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

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

Thomas Johnson (NPI 1366498545)

Field	Value
Entity Type	Individual
Organization	Thomas Johnson
Address	200 Executive Center Pkwy
City	Fredericksburg
State	VA
ZIP	22401
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	May 26, 2006

Payer Source	Total Paid
Medicare	$3.6M
Medicaid	$0

Key Findings

Specialty and service mix align with a Retina Specialist focused on intravitreal therapy and high-volume clinic-based retinal care: the provider reports J0178 (aflibercept) at $2M revenue (56.2% of Medicare revenue), J2777 (faricimab) at $313.2K, and J2778 (ranibizumab) at $120.3K, alongside significant retinal imaging and in‑office procedures such as 92134 ($124.5K) and 67028 ($192.4K). This pattern—dominant anti-VEGF billing plus imaging and occasional vitreoretinal surgery codes—is consistent with an outpatient retina practice that delivers frequent injection visits supported by diagnostic imaging.

Revenue is highly concentrated: the precomputed top-3 Medicare codes by revenue account for 74.7% of this provider's total Medicare revenue, with J0178 contributing $2M (56.2%), 92014 contributing $356.4K (9.8%), and J2777 contributing $313.2K (8.6%). This concentration indicates that a small number of services drive the majority of Medicare receipts for the practice.

The provider’s payer mix is effectively single-payer Medicare: Total Medicare revenue is $3.6M while Total Medicaid revenue is none (no Medicaid billing on file). Operational and competitive assessments should treat this entity as Medicare-dependent with no Medicaid activity to benchmark against.

On competitive standing for key services, this provider ranks notably high nationally: J0178 is ranked #189 of 3204 providers (94th percentile; notably above typical national volume), 92014 is ranked #22 of 35415 providers (100th percentile; extreme outlier), and 92134 is ranked #165 of 26868 providers (99th percentile; extreme outlier). These rankings suggest the provider is a major national-volume performer on established-patient comprehensive eye exams and retinal OCT imaging and is well above peers for aflibercept administration.

Not all high-revenue injection codes are above-peer outliers: J2777 (faricimab) is $313.2K and ranks #961 of 2039 providers (53th percentile; typical, unremarkable volume), and J2778 (ranibizumab) at $120.3K ranks #600 of 1208 providers (50th percentile; typical, unremarkable volume). This mixed competitive profile implies the practice has exceptional volume for certain drugs/procedures while other injectable agents are used at rates comparable to peers.

Procedure-level nuances: 67028 (injection into vitreous as isolated procedure) appears at $192.4K and ranks #488 of 4255 providers (89th percentile), suggesting the practice also performs a meaningful number of procedure-based intravitreal injections beyond clinic visit codes. High volumes of 92014 (3.7K claims, $356.4K) and 92202 (2.7K claims, $32.3K; 99th percentile; extreme outlier) indicate heavy clinic throughput and frequent established-patient encounters that likely enable the injection volume.

Use of unclassified and compounded drug codes is material but not extreme: J3490 ($143.3K, 56 claims) and J3590 ($120.8K, 47 claims) together account for notable standalone drug revenue but are described as typical/unremarkable in national rank (48th percentile and typical). The presence of J7999 ($9.5K) signals some compounded-drug billing, which is consistent with retina practices that occasionally use non-standard or compounded agents, though ranks do not indicate outlier behavior.

Longevity and likely referral base: the NPI was enumerated 2006-05-26 (~20 years ago), indicating an established practice tenure. Combined with extreme outlier national volumes for 92014 and 92134 and the dominant revenue share of J0178, this tenure supports the interpretation of a long-standing clinic with a stable referral and treatment population driving Medicare revenue.

Medicare: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,970	$690	$2M
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…	3,670	$100	$356.4K
J2777	Injection, faricimab‑svoa, 0.1 mg	10,800	$30	$313.2K
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.	1,850	$100	$192.4K
J3490	Unclassified drugs	60	$2,560	$143.3K
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.	3,770	$30	$124.5K
J3590	Unclassified biologics	50	$2,570	$120.8K
J2778	Injection, ranibizumab, 0.1 mg	650	$190	$120.3K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	630	$120	$75.6K
92202	The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece…	2,690	$10	$32.3K

Showing 1–10 of 21

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Virginia Distribution

Thomas Johnson — 5 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. state median

21 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	13	80	1,400	$690	$1.1M
J2777	34	60	13,200	$30	$517.1K
J2778	16	40	560	$180	$171.5K
J3590	5	20	40	$2,290	$126K
67028	24	90	1,000	$90	$107.1K
J2781	8	20	560	$120	$86.6K
Q5128	7	10	190	$220	$70.7K
92014	4	870	170	$80	$32.8K
67041	14	20	20	$1,110	$23.3K
J3490	53	110	60	$280	$20.5K

Showing 1–10 of 21

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Retina Group Of Washington, PLLC	MD	Ophthalmology Physician	$0	$19.5M
Virginia Oncology Associates	VA	Hematology & Oncology Physician	$0	$6.2M
Rohit Lakhanpal	MD	Retina Specialist (Ophthalmology) Physician	$6.1M	$0
Gordon Byrnes	VA	Retina Specialist (Ophthalmology) Physician	$4.9M	$0
Daniel Berinstein	MD	Retina Specialist (Ophthalmology) Physician	$4.3M	$0
Alexander Melamud	VA	Retina Specialist (Ophthalmology) Physician	$4.2M	$0
Michael Lai	MD	Retina Specialist (Ophthalmology) Physician	$4.2M	$0
Jordana Fein	VA	Retina Specialist (Ophthalmology) Physician	$4.2M	$0
Eric Weichel	MD	Ophthalmology Physician	$4.1M	$0
Gayatri Reilly	MD	Retina Specialist (Ophthalmology) Physician	$4.1M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rappahannock Area Community Services Board	VA	Community/Behavioral Health Agency	$0	$142.5M
Mary Washington Hospital Inc.	VA	General Acute Care Hospital	$0	$80.1M
Paragon Autism Services, LLC	VA	Behavior Analyst	$0	$21.6M
Fredericksburg Emergency Medical Alliance, Inc.	VA	Emergency Medicine Physician	$0	$15M
Mary Washington Healthcare Physicians	VA	Family Medicine Physician	$0	$13.3M
Pedsplus Urgent Care, LLC	VA	Urgent Care Clinic/Center	$0	$11M
Preferred Pediatrics At Snowden	VA	Pediatrics Physician	$0	$6.4M
Sunny Home Care Inc.	VA	Home Health Agency	$0	$6.3M
Central Virginia Surgi-center LP	VA	Ambulatory Surgical Clinic/Center	$3.2M	$318.9K
Eric Lee	VA	Retina Specialist (Ophthalmology) Physician	$2.6M	$0

Thomas 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