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

Why is the Medicaid comparison limited to Colorado 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. Colorado (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 Johnson (NPI 1598717977)

Field	Value
Entity Type	Individual
Organization	David Johnson
Address	8101 E Lowry Blvd
City	Denver
State	CO
ZIP	80230
Taxonomy	Specialist
NPI Enumerated	May 16, 2006

Payer Source	Total Paid
Medicare	$1.5M
Medicaid	$0

Key Findings

This provider is effectively a single-payer Medicare practice: lifetime Medicare revenue is $1.5M while Medicaid shows none on file, indicating no recorded Medicaid billing activity and concentrated exposure to Medicare reimbursement dynamics. Analysts should treat Medicaid-related competitive or access considerations as not directly observable from this profile.

Revenue is highly concentrated in a small set of drug and procedure codes: the precomputed top three Medicare codes account for 82.5% of the provider's Medicare revenue, led by J0178 (J0178 – $1M revenue, 68.1% of Medicare receipts) with subordinate contributions from 67028 (67028 – $116.3K, 7.7%) and J2778 (J2778 – $99.7K, 6.6%). This concentration means changes in utilization or reimbursement of these specific intravitreal therapies would materially affect overall revenue.

The code mix indicates an ophthalmic, retina-focused specialist operation that centers on intravitreal drug administration and retinal diagnostics: high-volume drug codes J0178, J2778, J2781, and biosimilar Q5128 correspond to anti-VEGF and related intravitreal therapies, while 67028 documents injection as an isolated procedure and 92134 captures posterior-segment retinal imaging. Together these codes point to a clinic workflow built around regular injection visits supported by retinal imaging and follow-up evaluations.

Competitive standing across key codes is generally modest-to-typical: J0178 ranks #828 of 3204 (74th percentile; typical, unremarkable volume for this code) and 67028 ranks #1130 of 4255 (73rd percentile; typical, unremarkable volume), while J2778 is lower at #683 of 1208 (43rd percentile; typical, unremarkable volume). These ranks suggest the provider operates at a typical national volume for widely used anti-VEGF agents rather than being a dominant national outlier.

One notable statistical outlier is retinal imaging volume: 92134 shows 1.7K claims and $52.1K revenue and ranks #1343 of 26868 (95th percentile; notably above typical national volume). This elevated imaging throughput relative to peers suggests robust diagnostic capacity that likely supports the high injection volume and may indicate efficient patient flow for retinal disease management.

Ancillary services and care-management activity are present but secondary to drug/diagnostic revenue: J7999 (compounded drug) shows 356 claims and $25.3K revenue (1.7%), while evaluation-and-management and chronic-care codes such as 92014 (457 claims, $42K) and 99426 (89 claims, $4.4K) appear at much smaller revenue shares. The mix implies the practice captures some routine follow-up and care-coordination revenue but remains primarily driven by ophthalmic drug and imaging procedures.

The provider has long tenure in the NPI registry, enumerated 2006-05-16 (~20 years ago), which aligns with an established practice pattern and sustained Medicare billing history; this longevity can be relevant when assessing referral relationships and historical utilization stability.

There is a visible pathway for biosimilar uptake and revenue substitution: Q5128 (biosimilar ranibizumab-eqrn) accounts for $95.3K (6.3% of Medicare revenue) with 441 claims and ranks #237 of 373 (36th percentile; typical, unremarkable volume). Given J0178's dominant $1M share (68.1%), any shift toward biosimilars or changes in preferred-drug mix could materially reallocate revenue among high-value injection codes without necessarily changing overall visit volumes.

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	1,490	$690	$1M
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.	1,200	$100	$116.3K
J2778	Injection, ranibizumab, 0.1 mg	550	$180	$99.7K
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	440	$220	$95.3K
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.	1,680	$30	$52.1K
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…	460	$90	$42K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	300	$120	$36K
J7999	Compounded drug, not otherwise classified	360	$70	$25.3K
99426	Clinical staff members, directed by a physician or other qualified healthcare professional, perform management and care plan services for a patient with a complex chronic condition, expected to last…	90	$50	$4.4K
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	$100	$2.3K

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. Colorado Distribution

David Johnson — 1 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. state median

15 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	11	60	740	$690	$618.3K
J2778	14	20	600	$180	$199.7K
J2781	12	10	470	$120	$79.4K
Q5128	3	10	220	$220	$76.1K
67028	17	80	670	$100	$73.3K
J7999	9	50	230	$70	$21.5K
92014	79	670	100	$80	$15.2K
92235	45	50	50	$110	$12.2K
92134	19	440	60	$30	$7.8K
92012	164	210	50	$60	$6.8K

Showing 1–10 of 15

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Robert Courtney	CO	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Salil Shukla	CO	Retina Specialist (Ophthalmology) Physician	$2.7M	$0
Murtaza Adam	CO	Retina Specialist (Ophthalmology) Physician	$2.3M	$0
Mimi Liu	CO	Retina Specialist (Ophthalmology) Physician	$2.2M	$0
Miriah Teeter	CO	Retina Specialist (Ophthalmology) Physician	$1.9M	$0
Nancy Christmas	CO	Retina Specialist (Ophthalmology) Physician	$1.8M	$0
Peter Hovland	CO	Ophthalmology Physician	$1.8M	$0
Curtis Hagedorn	CO	Ophthalmology Physician	$1.5M	$0
Ashleigh Levison	CO	Retina Specialist (Ophthalmology) Physician	$1.4M	$0
Brian Joondeph	CO	Retina Specialist (Ophthalmology) Physician	$1.4M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$25.5M
Total Longterm Care, Inc.	CO	Exclusive Provider Organization	$0	$13M
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$8.3M
Lowry Pediatrics, PC	CO	Pediatrics Physician	$0	$4.4M
Stephen Murphy	CO	Rheumatology Physician	$1.4M	$0
Gregory Barron	CO	Rheumatology Physician	$1.4M	$0
Rennie Mccabe	CO	Rheumatology Physician	$1.3M	$0
Vance Bray	CO	Rheumatology Physician	$1.3M	$0
Annemarie Whiddon	CO	Rheumatology Physician	$1.3M	$0
Kim Tyler	CO	Rheumatology Physician	$1.3M	$0

David 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