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

Why is the Medicaid comparison limited to South Dakota 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 Dakota (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 Bormes (NPI 1578568978)

Field	Value
Entity Type	Individual
Organization	John Bormes
Address	310 8th Ave Nw
City	Aberdeen
State	SD
ZIP	57401
Taxonomy	Ophthalmology Physician
NPI Enumerated	June 14, 2005

Payer Source	Total Paid
Medicare	$2.6M
Medicaid	$0

Key Findings

This provider’s billing footprint is effectively single‑payer: total Medicare revenue is $2.6M and there is no Medicaid billing on file, so Medicare accounts for the entirety of recorded public‑payer activity. Analysts should treat the profile as Medicare‑driven rather than dual‑payer when assessing network value or utilization patterns.

Revenue is highly concentrated in a few drug and surgical codes: the top three Medicare codes (J0178, J2777, 66984) account for 75.0% of this provider’s total Medicare revenue. Those three codes individually are J0178 – $848.2K (33.2%), J2777 – $803.9K (31.5%), and 66984 – $264.3K (10.3%), indicating most revenue is tied to intravitreal biologic therapy and cataract surgery.

The code mix indicates an ophthalmology practice focused on high‑volume intravitreal injections and cataract procedures: J0178 (aflibercept) and J2777 (faricimab) are the two largest revenue drivers, complemented by 66984 (cataract extraction with intraocular lens insertion). Supporting codes such as 67028 (intravitreal injection), 92134/92136 (retinal imaging), and E/M codes for comprehensive and intermediate ophthalmologic exams point to an integrated clinic workflow that combines diagnostic imaging, injection clinics, and operative cataract care.

National competitive standing for the two leading biologic injection codes is mixed: J2777 ranks #331 of 2039 providers (84th percentile) and is above typical national volume for that code, while J0178 ranks #1070 of 3204 providers (67th percentile) and is described as typical and unremarkable. In plain terms, the provider appears to deliver relatively strong faricimab volume versus a more ordinary aflibercept volume compared with national peers.

Surgical and procedural ranks suggest meaningful cataract and anterior segment activity: 66984 ranks #2514 of 15965 providers (84th percentile) and is characterized as typical but above average, while related procedures show variability — 66991 ranks in the 96th percentile (notably above typical) and 66982 sits at a lower relative position (42nd percentile, typical). This pattern points to a practice that performs a stable volume of standard cataract procedures and some higher‑than‑typical combined anterior‑segment device work.

Clinical evaluation and diagnostic services are clear outliers in national volume: 92012 ranks #56 of 17177 providers (100th percentile; extreme outlier, far above typical national volume) and 92004 ranks #148 of 26467 providers (99th percentile; extreme outlier, far above typical national volume). High ranks for 92134 (96th percentile; notably above typical) and 92136 (98th percentile; notably above typical) further indicate an above‑typical throughput of retinal imaging and established‑patient exams, consistent with a busy clinic managing chronic retinal disease.

Tenure data show the NPI was enumerated 2005-06-14 (~21 years ago), indicating a long‑standing presence in the market. That longevity, together with the high volumes on exam and imaging codes, is consistent with an established clinical practice rather than a recent entrant.

For payers and contracting analysts, the combination of concentrated revenue (75.0% in three codes), dominant Medicare exposure ($2.6M and no Medicaid), and substantial use of high‑cost intravitreal therapies suggests the provider’s value to a network is driven by injection clinics and cataract surgery capacity. Monitoring utilization patterns for J0178 and J2777 and confirming access pathways for intravitreal care would be priorities given how much revenue is tied to those biologic agents.

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	1,220	$690	$848.2K
J2777	Injection, faricimab‑svoa, 0.1 mg	27,720	$30	$803.9K
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	640	$410	$264.3K
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…	2,220	$60	$139.9K
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.	1,420	$90	$133.5K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	200	$340	$66.7K
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.	2,110	$30	$59K
66991	The provider inserts an intraocular lens prosthesis during the same session as extracapsular cataract extraction. The provider also inserts one or more anterior segment aqueous drainage devices in…	110	$520	$56.6K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	460	$100	$45.5K
J7999	Compounded drug, not otherwise classified	590	$70	$40.1K

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. South Dakota Distribution

John Bormes — 6 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. state median

21 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	5	10	690	$690	$788.7K
J2777	3	10	21,120	$30	$782K
66991	3	10	70	$1,370	$119.4K
67028	6	10	740	$90	$108.5K
66984	9	130	40	$410	$67.7K
15823	10	10	50	$510	$50.6K
J7999	5	10	260	$70	$39.1K
66821	9	30	100	$230	$35.6K
66982	17	20	40	$580	$25K
92014	87	200	170	$80	$17.1K

Showing 1–10 of 21

Related Providers

Other providers that share a Tax Identification Number (TIN) with John Bormes, 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
Brendan Girschek	AZ	Ophthalmology Physician	$3.2M	$0
Chad Laurich	SD	Vascular Surgery Physician	$3.2M	$0
NPI 1588636484	—	—	$3.2M	$0
Ryan Geraets	SD	Ophthalmology Physician	$3M	$0
John Purviance	WY	Radiation Oncology Physician	$2.5M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Adjustment Training Center, Inc.	SD	Developmentally Disabled Services Day Training Agency	$0	$40.3M
Northeastern Mental Health Center	SD	Mental Health Counselor	$0	$10.1M
Vision Care Associates, LLP	SD	Optometrist	$0	$6M
Sanford Health Network	SD	General Acute Care Hospital	$0	$4.4M
Avera St. Luke's	SD	Family Medicine Physician	$0	$2.3M
Sanford Health Network	SD	General Acute Care Hospital	$0	$1.9M
Avera At Home	SD	Home Health Agency	$0	$1.6M
Avera St Lukes	SD	General Acute Care Hospital	$0	$1.5M
Ty Hanson	SD	Dermatology Physician	$1.2M	$0
Fettig And Drake Dds PC	SD	General Practice Dentistry	$0	$1M

John Bormes — 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