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

Why is the Medicaid comparison limited to South 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. South 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.

David Johnson (NPI 1811942527)

Field	Value
Entity Type	Individual
Organization	David Johnson
Address	124 Sunset Court
City	West Columbia
State	SC
ZIP	29169
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	May 23, 2006

Payer Source	Total Paid
Medicare	$3M
Medicaid	$0

Key Findings

This provider is operating as a retina-focused ophthalmology practice heavily centered on intravitreal pharmacotherapy and retinal imaging. The single largest revenue driver is J0178 (aflibercept) with 3.2K claims, $689 avg paid/claim, $2.2M revenue (74.6% of this provider's total Medicare revenue), and the practice also reports high-volume retinal diagnostic imaging via 92134 (2.4K claims, $28 avg paid/claim, $68.3K revenue). The mix of high-volume injections plus frequent imaging is consistent with a retina service line managing chronic exudative retinal disease.

Revenue is highly concentrated: the precomputed top 3 Medicare codes account for 86.6% of this provider's total Medicare revenue, with J0178 at 74.6%, Q5128 at 7.0%, and 67028 at 5.0%. That concentration means a small set of procedures—primarily high-cost intravitreal injections—drive the majority of billed Medicare dollars rather than a broad mix of low-dollar office services.

The provider’s payer mix is effectively single-payer Medicare: Total Medicare revenue is $3M while Total Medicaid revenue is listed as none (no Medicaid billing on file). With no Medicaid billing on file, Medicaid does not materially contribute to this provider’s reported revenue or service mix.

Competitive standing on key services is strong nationally. J0178 ranks #149 of 3204 providers nationally (95th percentile; notably above typical national volume for this code), and 92134 ranks #697 of 26868 providers nationally (97th percentile; extreme outlier, far above typical national volume), indicating this clinician is a high-volume national participant for both aflibercept injections and retinal imaging.

The coding detail shows use of both originator biologic and biosimilar agents: Q5128 (ranibizumab-eqrn, biosimilar) appears with 944 claims, $218 avg paid/claim, $205.8K revenue (7.0% of Medicare revenue), and J2778 (ranibizumab) with 600 claims, $183 avg paid/claim, $109.8K revenue (3.7%). Alongside J3490 (46 claims, $1803 avg paid/claim, $82.9K revenue), this suggests the practice regularly administers and bills for multiple intravitreal drug products, including unclassified drug entries that contribute nontrivial revenue.

Visit and procedural mix includes substantial office follow-up and imaging as well as occasional surgery. Established eye exams and comprehensive visits appear with 92012 (867 claims, $62 avg paid/claim, $53.8K revenue) and 92014 (548 claims, $79 avg paid/claim, $43.3K revenue); new-patient office visits (99204) are notable at 196 claims, $111 avg paid/claim, $21.8K revenue and rank in the 98th percentile nationally, indicating higher-than-typical new-patient encounter volume for an ophthalmology practice.

The practice shows modest surgical procedural billing relative to injection and imaging volume: 67028 (injection into vitreous as isolated procedure) has 1.6K claims, $91 avg paid/claim, $146.9K revenue (5.0%), while vitrectomy code 67041 appears at 14 claims, $812 avg paid/claim, $11.4K revenue (0.4%). This pattern reinforces an ambulatory, injection- and imaging-centered retina practice with limited surgical throughput.

Provider tenure is long-standing: NPI enumerated (registered) on 2006-05-23 (~20 years ago), and the lifetime Medicare revenue reported is $3M. The combination of long enumeration and concentrated, high-volume billing for key retina services is consistent with an established specialty practice rather than a recent entrant.

Medicare: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	3,200	$690	$2.2M
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	940	$220	$205.8K
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.	1,610	$90	$146.9K
J2778	Injection, ranibizumab, 0.1 mg	600	$180	$109.8K
J3490	Unclassified drugs	50	$1,800	$82.9K
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.	2,440	$30	$68.3K
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…	870	$60	$53.8K
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…	550	$80	$43.3K
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…	200	$110	$21.8K
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…	10	$810	$11.4K

Showing 1–10 of 12

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Carolina Distribution

David Johnson — 2 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. state median

12 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	7	50	970	$690	$1.1M
J2778	20	30	1,440	$180	$337.4K
Q5128	8	10	1,150	$220	$273.3K
67028	18	50	1,140	$90	$110.3K
J3490	36	50	70	$510	$57.7K
92014	106	540	160	$80	$24.3K
67041	5	10	20	$990	$20.8K
92012	13	240	110	$60	$14.2K
67210	9	10	30	$380	$10.5K
92134	16	400	90	$30	$9.6K

Showing 1–10 of 12

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
Palmetto Retina Center LLC	SC	Ophthalmology Physician	$0	$10.6M
John Payne	SC	Ophthalmology Physician	$4M	$0
John Wells	SC	Ophthalmology Physician	$3.9M	$0
Joshua Robinson	MI	Ophthalmology Physician	$3.7M	$0
William Clark	SC	Ophthalmology Physician	$3.3M	$0
Barron Fishburne	SC	Retina Specialist (Ophthalmology) Physician	$3.3M	$0
Jeffrey Gross	SC	Retina Specialist (Ophthalmology) Physician	$3M	$0
Oksana Demediuk	GA	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Daniel Will	SC	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
Eugene Long	GA	Hematology & Oncology Physician	$1.9M	$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
Palmetto Infusion Services LLC	SC	Infusion Therapy Clinic/Center	$0	$93.6M
Lexington Health Inc	SC	General Acute Care Hospital	$0	$27.4M
Lexington County Health Services District Inc	SC	General Acute Care Hospital	$0	$19.2M
United Cerebral Palsy Of South Carolina, Inc	SC	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$15.7M
Lexington Health Inc	SC	Emergency Medicine Physician	$0	$4.2M
Karen Park Family Dentistry, P.A.	SC	Dentist	$0	$4.2M
Lexington County Health Serv	SC	General Acute Care Hospital	$0	$4M
Steven Madden	SC	Hematology & Oncology Physician	$4M	$0
Lexington Treatment Specialists LLC	SC	Methadone Clinic	$76.7K	$3.6M
Lexington Health Inc	SC	Obstetrics & Gynecology Physician	$0	$3.5M

David Johnson — Billing Profile & Reimbursement Data

Sign up for David Johnson — Billing Profile & Reimbursement Data policy alerts

David Johnson — Billing Profile & Reimbursement Data

Sign up for David Johnson — Billing Profile & Reimbursement Data policy alerts

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