicaid exposure in the dataset and suggests the publicly billed patient mix is skewed to Medicare-eligible populations.

Billing nuances and smaller contributors show limited diversification: an unclassified drug code J3490 appears 27 times with $1132 avg paid/claim for $30.6K revenue (0.9% of Medicare revenue) but ranks low nationally (#2361 of 2838, 15th percentile; typical), indicating a handful of high-dollar, low-volume claims. Similarly, J9035 (bevacizumab) contributes $27.2K (0.8% of Medicare revenue) and ranks #263 of 1852 (86th percentile; typical), showing the practice predominantly bills for branded anti-VEGF agents rather than relying on bevacizumab.

Tenure data show long-standing enrollment: the NPI was enumerated on 2005-08-02 (~21 years ago), consistent with an established practice and sustained Medicare billing history. This longevity combined with concentrated revenue streams suggests operational stability but also exposure to shifts in drug pricing and formulary policy.

Operational and payer-risk implications: because 80.4% of Medicare revenue stems from three drug codes (J0178, J2778, Q5128), the provider’s revenue is sensitive to changes in anti-VEGF reimbursement, biosimilar substitution, or formulary decisions. The combination of high-volume follow-up codes (92012, 67028) and concentrated drug billing creates both negotiating leverage for drug procurement and vulnerability to policy or market shifts that affect injectable biologic reimbursement.

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	2,660	$690	$1.8M
J2778	Injection, ranibizumab, 0.1 mg	2,560	$180	$465K
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	1,460	$220	$316K
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.	2,170	$90	$201.3K
J2777	Injection, faricimab‑svoa, 0.1 mg	5,520	$30	$160.1K
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…	2,010	$60	$122.9K
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.	2,030	$30	$56.9K
J3490	Unclassified drugs	30	$1,130	$30.6K
J9035	Injection, bevacizumab, 10 mg	490	$60	$27.2K
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…	120	$110	$14K

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

Barron Fishburne — 1 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	10	50	970	$690	$1.1M
J2777	31	40	15,960	$30	$594.7K
J2778	8	30	1,440	$180	$337.4K
Q5128	6	10	1,150	$220	$273.3K
67028	9	50	1,140	$90	$110.3K
J3490	45	50	70	$510	$57.7K
67042	16	30	20	$1,150	$32.3K
J9035	14	40	200	$50	$26.1K
92014	387	540	160	$80	$24.3K
92012	3	240	110	$60	$14.2K

Showing 1–10 of 15

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Palmetto Retina Center LLC	SC	Ophthalmology Physician	$0	$10.6M
John Payne	SC	Ophthalmology Physician	$4M	$0
John Wells	SC	Ophthalmology Physician	$3.9M	$0
Joshua Robinson	MI	Ophthalmology Physician	$3.7M	$0
William Clark	SC	Ophthalmology Physician	$3.3M	$0
Jeffrey Gross	SC	Retina Specialist (Ophthalmology) Physician	$3M	$0
David Johnson	SC	Retina Specialist (Ophthalmology) Physician	$3M	$0
Oksana Demediuk	GA	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Daniel Will	SC	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
Eugene Long	GA	Hematology & Oncology Physician	$1.9M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jamison Consultant's, LLC	SC	Mental Health Counselor	$0	$15.3M
About Play LLC	SC	Early Intervention Provider Agency	$0	$13.3M
State Of South Carolina	SC	Clinical Medical Laboratory	$0	$9.1M
Midlands Dental Group, P.l.	SC	Dental Clinic/Center	$0	$7.7M
Palmetto Surgery Center LLC	SC	Ambulatory Surgical Clinic/Center	$1.4M	$4.6M
Healthcare Etc, LLC	SC	In Home Supportive Care Agency	$0	$5.4M
Restorative Health Services Of Sc, LLC	SC	In Home Supportive Care Agency	$0	$3.9M
Dent,s Alternative Adult Daycare Health Services,llp	SC	Adult Day Care Clinic/Center	$0	$3.6M
Medogun PA	SC	Pediatric Adolescent Medicine Physician	$0	$2.5M
Carolina Children's Dentistry, PA	SC	Pediatric Dentistry	$0	$2M

Barron Fishburne — 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