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

Why is the Medicaid comparison limited to North Carolina 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 Carolina (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 Allen (NPI 1689968216)

Field	Value
Entity Type	Individual
Organization	John Allen
Address	13532 Steelecroft Pkwy
City	Charlotte
State	NC
ZIP	28278
Taxonomy	Ophthalmology Physician
NPI Enumerated	May 31, 2011

Payer Source	Total Paid
Medicare	$3.6M
Medicaid	$0

Key Findings

This provider is effectively a Medicare-only biller: lifetime Medicare revenue is $3.6M and there is no Medicaid billing on file, so payer mix is highly concentrated on fee-for-service Medicare rather than dual-payer activity. The absence of Medicaid revenue means analyses of state Medicaid competitive standing are not applicable for this NPI.

Revenue is extremely concentrated in a small set of services: the precomputed top 3 codes account for 89.6% of the provider’s total Medicare revenue, with J0178 at 52.7%, J2777 at 31.4%, and 99214 at 5.4%. This concentration indicates the practice’s financial performance is driven largely by a handful of high-revenue items rather than a broad mix of smaller services.

The code mix identifies a retinal injection–focused ophthalmology practice: J0178 (aflibercept) and J2777 (faricimab) together drive the majority of revenue, and 67028 and related vitreous-injection/surgery codes are present, suggesting routine intravitreal therapeutic administration with some surgical capacity. High volumes of retinal imaging codes (92134) and E/M codes (99214, 99213) support a workflow centered on ongoing medical management and monitoring of retinal disease.

Competitive standing for intravitreal therapy shows above-typical national volume for aflibercept: J0178 ranks #230 of 3204 providers (93th percentile) and is described as notably above typical national volume, indicating this provider is a major national-level user of that drug relative to peers. J2777 ranks #173 of 2039 providers (92th percentile) but is characterized in the data as typical, unremarkable volume—this suggests strong utilization but not outside expected peer behavior for that specific code.

Office evaluation-and-management activity is an outlier: 99214 has 2.1K claims, $93 avg paid/claim, $195K revenue and is labeled an "extreme outlier, far above typical national volume" (rank #1099 of 479517, 100th percentile). This indicates substantially higher E/M throughput or coding intensity for established patient visits compared with the national provider population.

Diagnostic imaging for the posterior segment is also an extreme outlier: 92134 shows 2.7K claims, $30 avg paid/claim, $81.9K revenue and is flagged as an "extreme outlier, far above typical national volume" (rank #533 of 26868, 98th percentile). This reinforces that monitoring and imaging of retinal disease is a dominant operational activity and a key component of the revenue base.

Surgical services are present but relatively modest contributors to revenue: codes like 67028, 67036, and 67041 appear in the top list but collectively represent small shares (e.g., 67028 accounts for 5.0% of Medicare revenue). This pattern suggests the practice performs some retinal surgical procedures but generates most revenue from office-based injections and imaging rather than operating-room volume.

Tenure and credentialing are established: the provider’s NPI was enumerated on 2011-05-31 (~15 years ago), indicating a stable presence in the market. Combined with the concentrated revenue mix and high national ranks on certain retina and E/M codes, the provider appears to operate as a long-standing, injection-centered ophthalmology practice with national-level utilization intensity in several key services.

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	2,770	$690	$1.9M
J2777	Injection, faricimab‑svoa, 0.1 mg	39,060	$30	$1.1M
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…	2,100	$90	$195K
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.	1,980	$90	$181.9K
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.	2,730	$30	$81.9K
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…	570	$70	$38.8K
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…	130	$110	$14.6K
J9035	Injection, bevacizumab, 10 mg	280	$50	$14.1K
67041	In this procedure, the provider removes scar tissue from the retinal membrane that obscures vision. He removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical…	20	$870	$13.1K
67036	The provider removes vitreous fluid from the eye to access the posterior segment of the eye and introduce surgical instruments through incisions in the pars plana.	20	$550	$12.6K

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 Carolina Distribution

John Allen — 3 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. state median

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	9	100	950	$690	$881K
J2777	8	70	12,990	$30	$503.7K
67028	12	120	780	$90	$80K
67041	7	10	20	$1,050	$23.2K
67036	6	20	20	$840	$16.7K
99214	6	18,060	110	$80	$15.1K
J9035	27	90	140	$50	$13.4K
92235	22	70	60	$100	$8.7K
92134	14	790	70	$30	$7.5K
99213	505	16,320	70	$50	$7.1K

Showing 1–10 of 17

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Charlotte Eye Ear Nose & Throat Associates, P.A.	NC	Ophthalmology Physician	$0	$20.4M
Justin Brown	NC	Ophthalmology Physician	$5M	$0
Omar Punjabi	NC	Ophthalmology Physician	$2.3M	$0
Alexander Barnes	NC	Ophthalmology Physician	$2.2M	$22.5K
Ronald Milam	NC	Retina Specialist (Ophthalmology) Physician	$2.2M	$0
Duncan Berry	NC	Ophthalmology Physician	$1.3M	$0
David Browning	NC	Ophthalmology Physician	$680.9K	$0
Andrew Antoszyk	NC	Ophthalmology Physician	$559.8K	$0
Wei Huang	NC	Ophthalmology Physician	$408.4K	$0
Pedro Cervantes Fanning	NC	Ophthalmology Physician	$384.3K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Steven Heavner	NC	Otolaryngology Physician	$131.9K	$0

John Allen — Billing Profile & Reimbursement Data

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John Allen — 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