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

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

David Williams (NPI 1558359554)

Field	Value
Entity Type	Individual
Organization	David Williams
Address	13800 Bluestem Ct
City	Baxter
State	MN
ZIP	56425
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	October 12, 2005

Payer Source	Total Paid
Medicare	$5.5M
Medicaid	$0

Key Findings

DAVID WILLIAMS is operating squarely as a retina-focused ophthalmology practice: the Medicare code mix is dominated by intravitreal therapeutic injections and posterior-segment imaging (notably J0178, Q5128, J2778, 67028, and 92134), which together point to routine anti-VEGF treatment and frequent retinal monitoring rather than broad general ophthalmology services. The clinical pattern—high volumes of injection codes plus very large volumes of code 92134—matches a workflow centered on repeated in-office injections with serial retinal imaging to manage chronic retinal diseases.

Revenue is heavily concentrated in a few drug/infusion codes: J0178, Q5128, and J2778 together account for 76.6% of this provider’s total Medicare revenue, with the individual code revenue lines reported as $2.1M (J0178), $1.7M (Q5128), and $327.8K (J2778). That concentration signals material dependence on anti-VEGF therapeutics for overall revenue and implies that changes in utilization, reimbursement, or drug selection for these products would disproportionately affect the practice’s Medicare revenue.

This provider is effectively single-payer at the current scale: lifetime Medicare revenue is $5.5M while there is no Medicaid billing on file. For payer strategy and network planning, DAVID WILLIAMS should be treated as a Medicare-centric retina practice with little to no Medicaid exposure in the available data.

DAVID WILLIAMS is an extreme national outlier on ranibizumab biosimilar utilization: Q5128 ranks #2 of 373 providers nationally (100th percentile; extreme outlier, far above typical national volume). That ranking indicates unusually high use of this biosimilar relative to peers and positions the provider as a major national-volume prescriber for Q5128 specifically.

The practice shows consistently elevated national standing on both drug and procedure volumes beyond just Q5128: J0178 ranks #173 of 3204 providers (95th percentile; notably above typical national volume) while 67028 ranks #66 of 4255 providers (98th percentile; extreme outlier) and 92134 ranks #88 of 26868 providers (100th percentile; extreme outlier). These percentiles together characterize the provider as much higher-than-typical in procedural throughput and retinal imaging volume, not just in a single drug line.

Unclassified drug lines are also a meaningful secondary revenue stream: J3490 contributes $210.4K (3.8% of Medicare revenue) and J3590 contributes $182.3K (3.3% of Medicare revenue), with J3590 at a notably elevated national rank (#32 of 631 providers, 95th percentile). The presence and scale of J3490/J3590 suggest additional reliance on non-standard or miscellaneous biologic/drug billing that supplements the core anti-VEGF revenue.

With an NPI enumeration date of 2005-10-12 (~21 years ago), this is an established provider with a long operational track record driving the observed billing patterns. Longevity combined with concentrated, high-volume injections and imaging suggests stable referral or patient-retention flows for chronic retinal care rather than sporadic or early-stage practice growth.

From a payer and network-management perspective, the provider’s profile represents both an opportunity and a concentration risk: the practice is a high-volume Medicare retina provider whose revenue is sensitive to anti-VEGF drug selection and reimbursement policy (given that J0178, Q5128, and J2778 make up 76.6% of Medicare revenue). Payers should monitor utilization patterns for Q5128 and J0178 and consider contracting or care-pathway arrangements that account for frequent injection visits and serial imaging (92134) when assessing network value and cost forecasts.

Medicare: Complete Services Breakdown

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

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	3,060	$690	$2.1M
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	8,030	$220	$1.7M
J2778	Injection, ranibizumab, 0.1 mg	1,810	$180	$327.8K
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.	3,340	$100	$317K
J3490	Unclassified drugs	130	$1,590	$210.4K
J3590	Unclassified biologics	770	$240	$182.3K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	1,170	$120	$140.4K
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.	4,430	$30	$132.8K
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…	1,370	$70	$91.6K
Q5124	Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg	320	$180	$55.1K

Showing 1–10 of 25

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 25 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Minnesota Distribution

David Williams — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. state median

25 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	5	40	580	$690	$743.4K
Q5128	1	20	1,410	$220	$393.8K
J2778	1	20	500	$180	$121K
J3590	1	10	220	$230	$73.7K
67028	2	80	420	$90	$64.8K
J2781	1	10	360	$120	$62.5K
Q5124	2	10	200	$170	$49.2K
67041	7	10	20	$1,090	$25.1K
J9035	28	40	220	$50	$16.9K
92014	24	830	100	$80	$11.9K

Showing 1–10 of 25

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vitreoretinal Surgery PLLC	MN	Ophthalmology Physician	$0	$27.8M
David Parke	MN	Ophthalmology Physician	$4.8M	$0
Sundeep Dev	MN	Ophthalmology Physician	$4.5M	$0
John Davies	MN	Ophthalmology Physician	$3.9M	$0
Polly Quiram	MN	Ophthalmology Physician	$3.7M	$0
Geoffrey Emerson	MN	Retina Specialist (Ophthalmology) Physician	$3.3M	$0
Robert Mittra	MN	Ophthalmology Physician	$3.1M	$0
Abdhish Bhavsar	MN	Retina Specialist (Ophthalmology) Physician	$2.3M	$0
Jacob Jones	MN	Retina Specialist (Ophthalmology) Physician	$2.3M	$0
Yevgeniy Sychev	MN	Retina Specialist (Ophthalmology) Physician	$1.9M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Joseph's Medical Center	MN	General Practice Physician	$0	$7.3M
Getty Inc.	MN	Home Health Agency	$0	$6.4M
Brainerd Lakes Surgery Center L L C	MN	Ambulatory Surgical Clinic/Center	$547.8K	$7.1K
Kassandra Nelson	MN	Nurse Practitioner	$114.1K	$0
Nicole Manecke	MN	Medical Physician Assistant	$108.7K	$0
Rebekah White	MN	Family Nurse Practitioner	$107.2K	$0
Travis Beniak	MN	Physical Therapist	$93.4K	$0
Costco Wholesale Corporation	MN	Community/Retail Pharmacy	$92.2K	$0
Timothy Dirks	MN	Cardiovascular Disease Physician	$89K	$0
Paul Lundstrom	MN	Dermatology Physician	$88.4K	$0

David Williams — 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