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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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ยฉ 2026 OpenMedicare. Independent data journalism. Built by TheDataProject.ai

Methodologyโ€ขDownload Data
  1. Home
  2. Providers
  3. John Payne
๐Ÿ‘๏ธ
MDIndividual

John Payne, MD

NPI: 1528143021
West Columbia, SC
10 years of data
Ophthalmology
$37.4M
Total Payments
133
Beneficiaries
164.5K
Services
2.46x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$37.4M
Specialty median$383.7K
Rank #136 of 189 in specialty

๐Ÿ“‹ Key Findings

1Billed $37.4M over 10 years
22.46x markup ratio (above median)
399th percentile in Ophthalmology by payments
466 services/day โ€” unusually high
5Payments surged 159% in 2015
611 procedures with >3x markup

This provider averages 66 services per working day

Based on 164.5K total services over 10 years (250 working days/year). Learn about impossible service volumes โ†’

๐Ÿ”Ž Data Analysis

This provider's $37.4M in total Medicare payments ranks in the 99th percentile of Ophthalmology providers nationally.

Averaging 66 services per working day raises questions about billing patterns.

Medicare payments to this provider grew 291% from 2014 to 2023.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

๐Ÿ“ˆ

Notable: Payments increased 159% in 2015

Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid โ€” the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$407.32$153.222.66x$254.10$1.0M6.7K14
2015$522.65$225.722.32x$296.93$2.7M11.8K18
2016$570.52$249.932.28x$320.59$3.7M14.7K16
2017$583.98$256.362.28x$327.62$4.2M16.6K14
2018$573.97$248.122.31x$325.85$4.3M17.5K13
2019$572.65$243.392.35x$329.26$4.5M18.6K11
2020$580.31$241.852.40x$338.46$4.4M18.4K11
2021$589.67$233.542.52x$356.13$4.7M20.2K13
2022$647.46$238.592.71x$408.87$3.7M15.5K11
2023$484.72$164.892.94x$319.83$4.0M24.5K12

Top Procedures (20)

J2778Injection, ranibizumab, 0.1 mg
$18.0M
66.7K services$269.35/svc1.85x markup
J0178Injection, aflibercept, 1 mg
$14.9M
20.4K services$729.38/svc2.05x markup
67028Injection of drug into eyeโš  11.5x markup
$1.7M
19.6K services$86.50/svc11.52x markup
92134Imaging of retina
$817.0K
28.1K services$29.11/svc2.60x markup
92014Established patient complete exam of visual system
$457.8K
5.6K services$82.18/svc1.74x markup
92012Established patient problem focused exam of visual system
$405.0K
6.9K services$58.82/svc1.78x markup
J2777Injection, faricimab-svoa, 0.1 mgโš  3.8x markup
$337.7K
11.7K services$28.87/svc3.81x markup
99204New patient office or other outpatient visit, 45-59 minutes
$148.1K
1.3K services$111.93/svc2.17x markup
67042Removal of membrane of retina with removal of internal limiting membrane of retinaโš  7.5x markup
$129.4K
148 services$874.37/svc7.46x markup
Q5128Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mgโš  6.2x markup
$113.0K
520 services$217.25/svc6.24x markup
92004New patient complete exam of visual system
$95.2K
936 services$101.71/svc1.67x markup
67041Removal of membrane from the retinaโš  6.0x markup
$73.9K
82 services$900.93/svc5.95x markup
92235Exam of retinal blood vessels using a special camera after injection of a dyeโš  3.4x markup
$72.5K
968 services$74.92/svc3.41x markup
67108Repair of detached retina with drainage and removal of eye fluid between lens and retinaโš  7.8x markup
$49.5K
56 services$883.46/svc7.85x markup
67113Repair of detached retina and drainage of eye fluid between lens and retinaโš  5.9x markup
$43.7K
37 services$1.2K/svc5.88x markup
67036Removal of eye fluid (vitreous) between the lens and retinaโš  7.5x markup
$24.6K
37 services$665.49/svc7.46x markup
J3590Unclassified biologics
$22.4K
429 services$52.23/svc1.44x markup
765122d ultrasound scan of eye tissue and structuresโš  7.8x markup
$17.6K
338 services$51.93/svc7.75x markup
67145Preventive retinal detachment treatment by heat or laser, 1 or more sessionsโš  3.9x markup
$15.8K
41 services$386.26/svc3.86x markup
67228Laser destruction of leaking retinal blood vessels, 1 or more sessions
$13.8K
19 services$728.32/svc2.75x markup
Show detailed table โ–พ
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
J2778Injection, ranibizumab, 0.1 mg66.7K$18.0M$269.351.85x
J0178Injection, aflibercept, 1 mg20.4K$14.9M$729.382.05x
67028Injection of drug into eye19.6K$1.7M$86.5011.52x
92134Imaging of retina28.1K$817.0K$29.112.60x
92014Established patient complete exam of visual system5.6K$457.8K$82.181.74x
92012Established patient problem focused exam of visual system6.9K$405.0K$58.821.78x
J2777Injection, faricimab-svoa, 0.1 mg11.7K$337.7K$28.873.81x
99204New patient office or other outpatient visit, 45-59 minutes1.3K$148.1K$111.932.17x
67042Removal of membrane of retina with removal of internal limiting membrane of retina148$129.4K$874.377.46x
Q5128Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg520$113.0K$217.256.24x
92004New patient complete exam of visual system936$95.2K$101.711.67x
67041Removal of membrane from the retina82$73.9K$900.935.95x
92235Exam of retinal blood vessels using a special camera after injection of a dye968$72.5K$74.923.41x
67108Repair of detached retina with drainage and removal of eye fluid between lens and retina56$49.5K$883.467.85x
67113Repair of detached retina and drainage of eye fluid between lens and retina37$43.7K$1.2K5.88x
67036Removal of eye fluid (vitreous) between the lens and retina37$24.6K$665.497.46x
J3590Unclassified biologics429$22.4K$52.231.44x
765122d ultrasound scan of eye tissue and structures338$17.6K$51.937.75x
67145Preventive retinal detachment treatment by heat or laser, 1 or more sessions41$15.8K$386.263.86x
67228Laser destruction of leaking retinal blood vessels, 1 or more sessions19$13.8K$728.322.75x

Markup Analysis

Charge-to-Payment Ratio

2.46x

This provider submits charges 2.46 times higher than what Medicare actually pays.

What This Means

A markup ratio of 2.46x means for every $100 Medicare pays, this provider initially charges $246. This is higher than the national average.

Location

West Columbia, SC

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

Similar Providers

Other Ophthalmology providers in SC for peer comparison.

John Payne (you)
$37.4M
Eric Jablon, M.D.
$49.1M
John Wells, MD
$38.6M
John Kerrison, M.D.
$35.7M
David Johnson, MD
$34.8M
Show detailed table โ–พ
ProviderLocationTotal PaymentsStatus
Eric Jablon, M.D.Charleston, SC$49.1Mโœ“ Clear
John Wells, MDWest Columbia, SC$38.6Mโœ“ Clear
John Kerrison, M.D.Charleston, SC$35.7Mโœ“ Clear
David Johnson, MDWest Columbia, SC$34.8Mโœ“ Clear

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Data Sources

  • โ€ข Centers for Medicare & Medicaid Services (CMS)
  • โ€ข Medicare Provider Utilization and Payment Data (2014-2023)
  • โ€ข National Plan and Provider Enumeration System (NPPES)

Last Updated: February 2026 (data through 2023, the latest CMS release)

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.

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