Physician

John Martin Downey, D.O.

According to 2025 Medicare claims, John Downey, D.O. (NPI: 1104884246) practices physical medicine and rehabilitation in the Augusta-Richmond County, GA-SC market, with the plurality of this provider's patient population coming from Richmond, GA. This provider's primary affiliated billing organization is ROYAL PAIN CENTER PC (NPI: 1396905816; TIN: 030413644) and primary practice location at 30907-6532. Downey is affiliated with the Southeastern Health Partners (ACO ID: A3325), participating under the MSSP model.

Downey's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 513 traditional Medicare patients, billed 11,457 HCPCS/CPT codes, and received $393,418 in Medicare payments. The top billing code was 99214 (Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more). Part D data shows 14,819 prescription claims across 1,022 beneficiaries totaling $798,855 in drug costs, led by Oxycontin (Oxycodone Hcl). 2022 DME data shows 12 claims. Open Payments data shows 1 records totaling $28. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has changed little. Similarly, Part D prescription costs have changed little. In contrast, DME billing represents a smaller volume and started with an early spike, then settled into a lower baseline, moving from $46,476 to $1,547.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	823	18,994	$454,046
2016	894	16,347	$359,405
2017	910	18,586	$413,307
2018	924	15,521	$412,106
2019	920	17,537	$474,895
2020	888	14,265	$384,577
2021	819	13,554	$441,593
2022	643	10,617	$373,827
2023	547	11,400	$422,126
2024	513	11,457	$393,418

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	815	12,812	$1,026,751
2016	843	13,520	$1,036,749
2017	947	14,398	$993,492
2018	1,051	14,979	$1,097,720
2019	1,135	15,663	$1,133,450
2020	1,204	17,138	$1,151,454
2021	1,183	17,138	$1,096,565
2022	1,075	15,721	$1,044,730
2023	1,080	15,225	$932,442
2024	1,022	14,819	$798,855

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	13	49	$5,341
2016	12	12	$3,631
2017	N/R	N/R	N/R
2018	N/R	N/R	N/R
2019	N/R	N/R	N/R
2020	N/R	N/R	N/R
2021	N/R	11	$169
2022	N/R	12	$315
2023	N/R	N/R	N/R
2024	N/R	N/R	N/R

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	443	3,248	$78
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	126	366	$53
20551	Injection into tendon at attachment to bone or muscle	270	2,629	$27
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	293	1,528	$1
J1885	Injection, ketorolac tromethamine, per 15 mg	293	1,526	$1

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Oxycontin	Oxycodone Hcl	190	5,234	$137,253
Xtampza Er	Oxycodone Myristate	110	2,977	$99,088
Oxycodone Hcl	Oxycodone Hcl	4,235	113,713	$95,903
Oxycodone-Acetaminophen	Oxycodone Hcl/Acetaminophen	3,011	81,210	$91,119
Fentanyl	Fentanyl	431	12,642	$54,860

Top 5 DME services in 2024

No connected or detailed DME service-level records for 2024.

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	1	$28	Boston Scientific Corporation
Research Payments	Reported research-related payment or transfer-of-value amount.	0	$0	N/R
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

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FAQ

What Medicare data is available for John Martin Downey, D.O.?

Tedicare shows public-source Medicare data for John Martin Downey, D.O. (NPI 1104884246), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does John Martin Downey, D.O. have ACO affiliation data?

John Martin Downey, D.O. is shown with ACO affiliation data for Southeastern Health Partners (MSSP, ACO ID A3325).

What billing organization is linked to John Martin Downey, D.O.?

John Martin Downey, D.O. is linked to ROYAL PAIN CENTER PC (billing NPI 1396905816) in the available physician profile data.

Does John Martin Downey, D.O. have Open Payments data?

John Martin Downey, D.O. has 1 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.