This provider's $4.1M in total Medicare payments ranks in the 95th percentile of Ophthalmology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2014 | $477.50 | $235.99 | 2.02x | $241.51 | $466.1K | 5.5K | 4.3K |
| 2015 | $419.08 | $194.85 | 2.15x | $224.23 | $422.0K | 5.2K | 4.1K |
| 2016 | $442.31 | $199.28 | 2.22x | $243.03 | $410.8K | 5.6K | 4.4K |
| 2017 | $785.21 | $211.25 | 3.72x | $573.96 | $393.3K | 5.7K | 4.1K |
| 2018 | $725.50 | $177.30 | 4.09x | $548.20 | $398.0K | 6.3K | 4.4K |
| 2019 | $773.07 | $211.85 | 3.65x | $561.22 | $523.1K | 6.8K | 4.3K |
| 2020 | $847.62 | $227.46 | 3.73x | $620.16 | $396.4K | 6.0K | 3.6K |
| 2021 | $502.14 | $142.50 | 3.52x | $359.64 | $408.1K | 6.5K | 4.1K |
| 2022 | $742.77 | $183.27 | 4.05x | $559.50 | $347.5K | 5.5K | 3.3K |
| 2023 | $1.0K | $238.87 | 4.26x | $778.88 | $330.8K | 5.4K | 3.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 92014 | Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits | 13.3K | $1.0M | $77.30 | 4.04x |
| 65855 | Laser repair to improve eye fluid flow, 1 or more sessions | 5.5K | $1.0M | $184.70 | 3.57x |
| 92133 | Diagnostic imaging of optic nerve of eye | 12.3K | $315.5K | $25.73 | 3.30x |
| 66180 | Creation of shunt to improve eye fluid flow | 345 | $286.0K | $829.04 | 3.11x |
| 92012 | Eye and medical examination for diagnosis and treatment, established patient | 5.2K | $274.6K | $53.12 | 3.11x |
| 66821 | Removal of recurring cataract in lens capsule using laser | 958 | $219.9K | $229.51 | 3.31x |
| 92020 | Examination of cornea and iris using lens device and slit lamp | 11.5K | $216.5K | $18.83 | 3.32x |
| 66183 | Insertion of eye fluid drainage device | 266 | $200.4K | $753.32 | 2.60x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.7K | $183.7K | $108.29 | 2.64x |
| 92083 | Measurement of field of vision during daylight conditions | 4.1K | $155.4K | $37.88 | 3.97x |
| 66710 | Destruction of lens tissue using laser | 205 | $55.6K | $271.02 | 3.11x |
| 66761 | Creation of eye fluid drainage tracts in iris using laser, per session | 125 | $27.1K | $217.19 | 3.68x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 182 | $26.3K | $144.69 | 2.89x |
| 76514 | Ultrasound of corneal structure and measurement | 2.0K | $19.1K | $9.44 | 3.11x |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 103 | $16.4K | $159.18 | 3.02x |
| 99497 | Advance care planning by the physician or other qualified health care professional, first 30 minutes | 138 | $11.1K | $80.18 | 3.06x |
| 99213 | Established patient outpatient visit, total time 20-29 minutes | 120 | $8.4K | $69.67 | 2.05x |
| 65820 | Incision to improve eye fluid flow | 14 | $5.9K | $420.18 | 5.06x |
| 92004 | Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits | 56 | $5.7K | $101.80 | 1.78x |
| 68200 | Injection into conjunctiva | 176 | $5.2K | $29.28 | 2.24x |
This provider submits charges 3.48 times higher than what Medicare actually pays.
A markup ratio of 3.48x means for every $100 Medicare pays, this provider initially charges $348. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Ophthalmology providers in OK for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Sumit Nanda, MD | Oklahoma City, OK | $40.7M | ✓ Clear |
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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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