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

Why is the Medicaid comparison limited to North 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. North 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.

Max Johnson (NPI 1679559975)

Field	Value
Entity Type	Individual
Organization	Max Johnson
Address	4450 31st Ave S Ste 200
City	Fargo
State	ND
ZIP	58104
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	December 19, 2005

Payer Source	Total Paid
Medicare	$2.8M
Medicaid	$0

Key Findings

MAX JOHNSON's billing is almost exclusively Medicare-driven: total Medicare revenue is $2.8M while there is no Medicaid billing on file, making this effectively a single-payer (Medicare) practice based on available claims data. The absence of any Medicaid codes in the Top 25 and the explicit note "none below — this provider has no Medicaid billing on file" suggest limited or no participation in state Medicaid reimbursement streams.

Revenue is highly concentrated in intravitreal drug administration: the precomputed top-3 Medicare codes by revenue account for 87.7% of this provider's total Medicare revenue, driven primarily by J0178 (63.2%), J2777 (19.5%), and 67028 (5.0%). This concentration indicates the practice’s financial performance depends heavily on a small set of high-revenue retinal injection services.

The code mix and descriptions point to a retina-focused, injection-centric service line: J0178 (Injection, aflibercept) shows 2.6K claims, $675 avg paid/claim, $1.8M revenue and J2777 (Injection, faricimab-svoa) shows 20.2K claims, $27 avg paid/claim, $545.9K revenue, while 67028 (intravitreal injection as an isolated procedure) contributes $139.1K. In addition, high volumes of diagnostic imaging codes (for example, 92134 with 2.2K claims and $65.2K revenue) confirm a practice workflow built around retinal injections supported by retinal imaging and follow-up exams.

Competitive standing is mixed across service lines: for the primary revenue driver J0178 the provider ranks #274 of 3204 nationally (91th percentile; typical, unremarkable volume for this code), and for J2777 the provider ranks #518 of 2039 (75th percentile; typical, unremarkable volume for this code), indicating solid but not dominant national positioning in anti-VEGF administration. By contrast, diagnostic and exam codes are relatively strong—92014 ranks #2035 of 35415 (94th percentile; notably above typical national volume for this code) and 92134 ranks #827 of 26868 (97th percentile; notably above typical national volume for this code)—suggesting the provider is above-typical nationally for retinal imaging and comprehensive ophthalmologic follow-up.

Clinical breadth includes multiple anti-VEGF agents and retinal procedures: in addition to J0178 and J2777, J2778 (ranibizumab) appears with 769 claims and $136.1K revenue and 67028 is separately billed for intravitreal injection procedures. The presence of several drug codes and procedure codes together implies routine use of multiple medication options and concurrent procedural billing patterns typical for a retina specialist.

Evaluation-and-management and chronic care management services are present but represent a small share of revenue: 99213 accounts for 326 claims and $19.2K (0.7% of Medicare revenue), 99214 for 122 claims and $10.7K (0.4%), and chronic care management codes 99426/99427 together contribute a modest portion of revenue. These volumes and their national ranks are described as typical or unremarkable for most E/M and care-management codes, indicating the practice’s financial profile is driven more by procedure/drug revenue than by office visit billing.

The provider has long-standing enrollment: NPI enumerated (registered) 2005-12-19 (~21 years ago), which indicates an established practice presence and multi-year participation in Medicare billing. That tenure, combined with high imaging volumes and concentrated injection revenue, suggests an entrenched retina practice model rather than a recent or transient billing pattern.

Operational and contracting implications: with $2.8M in Medicare revenue and no Medicaid activity on file, payers assessing network value should view this provider chiefly as a Medicare-focused retina specialist whose negotiating leverage and utilization patterns will be driven by high-cost injectable drugs (notably J0178 at $1.8M revenue) and above-typical retinal imaging volumes (92014 and 92134). The combination of concentrated drug/procedure revenue and strong imaging/exam activity is important for forecasting cost and access impacts in payer networks.

Medicare: Complete Services Breakdown

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,620	$680	$1.8M
J2777	Injection, faricimab‑svoa, 0.1 mg	20,220	$30	$545.9K
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.	1,500	$90	$139.1K
J2778	Injection, ranibizumab, 0.1 mg	770	$180	$136.1K
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…	910	$90	$79.9K
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.	2,250	$30	$65.2K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	330	$60	$19.2K
99214	The provider sees an established 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…	120	$90	$10.7K
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…	90	$110	$10K
J7999	Compounded drug, not otherwise classified	110	$70	$7.1K

Showing 1–10 of 17

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. North Dakota Distribution

Max Johnson — 5 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Dakota

Full comparison — all codes billed, vs. state median

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	1	20	440	$680	$445.3K
J2777	2	10	7,410	$30	$412.9K
J2778	1	10	680	$180	$121.4K
67028	2	30	290	$80	$40.6K
92014	1	170	160	$70	$15.6K
99214	599	1,470	90	$60	$10.4K
J7999	2	10	110	$70	$9.4K
99426	2	10	140	$50	$6.7K
99213	118	1,490	80	$50	$5.8K
99205	141	160	30	$140	$5.1K

Showing 1–10 of 17

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services, Inc.	UT	Children's Hospital	$0	$129.5M
Sanford Medical Center Fargo	ND	Family Medicine Physician	$0	$75.9M
Sanford Medical Center	SD	Family Medicine Physician	$0	$68.8M
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$68.7M
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$65.8M
Ihc Health Services Inc	UT	General Acute Care Hospital	$0	$54.1M
Sanford Medical Center Fargo	ND	General Acute Care Hospital	$0	$50.2M
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$44.3M
Ihc Health Services Inc	UT	Home Infusion Therapy Pharmacy	$0	$38.1M
Altru Health System	ND	Clinic/Center	$0	$29.7M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pediatric Therapy Partners, Inc.	ND	Early Intervention Provider Agency	$0	$7M
Marina Gilca	ND	Retina Specialist (Ophthalmology) Physician	$4.3M	$0
Fargo Maple View LLC	ND	Alzheimer Center (Dementia Center)	$0	$4M
Beyond Boundaries Occupational Therapy, Inc.	ND	Multi-Specialty Clinic/Center	$0	$3.9M
St. Sophie's, LLC	ND	Adolescent and Children Mental Health Clinic/Center	$0	$2.7M
Shangri-la Home Care	ND	Home Health Agency	$0	$2M
Beyond Boundaries Speech Language Therapy, Inc.	ND	Speech-Language Pathologist	$0	$2M
About Smiles Dental, LLC	ND	Dental Clinic/Center	$0	$1.7M
Center For Pain Medicine Surgery Center LLC	ND	Ambulatory Surgical Clinic/Center	$1.2M	$0
Davita Dakota Dialysis Center LLC	ND	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.2M

Max 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