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.

John Kerrison (NPI 1952416257)

Field	Value
Entity Type	Individual
Organization	John Kerrison
Address	3531 Mary Ader Ave
City	Charleston
State	SC
ZIP	29414
Taxonomy	Ophthalmology Physician
NPI Enumerated	August 20, 2006

Payer Source	Total Paid
Medicare	$5M
Medicaid	$0

Key Findings

Provider profile and tenure: JOHN KERRISON is an Ophthalmology Physician enumerated at NPI on 2006-08-20 (~20 years ago), indicating long-standing Medicare enrollment and an established practice footprint in CHARLESTON, SC. The longevity supports continuity in billing patterns observed in the Medicare data set.

Payer mix and scale: This provider is effectively single-payer in the available data — total Medicare revenue is $5M and there is no Medicaid billing on file. The absence of Medicaid activity means the payer mix is heavily concentrated on Medicare, which has implications for network negotiations and population served.

Revenue concentration: The practice’s Medicare revenue is highly concentrated in a small number of drug/injection codes; the precomputed top 3 Medicare codes by revenue account for 73.5% of total Medicare revenue. The largest single driver is J0178 with $3M (60.6% of Medicare revenue), indicating dependence on anti-VEGF/aflibercept injections for most of the practice’s revenue.

Service-line implication — retina/intravitreal focus: The code mix (high volumes of J0178, Q5128, J3490 and procedure 67028) points to a retina-focused practice that delivers large volumes of intravitreal injections and related office-based retinal procedures. High utilization of retinal imaging (92134) and intermediate/comprehensive established eye exam codes (92012, 92014) further supports a workflow centered on chronic retinal disease management and frequent follow-up.

Competitive standing on top drug: J0178 (Injection, aflibercept) is a clear national outlier for this provider, with $3M revenue, 4.4K claims and ranking #47 of 3204 providers nationally (99th percentile; extreme outlier). This placement indicates the provider is a major national-level user of aflibercept relative to peers, not a modest participant.

Additional notable volumes and outliers: The provider also reports 3.8K claims for 92134 ($107.1K, 2.2% of Medicare revenue) and 1.3K claims for 92012 ($83.6K, 1.7% of Medicare revenue), both ranked in the 99th percentile and labeled as extreme outliers. These exceptionally high volumes of diagnostic imaging and established-patient intermediate exams are consistent with a high-throughput retina/injection clinic model.

Surgical and other services are present but limited: Surgical retina codes such as 67042 ($19.4K), 67108 ($17.1K) and several additional vitreoretinal procedure codes appear at much lower volumes, suggesting the practice is more focused on medical retina and office-based procedures than high-volume retinal surgery. The distribution implies injections and imaging drive the business while surgeries are a smaller supplemental revenue stream.

Risk and contracting considerations: With $5M in Medicare revenue and no Medicaid billing, revenue risk is concentrated in a few high-volume injectable drug codes (top three = 73.5%) and in a single payer. Contracting teams should account for this concentration when assessing reimbursement sensitivity to drug pricing, utilization management, and Medicare policy changes that would disproportionately affect this provider.

Medicare: Complete Services Breakdown

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

27 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	4,360	$690	$3M
J3490	Unclassified drugs	200	$1,760	$345.4K
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	1,360	$220	$295.8K
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.	2,550	$90	$234.6K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	1,970	$120	$229.9K
J2777	Injection, faricimab‑svoa, 0.1 mg	6,780	$30	$196.6K
J2778	Injection, ranibizumab, 0.1 mg	970	$170	$165.5K
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.	3,830	$30	$107.1K
Q5124	Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg	550	$170	$92.1K
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…	1,350	$60	$83.6K

Showing 1–10 of 27

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 27 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Carolina Distribution

John Kerrison — 4 of 25 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

27 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	2	50	970	$690	$1.1M
J2777	29	40	15,960	$30	$594.7K
J2778	17	30	1,440	$180	$337.4K
Q5128	7	10	1,150	$220	$273.3K
J2781	2	20	720	$120	$128K
67028	5	50	1,140	$90	$110.3K
Q5124	1	10	550	$170	$92.2K
J3490	7	50	70	$510	$57.7K
67036	11	20	20	$1,110	$40.1K
67042	13	30	20	$1,150	$32.3K

Showing 1–10 of 27

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eric Jablon	SC	Ophthalmology Physician	$8.9M	$0
Stephen Phillips	SC	Ophthalmology Physician	$5M	$0
Charleston Neurosciences Institute	SC	Ophthalmology Physician	$0	$4.2M
Daniel Alfaro	SC	Ophthalmology Physician	$3.6M	$0
Michael Johnson	SC	Ophthalmology Physician	$3M	$0
Mona Camacci	SC	Ophthalmology Physician	$1.1M	$0
Scott Anfinson	SC	Ophthalmology Physician	$775.5K	$0
John Chancellor	TX	Ophthalmology Physician	$647.3K	$0
Robert Brame	SC	Ophthalmology Physician	$560.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Carolina Dept Of Mental Health Accounting Office	SC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$65.9M
Bon Secours St. Francis Xavier Hospital Inc.	SC	General Acute Care Hospital	$0	$35.9M
Coastal Pediatric Associates, P.A.	SC	Pediatrics Physician	$0	$25M
Charleston Ent Associates, LLC	SC	Otolaryngology Physician	$0	$7.1M
Physicians Eye Surgery Center LLC	SC	Ambulatory Surgical Clinic/Center	$3.9M	$70.1K
Bon Secours St Francis Xavier Hospital, Inc.	SC	Emergency Medicine Physician	$0	$2.3M
Charleston Endoscopy Center	SC	Ambulatory Surgical Clinic/Center	$1.6M	$434.5K
Lowrey King	SC	Ophthalmology Physician	$1.3M	$0
Palmetto Endoscopy Center LLC	SC	Ambulatory Surgical Clinic/Center	$684.7K	$105.5K
Saima Ismaili	SC	Podiatrist	$683K	$0

John Kerrison — Billing Profile & Reimbursement Data

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John Kerrison — 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